Truth in Cosmetic Surgery

An Honest Orange County California Plastic Surgeon Blogs

Archive for the ‘Lumps’ category

A Lipoma Can Get Really Large- Picture Alert

June 30th, 2010

Neck_lipoma

A lipoma is not something to be left alone. This Navy career man was told for 17 years by his doctor that this growing mass did not require removal. “It was just a lipoma.” This thing slowly grew to the point at which when he retired this large lump was visible even in clothing.

The bottom line here is that even if a soft fleshy lump is not cancer, it can grow and produce a problem if ignored for long enough.
My baseline recommendation is that people get these things removed early. On Page 2 is an image of the tumor once it was removed.

Best Regards,

John Di Saia MD

Originally posted 2009-11-10 07:30:14.

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Posted in Lumps, Picture Warning

Tags: large lipoma removal surgery pictures

Reader Question – Lipoma on My Labia?

May 11th, 2010

Inquiry: Hello,
I am looking for your expert opinion on my situation. I have a massive Lipoma located in my left Labia majora. It measures 3cm x 7cm long. It is extremely mobile within the entire Labia majora. I have seen 2 gynecologists and 2 plastic surgeons for opinions and all have differing opinions on how to proceed.
1 Gyne – No way/Not paid by insurance/not touching it.
1 Gyne – Wow, needs to be done in hospital/covered by insurance/high risk of bleeding
1 PS – Wow, needs to be done by a gyne
1 Ps – Booked my for surgery

My concerns are risks of bleeding out and scarring/loss of sensation.

My choices are to go with a Gyne who will try and place the scar within the labia minor in a hospital setting

OR

A plastic surgeon, specializing in the vaginal area, who will place the scar in the natural crease which runs down the labia majora.

Questions – who do YOU think is better qualified to do this? Due to scarring/nerve damage is the scar lower/more inside/further away from clitoris better or worse?

- Dawn (I am in Canada)

On qualifications, it depends upon if you care what it looks (and maybe feels) like afterward. If you don’t care then go to the non-plastic surgeon. On the lipoma in general, take into account that until it is removed you are not certain it is a lipoma. From what you describe, it sounds like the incision can be easily placed away from your sensitive parts.

Best Regards,

John Di Saia MD

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Posted in Lumps

Tags: labia lipoma

Reader Question: What Does A Sebaceous Skin Cyst Look Like?

January 5th, 2010

Reader Question:

My doctor says I have a cyst under my skin. I am wondering what it looks like under there. Have you ever removed one of these?

A Sebaceous Cyst or Epidermal Inclusion Cyst (EIC) is a non cancerous growth under the skin. They slowly get larger over time. I used to remove them more frequently than I do now as the economy slows down non-essential surgery a bit. They can usually be removed in the office under local. They can leave a dent after removal so some patients prefer a plastic surgeon do the surgery to help minimize this.

Here are a few images of such a cyst from the skin surface skin (a shoulder) and a picture of the cyst after I removed it. These cysts can rupture and get infected and are easier to remove if neither of these things happens. They can recur. It is easier and looks better if you get rid of it earlier as opposed to later.

Sebaceous Cyst After Removal

Best Regards,

John Di Saia MD

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Posted in Lumps

Tags: cyst epidermal sebaceous Skin surgery pictures

Reader Question: Do You Ever Do Local Numbing Only Plastic Surgery?

September 14th, 2009

Reader Question:

I would like some lipomas and moles removed by a plastic surgeon. Do you do numbing only surgery in your Orange County office?

Yes I do. Small cases including small wounds, scar revisions, small lumps and bumps and the like can be operated in the office under straight local anesthesia (only numbing shots). We do this mostly for cash business as health insurance will not reimburse us for materials we use during the surgery. Some patients like this as they can drive themselves home afterward.

Best Regards,

John Di Saia MD

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Posted in Lumps

Tags: local anesthesia local plastic surgery Lumps moles numbing shots orange county scar revision

Reader Question: Should I Have My Lipoma Removed?

July 23rd, 2009

Reader Question:

I went to my doctor and was told I have a Lipoma? What is a Lipoma? Should I have it removed?

A lipoma is a noncancerous fatty tumor usually found in the fatty layer under the skin. They grow slowly and are usually no more than a nuisance; that is unless they have been growing for a while. They usually appear as a kinda soft lump under the skin.

As they grow, the displace and occupy the space of tissues around them (usually fat.) They can become quite large over the course of years. There is the other potential problem; namely that you can’t be 100% sure that your “lump” is a just a lipoma until you remove it and send it to the pathologist. Some lumps are cancerous.

The bottom line is that I usually recommend removal.

Try to have it removed while it is small so there is less of a “dent” and the surgery is usually pretty low key. Often small ones can be done in the office under local anesthesia. And consider sending the removed lump for pathology just so you know what it was.