Novel Technique for Obtaining Aesthetic Results in Multiple Lipomatosis Surgery

Abstract

Introduction: Multiple lipomatosis is often perceived as a cosmetically disfiguring condition‚ and therefore‚ patients seek treatment. Multiple lipomas are commonly treated with excision or liposuction or a combination of both. To obtain a better aesthetic result, various modifications of the above have been tried, like using remote small incision, squeeze delivery technique‚ and endoscopic-assisted removal. We have used a combination of the above techniques, with the aim of removing the maximum number of lipomas with fewer and smaller incisions. The ultimate outcome is that the patient has a less scarred body. Methods: This is a nonrandomized uncontrolled case series, conducted over 3 years from 2018 to 2021. It included all patients with visible multiple lipomas over upper limbs, lower limbs, chest, abdomen, and back. A total of 30 patients were operated on. The technique used in all patients was liposuction, limited incisions, tunneling, and squeezing out the lipomas. The patients were regularly followed up for 6 months. Result: Lipomas of various sizes were removed by the above mentioned technique. Early postoperative period bruising was noted in seven cases which needed no intervention. Two patients had hematoma collection and one seroma, which was managed with aspiration. Among the 30 patients, 90% were pleased with the cosmetic result‚ and recurrence was seen in five cases. Conclusions: Our modified technique of treating multiple lipomatosis gives a good aesthetic result and high patient satisfaction for a short-term study. However, comparable and long-term studies need to be performed for more conclusive results.

Mesenchymal Tumors of the Breast: Fibroblastic/Myofibroblastic Lesions and Other Lesions

“…Conventionally, the entire capsule should be removed during excision. There is research ongoing into more minimally invasive techniques for removal, including liposuction [132]. A series of 30 patients using minimally invasive techniques (a combination of liposuction, minimal incisions, tunneling, and "squeezing out" the lipoma) for multiple lipomas demonstrated excellent cosmetic results but recurrence in 5 patients [132].…”

“…There is research ongoing into more minimally invasive techniques for removal, including liposuction [132]. A series of 30 patients using minimally invasive techniques (a combination of liposuction, minimal incisions, tunneling, and "squeezing out" the lipoma) for multiple lipomas demonstrated excellent cosmetic results but recurrence in 5 patients [132]. Deoxycholic acid has been injected neoadjuvantly to limit the size of the resection and scar with some success [131].…”