Typical lipoma
Soft, mobile, not painful, and grows slowly. It lies under the skin — on the neck, forehead, or anywhere on the head and face.
CONDITION / TUMOURS
Lipomas of the head, face and neck.
A lipoma on the neck, face, or head is a soft fatty lump under the skin, usually harmless. But rare malignant tumors can look similar, so a lump that is growing, large, or deep is first examined.
CONCEPTUAL VISUALIZATION- What it is
- A benign soft lump of fat tissue under the skin.
- How common
- Lipomas are common, but a smaller portion occurs on the head and neck.
- When to examine
- It grows, is over 5 cm, lies deep, is hard and immobile, painful, or has reappeared.
- Who treats it
- Removed by a surgeon; if sarcoma is suspected, the plan is made with an oncologist.
01 / WHAT IS ITWhat is
What is
lipoma.
A lipoma is a benign tumor of fat tissue that grows under the skin. To the touch, it is soft, slightly movable under the fingers, usually painless, and grows slowly. Size ranges from a pea to several centimeters.
Lipomas occur frequently and can appear anywhere, including on the forehead. A smaller proportion is found on the head and neck. In a series of 24 patients with lipomas of the head and neck, the most common location was the back surface of the neck under the skin. There are also deep lipomas — near the pharynx, larynx, or parotid salivary gland.
The main question is whether it is really a lipoma. Similar ones can be an atypical lipomatous tumor or a liposarcoma, a malignant tumor of fatty tissue. They are rare on the head and neck: in one study of 140 removed fatty tumors, 138 were lipomas and 2 were liposarcomas. Therefore, it is important not to fear the lump itself, but to know the signs that require examination.
This is general information. The doctor will tell you what will suit you after the examination.
02 / SIGNSHow to notice
How to notice
A worrisome sign.
A doctor can suspect a lipoma already during the examination. Some signs are a reason to investigate the lump before removing it.
Over 5 cm
In a study of 135 patients referred with suspected sarcoma, a size over 5 cm was the most indicative sign of a malignant tumor: 76% of such tumors had this size.
Soft tissue sarcomaGrowth and depth
In the same study, the combination that most accurately indicated malignancy was: over 5 cm, increasing in size, lying deep, and not painful — among 13 patients with this combination, 10 had a malignant tumor. If a lump is increasing and the cause is unclear, an ultrasound should be done within 2 weeks.
pain
Pain, redness, or warmth over the lump — also a reason to see a doctor. But as a sign of cancer, pain is the least indicative: it was present in 27% of malignant tumors in that study.
Compression in the neck
A deep neck lipoma can press on neighboring organs: swallowing becomes more difficult, shortness of breath appears, or the voice changes.
Returned
A hardening has appeared again at the site of the removed area — this is a reason for examination and check-up.
03 / REASONSLipoma or
Lipoma or
something else.
Under the skin of the head and neck, there can be various lumps. Among fatty tumors, the most common is a lipoma, but it is distinguished from rare tumors, which are treated differently.
Lipoma
The most common benign tumor of soft tissues. In a cohort of 47 patients with limb lipomas, after removal, none returned over an average of 52 months.
Atypical lipomatous tumor
Resembles a lipoma, but it is treated differently. In a review of 13 studies (1390 patients), it was most often described as follows: size over 110 mm, patient older than 60 years, tumor on the legs, and on MRI or CT — irregular shape and nodules. In a cohort of 43 patients with such limb tumors, after removal without a margin of healthy tissue, it recurred in 13.9%.
Liposarcoma
Malignant tumor from fat. According to data from 318 cases in the head and neck, it was mostly subcutaneous (81%) and had a low grade of malignancy (70.1%).
Other swellings
On the back of the neck, in a series of 28 removed growths, 79% were lipomas, and all were found to be benign. Under the skin, there can also be cysts: in a study of 391 growths, the most common were epidermoid cysts.
Sealing under the skin
04 / SEEK MEDICAL ADVICE
When to seek medical advice?
A lipoma itself does not require urgent care. But some signs are a reason not to delay examination, and several — to call an ambulance.
103 immediately if:
- it is very difficult to breathe - a person gasps for air, suffocates or cannot utter words;
- lips or skin suddenly turned pale, blue or gray;
- Sudden confusion appeared;
- the neck or face quickly swells and it becomes difficult to breathe;
- Bleeding from the wound after removal does not stop, even though you are pressing the wound tightly;
- the blood spurts, bright red and hard to stop.
See a doctor without delay if:
Immediately - to the surgeon who operated, and if it does not work - to the waiting room: After removal, pain or swelling in the wound area increases, the wound becomes red or discharges pus, a high fever appears. On the same day: Shortness of breath is stronger than usual; it has become difficult to swallow, the person coughs or chokes while eating. Within 2 weeks — on ultrasound: The lump increases, and there is no clear reason for this; in a child or a young person up to 24 years old — within 48 hours. If an ultrasound indicates sarcoma or does not provide an answer, and doubt remains, — immediately to an oncologist. In the near future - to the doctor: A lump over 5 cm, deep, hard and immobile, painful, red or hot to the touch, reappeared where it was removed. Planned: A soft movable lump that does not change, but is bothersome or looks unpleasant.
05 / DIAGNOSTICSHow they check
How they check
Lump.
- Review
The doctor assesses the size, density, mobility, and depth of the lump and asks how long it has been present and whether it has changed.
- ultrasound
The first examination for a superficial lipoma. In a review of 6 studies, ultrasound identified 86.87% of lipomas, and among other formations, correctly excluded lipoma in 95.95%.
- MRI or CT
If the lump is large, deep, near important organs, or ultrasound does not give an answer. In a series of 24 patients, all three deep lipomas were correctly identified even before surgery; CT or MRI allows for a preoperative diagnosis.
- Biopsy
A piece of tissue is examined under a microscope. It can be omitted only for small, up to 5 cm, superficial lumps or when MRI shows typical signs of a lipoma.
- Histology
The removed tissue is examined to confirm that it is a lipoma.
06 / TREATMENTHow we treat
How we treat
Lipomas.
A lipoma does not always require surgery. If it is to be removed, the method is chosen based on its size, depth, and location — and only when it is clear that it is a lipoma.
01
Observe or remove
The decision is made after examination and investigation.
- Follow-up
- Lipomas are harmless and usually do not require treatment. A small superficial lipoma with typical features can be monitored or simply removed.
- When to remove
- A lipoma is removed if it grows, presses on neighboring organs, interferes or is bothersome in appearance, or if the diagnosis is doubtful.
- First the diagnosis
- If there is suspicion of sarcoma, examinations and a biopsy are done before surgery, and treatment is planned by a team of sarcoma specialists.
02
Methods of removal
The method determines the scar and whether the lipoma will return.
- Excision
- The common method: the lipoma is completely removed through an incision and sent for histology.
- Forehead lipoma
- An incision directly over the lipoma risks damaging vessels and leaving a noticeable scar. In a study of 30 patients, an incision along the hairline gave a better appearance; after a direct incision, there were 2 skin necroses and 3 lipoma recurrences. In a study of 83 patients, in the endoscopic removal group (56 people), there were no complications, no forehead scars, or recurrences, although the operation lasted longer.
- Liposuction
- For individual lipomas from 5 cm. In a series of patients, there were no recurrences over 12 months, but high-quality comparative studies are lacking. Before this, a malignant tumor must be ruled out.
03
If it is not a lipoma
- Deep in the neck
- Important thin structures are nearby, so surgery is planned using MRI or CT.
- Atypical tumor
- It may recur after removal, so follow-up is needed.
- Liposarcoma
- After confirming the diagnosis, the main treatment is surgery, with radiotherapy if needed; then regular follow-up. Treatment is conducted by an oncologist together with a surgeon.
07 / AT THE VALIKHNOVSKYI INSTITUTE
How
How
we treat it.
Lipomas of the head, face, and neck at the Valikhnovskyi Institute of Surgery are part of the 'Soft Tissue Oncosurgery' program. First, it is determined what kind of enlargement it is, and only then is removal planned. If the examination shows a sarcoma, treatment is planned together with an oncologist and a radiotherapist; the clinic is responsible for tumor removal and tissue reconstruction.
CLINIC SERVICE
Oncosurgery of soft tissues
Sarcomas and other soft tissue tumors — with preservation of the limb and restoration of tissues in the same operation.
View service
What we do for this condition
- Examination before surgery — if examination or ultrasound raises suspicion of sarcoma, an MRI is performed first, followed by a core needle biopsy with histology; surgery is planned only after a diagnosis.
- Single block deletion — if the biopsy confirms a sarcoma, it is excised entirely, with a margin of healthy tissue around it; whether the margins are clear is assessed by a pathologist.
- 3D modeling — For a large or deep tumor, MRI and CT images are combined into a 3D model if needed, and even before the surgery, they can see where nearby vessels and nerves are located.
- Local flaps of the face and neck — If a defect remains after removal, it is covered with adjacent tissues, closest in color and texture.
- Reconstruction during the same surgery — If the wound cannot simply be sutured, it is closed with a flap, most often simultaneously with tumor removal.
Rostislav Valikhnovskyi
Plastic surgeon, candidate of medical sciences, founder of Dr. Valikhnovskyi Institute of Surgery.
How treatment works with us
- Photo onlineSend a photo of the lump and ultrasound or MRI results, if available — the doctor will preliminarily assess the situation.
- ConsultationExamination, discussion about how long the lump has been present and whether it has changed.
- ExaminationUltrasound, and if necessary — MRI and biopsy, to know the diagnosis before surgery.
- RemovalThe method and location of the incision are chosen according to the location of the lipoma; the tissue is sent for histology.
- Conclusion and follow-upThe doctor explains the histology result and monitors healing; in case of sarcoma — a joint plan with an oncologist.
08 / QUESTIONS AND ANSWERSCommon
Common
questions
Short answers. What is right for you, the doctor will tell you during the consultation.
Can a lipoma be cancer?
A lipoma is benign. But similar rare tumors can be atypical lipomatous tumor and liposarcoma. They are rare in the head and neck: in one series of 138 lipomas, there were 2 liposarcomas. Therefore, masses that are growing or over 5 cm are examined.
Is it necessary to remove a lipoma?
No. If it does not grow, press, or cause discomfort, it can be observed. It is removed when it enlarges, causes symptoms, or is bothersome in appearance.
Why an ultrasound if the doctor can already see the lipoma?
Ultrasound clarifies the diagnosis. In a study of 77 lipomas, only examination provided the correct diagnosis in 50.6%, while examination together with high-frequency ultrasound did so in 94.8%.
Can a lump just be removed without examination?
Biopsy can be avoided only for small, up to 5 cm, superficial lumps or when MRI shows a typical lipoma. If sarcoma is suspected, MRI and biopsy are first performed.
Will the lipoma return after removal?
It depends on what it was and how it was removed. In a cohort of 47 limb lipomas, none returned over an average of 52 months. On the forehead, after incision over the lipoma, 3 recurrences occurred in 14 patients.
Will a scar remain on the face?
A scar remains after any incision, so it is planned according to location. A forehead lipoma can be removed through an incision along the hairline or endoscopically — studies showed that scars were less noticeable.
Is it possible to remove a lipoma with liposuction?
Sometimes yes, for certain lipomas. In a series of patients, there were no recurrences within 12 months, but there are few high-quality studies. Malignant tumors should be ruled out first.
Sources
21 sources · reviews, guidelines and researchshowCollapse
- UK guidelines for the management of soft tissue sarcomasBritish Journal of Cancer, 2025doi:10.1038/s41416-024-02674-y ↗
- Lipomatous tumours of the head and neck: a spectrum of biological behaviourEuropean Archives of Oto-Rhino-Laryngology, 2015doi:10.1007/s00405-014-3065-8 ↗
- Liposarcoma of the head and neck: analysis of 318 cases with comparison to non-head and neck sitesHead & Neck, 2014doi:10.1002/hed.23311 ↗
- Evaluating the British sarcoma referral formAnnals of the Royal College of Surgeons of England, 2015doi:10.1308/rcsann.2015.0002 ↗
- The diagnostic accuracy of ultrasonography for soft tissue lipomas: a systematic reviewActa Radiologica Open, 2017doi:10.1177/2058460117716704 ↗
- Diagnostic value of high-frequency ultrasound (HFUS) in evaluation of subcutaneous lesionsSkin Research and Technology, 2023doi:10.1111/srt.13464 ↗
- Use of radiologic imaging to differentiate lipoma from atypical lipomatous tumor/well-differentiated liposarcoma: Systematic reviewSAGE Open Medicine, 2024doi:10.1177/20503121241293496 ↗
- Recurrence After Marginal Excision for Atypical Lipomatous Tumors Versus Lipomas of the ExtremitiesOrthopedics, 2016doi:10.3928/01477447-20160610-02 ↗
- Lipomas of the head and neck: presentation variability and diagnostic work-upJournal of Laryngology & Otology, 2006doi:10.1017/S0022215105004597 ↗
- Retrospective analysis of radiological investigation of surgically excised head and neck lipomasEuropean Archives of Oto-Rhino-Laryngology, 2024doi:10.1007/s00405-024-08672-3 ↗
- Characterizing Posterior Neck Masses: A Single-Institution Retrospective and Systematic ReviewEar, Nose & Throat Journal, 2021doi:10.1177/0145561319881845 ↗
- Symptomatic head and neck lipomasEuropean Annals of Otorhinolaryngology, Head and Neck Diseases, 2019doi:10.1016/j.anorl.2018.12.001 ↗
- Advantages of A Hairline Incision for the Excision of Forehead LipomasDermatologic Surgery, 2020doi:10.1097/DSS.0000000000002330 ↗
- Minimally Invasive Removal of Frontal Lipoma with EndoscopeAesthetic Plastic Surgery, 2026doi:10.1007/s00266-025-05293-x ↗
- Liposuction Assisted Lipoma Removal - Option or Alternative?Open Access Macedonian Journal of Medical Sciences, 2017doi:10.3889/oamjms.2017.186 ↗
- LipomaNHS, 2023nhs.uk/conditions/lipoma ↗
- LumpsNHS, 2024nhs.uk/symptoms/lumps ↗
- Suspected cancer: recognition and referral (NG12) — recommendations organised by site of cancerNICE, 2026nice.org.uk/guidance/ng12/chapter/Recommendations-organised-by-site-of-cancer ↗
- Shortness of breathNHS, 2024nhs.uk/symptoms/shortness-of-breath ↗
- Dysphagia (swallowing problems)NHS, 2023nhs.uk/symptoms/swallowing-problems-dysphagia ↗
- Cuts and grazesNHS, 2026nhs.uk/conditions/cuts-and-grazes ↗
The figures on the page are from these sources.
A lump has appeared
on the neck or face?
Send a photo and ultrasound results, if available. The doctor will say whether an examination is needed and how best to remove the lipoma.