Minimal Incision Extraction of Lipomas

Cosulich, Michael T.; Molenda, Matthew A.; Mostow, Eliot N.; Bhatia, Ashish C.

doi:10.1001/jamadermatol.2014.3234

Cited by 9 publications

(11 citation statements)

References 2 publications

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“…Repeated dissection and extraction through a small incision can lead to contusion of the incision skin margin. Although Cosulich et al 5 reported piecemeal extraction through a minimal incision (25%-50% of lipoma diameter), we were able to perform complete excision using a similar size incision with tumescence (40% lipoma diameter). Our procedure is practical and easy to perform in an outpatient setting.…”

Section: Discussionmentioning

confidence: 78%

Excision of Large Lipomas Using Tumescent Local Anesthesia

2016

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Section: Discussionmentioning

confidence: 78%

Excision of Large Lipomas Using Tumescent Local Anesthesia

2016

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“…However, for large lipomas, minimally invasive procedures have drawbacks such as time‐consuming surgical processes, difficulty piecemeal removal, and blind spots leading to incomplete excision or inadequate hemostasis. In a survey performed in the United States, dermatologists generally preferred minimal incision extraction for small lipomas (1 cm); however, this tendency was significantly lower for larger lipomas (3 cm) (Cosulich, Molenda, Mostow, Bhatia, & Brodell, ). In addition, the tendency for referral or forgoing treatment was higher for large‐sized lipomas.…”

Section: Discussionmentioning

confidence: 99%

Surgical management of lipomas: Proposal of the Z‐incision design and surgical algorithm based on tumor size

Won

Hur

Ohn

et al. 2019

Dermatologic Therapy

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Surgical excision is the treatment of choice for lipomas. However, linear incision methods or minimal extraction techniques often do not provide a sufficient surgical view. Therefore, removing large lipomas is often difficult. To present the Z-incision and half Z-incision designs for lipoma extraction, this retrospective study analyzed lipomas surgically excised at our institution between September 2015 and December 2018. The area of surgical field exposed by the Z-incision versus that exposed by the linear incision was calculated using a schematic model. Cure rate, complications, and surgical field area were investigated. A total of 84 lipomas were included. A Z-or half Z-incision was used to treat 30 lipomas, while a linear incision was used to treat 54 lipomas. The mean diameter of the mass in the Z-or half Z-incision group was 47.7 mm (range, 15-160 mm), larger than that in the linear incision group (25.5 mm; range, 7-59 mm) (p < .001). The Z-incision involved making rectangular windows by lifting 2 triangular flaps. According to our mathematical model, the Z-incision provided a larger surgical field area than that provided by the linear incision based on stretched angles (1.81 times larger at 30 and 3.14 times larger at 15 ). The Z-and half Z-incisions were successfully performed in all but 1 lipoma (29 lipomas, 96.7%).There was 1 lipoma that resulted in postoperative complications (seroma, 3.3%). The Z-incision design can be a useful alternative technique for the extirpation of lipomas, especially large lipomas. Here, we proposed a surgical algorithm for lipoma surgery based on tumor size. K E Y W O R D Salgorithm, lipoma, skin neoplasms, surgery, surgical procedure, technique

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“…Approximately 33% of dermatologists do not use the punch technique to remove lipomas (even solitary 1-cm lesions), most commonly because they are not familiarized with the procedure. 3 Recurrence rate of lipomas removed with punch has been reported to be around 1.4%. 3 Other treatment modalities include intralesional steroids and deoxycholic acid for extensive disease.…”

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confidence: 99%

“…3 Recurrence rate of lipomas removed with punch has been reported to be around 1.4%. 3 Other treatment modalities include intralesional steroids and deoxycholic acid for extensive disease. 4 Limitations to our technique might include larger lipomas and other variants of Dercum's disease with diffuse painful adipose tissue.…”

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confidence: 99%