Minimal One-Third Incision and Four-Step (MOTIF) Excision Method for Lipoma

Abstract

Excision is the gold standard for lipomas. Patients desire minimal scars, but minimal incisions can increase complications and produce hypertrophic scars. We propose an algorithmic method named the minimal one-third incision and four-step extraction method (MOTIF) for lipoma excision. This retrospective study analyzed lipomas surgically excised using the MOTIF method at our institution between January 2016 and December 2018. A total of 112 lipomas were included. The complication rates and Vancouver Scar Scale (VSS) for three different size groups (<3 cm, 3 ~ 6 cm, >6 cm) were compared. Complete excision of all palpable lipomas was achieved with this approach. There were two seromas, two hematomas, and one postoperative nerve injury. There was no difference in complication rates and VSS between the three size groups. The MOTIF method is a cost-effective, reliable, and cosmetically pleasing method that can be applied to all lipomas regardless of size and location.

Lumps, bumps, and…nerve-end stumps? A collection of guidelines for safe in-office lipoma excision

“…Though varying techniques for lipoma excision have been described in the literature, we advocate for the use of a longitudinal incision without elliptical skin excision. [ 1 14 15 ] Excision of skin for lipoma removal is not indicated as excess skin almost always flattens over time. Skin closure completed under tension as a result of unnecessary skin excision places the patient at risk for complications such as dehiscence and widened scar formation.…”

“…Though these growths are rarely symptomatic, patients desire removal for a variety of reasons. [ 1 ] Lipomas may be found in nearly any anatomical location, however, are most frequently located in the subcutaneous tissue making in-office excision common practice. [ 2 - 6 ] Due to limitations of the in-office setting such as inconsistent access to electrocautery, suboptimal lighting, and reliance on local anesthesia, the risk of serious complications exists.…”

“…Hematoma formation and nerve injury have been reported to occur in 1.6% and 0.8% of patients. [ 1 ] We present a collection of clinical guidelines for the avoidance of major complications during in-office lipoma excision. The importance of these guidelines is highlighted by a case report of radial nerve transection causing wrist drop during an in-office lipoma excision.…”

Do the Clinical Characteristics of Lipomas Influence the Incision Length During Minimal Incision Extraction?

“…1 Though there has been no consensus, a few previous studies defined ‘large’ lipomas as a diameter greater than 5 or 6 cm, and ‘small’ lipomas as a diameter less than 3 cm. 2,3 They are usually asymptomatic, but large lipomas that cause cosmetic or functional problems requires removal. 4 Although injection lipolysis or liposuction has been shown to be effective in the removal of lipomas, surgical excision still remains the treatment of choice allowing complete removal of the mass with a low recurrence rate.…”

“…4 Although injection lipolysis or liposuction has been shown to be effective in the removal of lipomas, surgical excision still remains the treatment of choice allowing complete removal of the mass with a low recurrence rate. 3…”