Removed 3 Lipoma's at home yesterday.

[marcod]

ok, I bought almost everything on ebay and amazon and I'm waiting for the disinfectant (kodan).
I'd like to ask Drav a couple of practical questions, before starting:
- How long do you put ice on the lipoma?
- do you dry and disinfect the area after iceing it?
- Where do you "park" the scalpel, when you want to try to push out the lipoma?
- and, after "parking" it, do you disinfect it again, before keep on cutting up the lipoma?
- I have a 4/5 cm long lipoma on my left arm, do you think I can manage to push it all out form a 3/4 mm hole?
- When you cut up the lipoma, do you just spear it(sorry for my english) or you cut it up and down left and right (in all directions).
- scary question: can you see veins or even nerves close to your lipoma through the hole?
- I have some lipoma which are less moveable and seems to be attached to the muscles below and also to the skin above. Did you have something like that? and did you use some scissors as you can see in some video on you tube, to separate the skin from the lipoma?

I almost convinced my wife to support me in this craziness, I will post some video if she cooperates

Thank you
Marco

[Guest]

ICE for 2-3 minutes at start. The after closing with glue, wait 2-3 or minutes for the glue to fully harden if you get water on the glue it can go white, then ice for as long as you like at the end, as this will prevent bruising.

When closing lightly bring the skin together and you don't need much glue, the less the better.

As its your first time, take your time, it could take you 10 minutes or it could take an hour, so prepare yourself. You will need to be persistent and calm!

You may have to squeeze quite hard, but the more cutting you do the less squeezing, its a fine balance, as you don't want to cut to much and you don't want to squeeze to hard.

After icing, just wipe with your sterile gauze.

I park the scalpel of sterile gauze when not in use.

Make sure you use sterile gloves and you cut your nails, this will prevent bruising.

You can get all the lipoma out of a 3-4mm hole.

Do you have a clamp, make sure its not too tight and positioned under the lipoma.

When you are cutting up the lipoma, push through the lipoma there will be no pain, carefully break up the lipoma, when you squeeze, it out it will come out easier.

Ive removed 40-50 and never had a problem with a vein, if you can get the clamp under the lipoma I doubt there will a vein lifted to the surface, but please inspect the incision area first.

Where there seemed to be a vein on one that I did, I moved the incision site further away buy 6-7mm.

Never seen a vein through the hole, you wont actually see very much.

I have never used scissors, the whole is small so not sure how scissors would work. I've only ever used a scalpel. I have been looking for a 2-3mm hook, but not found one.

I use the scalpel to separate the lipoma from any tissue, when squeezed through the outside.

Make sure you get it all, spend a bit of extra time before closing. Anything left will probably grow back and annoy the hell out of you, when it heals.

I don't think this is crazy at first I may of done, but after doing a few, feels perfectly normal and the results are amazing. BEEN SWIMMING WITH MY SON! LOL

[Drav]

You break it up by spearing it, and you only need to disinfect once.

[lippohippo]

@drav, @marcod
are all the lipomas you removed of the same ... consistency? i removed a small (5mm) one that was like soft chicken fat and part of another one (3cm) that was like hard fibrous gristle. if i were to speculate, the older it is the harder and more fiberous it gets.
the small one was easily removed simply by squishing it out from a 3mm hole.

however, i only managed to remove 1cm from the 3cm fiberous lipoma from a 1cm hole over 6 hours. i was meticulous making sure not to cut any vessels. what made it hard to operate on was that there were alot of veins around and so i had to make an incision off to the side. the initial incision was too small (5mm) and i set a limit of max 1cm. it might have potentially been possible to remove it comletely were i to extend it to 1.5cm but at that point i would have needed stiches. i understand why now they cut to the diameter of the lipoma -- if the incision is too small(and not made in the centre of the lipoma), you can remove some by chopping it up but the remaining will be deeper inside. meaning, the leftover won't be popping out like the initial 1/3rd. meaning, it's harder to work at. i was uncomfortable working that deep(over 1cm) and so stopped there.
you can feel what i think is the boundary of the lipoma once you are in it, which brings some comfort as to not wanting to cut too deep into the lipoma when breaking it up. i used a diff tools: needle, scapal and a metal rod. as in the videos, trying to 'unstick' the sac from the lipoma (some used their fingers/blunt-tong-scissor-looking-device) sorta helped in the lipoma being more moveable. however, it leads me to the impression that it would increase the chances of needing stitches in that it loosens the skin -- but requring stiches is largely determined on the length of the incision (ymmv).
the actual lipoma was fucking waay more fiberous than i thought it would be. ...like a knotted bundle of threads. like, i stabbed part of the protruding lipoma with a sewing needle and ended up bending the needle trying to pry it out. i stabbed it countless times but that doesn't really break it up.. it just softens it so that scraping becomes a bit more feasible in that it removes only a slight amount. (cutting, as opposed to stabbing, seemed more risky as it was less controllable. stabbing also has the fibrous sac to limit your stabs in case you stab too far which is why i don't recommend trying to seperate the lipoma from the sac until you are done stabbing.) i was using a no 11 scapel so maybe a drav's no. 15?? would work better. perhaps stabbing and twisting would work better. or perhaps a fishing hook -- hook it pull it till it breaks and repeat. i can understand why some doctors used scissors to cut it (they were doing it blindly which looked dangerous). the scapel it seemed to me was the least dangerous. i'd like see how a micro soldering iron would work to chop/burn it up -- i have a steady hand.

half diameter incision, as drav suggests, seems doable but i wouldn't go into it unless you ready to go for the whole diameter of it.
in conclusion, cut over the middle of the lipoma if you can, and hope that it's a soft type and not fibrous.

all my lipomas are under or next to veins. hope all that info helped

[Drav]

I never twist the scalpel, I may go in at different angles.

Never seen a vein. Have moved away from one, but did this before the incision.

I use my fingers under the lipoma or a clamp.

I never push through unless I have my fingers under the lipoma or a clamp, so its never flat against my muscle when I am cutting up.

I move the lipoma around with my fingers and push through the lipoma with the scalpel.

When cutting, it does not hurt to cut through lipoma, but pushing the scalpel even lightly against anything but lipoma will hurt so you know, your not cutting lipoma.

I never go deeper than the length of the blade say 10mm.

Some are beyond easy to come out, some are alot more taxing!

Sometimes I have to squeeze quite hard, some split with the pressure and pop. Once in a restaurant I showed my wife with an olive how hard you have to squeeze to break it down, it can be quite hard. But really try it, its quite similar.

The first few you do will always be the hardest, like anything the more you practice the better the results.

But agree, its not for everyone, some people have tried and not been able to do it.

With me, I am persistent and will get it out, regardless.

I accept that this is not for everyone, but for me, I think I have had really great results.

[Guest]

@drav
thanks for that introspective post. it was exactly the subjective pov experience i was looking for.
what is the longest incision you have made?

#update:
removed another 2: one pea sized and another cashew-sized, both fibrous. i didn't really do anything that differently except to squish it harder and more often in attempts to break it up to the point where i was bruised somewhat. that worked (thanks drav). i guess i wasn't doing it enough. despite remove a few, i got a sense hopelessness while doing it .. perhaps, in part, of the tediousness and due to the lack of immediate result and mostly the uncertainty (and the thought of having to make the incision bigger or too big).

before removing, the pea sized one looked discolored compared to the others; it looked more blue-ish. removed, it was just drierandthereforeslightlyharder/waxy/moresaturatedincolor than the others. i left the other 'normal' cashew-lipoma in ziplock bag overnight and it dried out somewhat. it had similar consistency and look to that of the pea.

this time, it took less work: 1hr/lipoma. it's my reservations that is taking up the time

i took the excised lipoma and was able to cut through it easily using a soldering iron. setting the iron to a higher wattage makes the lipoma melt into a puddle of oil. too clunky/dangerous to use. medical cauter-tools may work but you get good feedback using a scalpel.

@marcod

- I have a 4/5 cm long lipoma on my left arm, do you think I can manage to push it all out form a 3/4 mm hole?

unlikely. maybe if it's soft. though, what feels soft often turns out to be fiberous in which case -- no. you could make the initial cut and see if it is, but i wouldn't unless you are willing to go at least 1/2 diameter. and at your length of your lipoma, i wouldn't (unless you get stiches).
drav even recommends the 1/2 dia. but then he says that every one he did was 4/5mm. i think the important thing is to make the incision in the middle of the lipoma. otherwise, the scalpel would have to go the full length of the lipoma .. which would be deep. what would likely happen if you made the incision at one end (and just using a scalpel) is that you might get the first cm. then you have to go deeper which makes it more awkward/dangerous. it's possible, but not ideal. small/circular ones -- sure, elongated ones -- notsomuch.

check out the vid i posted earlier: (https://www.youtube.com/watch?v=Rl-8wwclCTQ)
while it seems technically feasible we don't know if it is soft or fiberous. my guess is that it doesn't matter with those tools though.
what concerns me in vid is the largely the ending: he twists the 'sac'. ...When removing my lipoma, there's the end part -- the 'stalk' -- that's very fiberous that you cut. you can pull it out a bit but you can't see exactly what's it is attached too. i wouldn't want to pull that much in attempts to remove it. it just feels wrong when pulling it. (there's other vids that pull with and has an endoscrope view.. but you never know). also, it would be harder to tell if you got it all.
moreover, if you make the incision at one end, you have to have something like those tools as a scalpel wouldn't/shouldn't go in that far at that size of incision.

my first attempt was something akin to that of the video: i used a needle that is used to inflate basketballs etc. i modded it a little: increased the diameter a bit and cut the end at and angle and filed it down until it was semi-sharp. i suppose anything would do for the initial breakingdown: the eye of the needle-side worked ok for me. this was done on a 2cmx2cm lipoma. maybe.. maybe if i kept at it (jabbing it in until it was mushy) it might have eventually been possible. it was my first and was expecting too much and probably didn't stab and squish it enough. i suspect though that it isn't practical/feasible without the proper tools.
i intend this technique again on another 1cm lipoma. if it doesn't work, i'll just make the incision bigger and get it out. 5mm seems fine.
start on a pea-sized lipoma somewhere away from important veins. don't make the mistake of doing the ones you want gone first. obviously, a dr should only be doing this. but there's the info anyways.

[Drav]

I had exactly the same concerns and feelings on the first few that I did, you just don't know if its going to come and what to do to make it come out, however with me, eventually they all came out.

At first an hour, now 5 minutes, practice and experience.

The largest scar I have is 5mm which is on my back to the side, the reason the scar was larger was because i could barely get to it with my arm, it was just really awkward, but it came out.

In the early ones, I did more squeezing then cutting, now I do more cutting than squeezing. It is easier to remove if the hole is bigger that goes without saying, but then the scar is more noticeable, which I don't want.

If you can get the majority of the lipoma to within 6-7mm of the incision site, you can get it, other than that, I'd plan on 2 incisions, remember 2 or even 3 4mm scars are barely noticeable.

I have removed some monsters in the early day's through 4/5mm holes and I would squeeze quite hard and it would take ages. But now I cut more and the day after you would not know it, the glue also kinda hides the incision site, I guess I've desensitized myself to it all, and I just dig in!

I would love to however make some kind of extraction tool!

Those concerns and feelings I had in the early days are long gone.

[lippohippo]

If you can get the majority of the lipoma to within 6-7mm of the incision site, you can get it, other than that, I'd plan on 2 incisions, remember 2 or even 3 4mm scars are barely noticeable.

ah. i can see how that's much more doable. just more holes.

the no.11 scalpel i am using isn't suited to that task. no.15 seems the best and i can see why you'd want the blade a mm or so less in width. going to hold off till i get some.

my 1cm is going to be scarred. despite it being visibly on my arm, i don't mind if it's just the one. 3 days later, i felt what seemed to be a missed/new lipoma right where i removed the pea-sized lipoma. i squished it and seems to have gone away. although i wan't going to, it was tempting to open it up and get it out.

[marcod]

I just removed my first lipoma. It was harder than I thought and at a certain point I was near to leave half inside. It took 2 hours for a 1 1/2 cm lipoma. It was on my left arm and I used a clamp.
And this was the main problem: Drav, doesn't the clamp bother you while cutting the lipoma? I had the impression to cut always in the same areas because I could use the scalpel only with a certain angle, if you understand what I mean...
In any case at the end I managed to take it out squeezing it and I pretty sure that next time it will take less time.
2 problems:
- the stalk: I pull it a bit then the lipoma went away and a part of the stalk remain outside the hole and i didn't know what to do with it. At the end I partially cut it and the rest i put it inside the hole.
With one hand it was difficult to cut it with the scalpel!
- the glue: also with one hand, so I put it without closing the hole properly, how do you do guys? Probably the scar will be small but a bit large now...
I bought liquidband optima, thinking that was better than the normal one, but I'm not sure..., it has the soft ending to control the liquid flow...can you use it more than one time.?It doesn't seem so hygienic...
Thank you again for your support

[Drav]

the no.11 scalpel i am using isn't suited to that task. no.15 seems the best and i can see why you'd want the blade a mm or so less in width. going to hold off till i get some.

my 1cm is going to be scarred. despite it being visibly on my arm, i don't mind if it's just the one. 3 days later, i felt what seemed to be a missed/new lipoma right where i removed the pea-sized lipoma. i squished it and seems to have gone away. although i wan't going to, it was tempting to open it up and get it out.

Ages ago I got 100 No.15 blades on ebay for approx £10 I used them for loads of household tasks now, very handy!

On a few occasions, after the op, ive noticed a lump straight under the incision site, you think, how could I have missed that! However after approx 6 weeks its gone. So just leave it and forget for 6 weeks, it should slowly disappear, probably some swelling or slight tissue damage. If there is something left, you can go straight back in the same whole after 6 weeks, it will heal just as well the second time.

[Drav]

I just removed my first lipoma. It was harder than I thought and at a certain point I was near to leave half inside. It took 2 hours for a 1 1/2 cm lipoma. It was on my left arm and I used a clamp.

Very well done, you must be very happy today !

Now with the glue, you can use surgical tape to close the wound, or get your wife, or find someone! I tend to use tape! Tape it so it's closed lightly, then sparingly apply the glue. Do not apply the glue if the wound is weeping make sure everything is dry before applying.

If you mess up, you can wet the glue and you can carefully pick the glue off with a scalpel, or a wet surgical swab and then you can reapply. It will come off like a plastic scab, generally in a few pieces or whole.

The glue is supposed to be single use, but it's quite expensive, I just cap the lip and reuse, I've not had any infections. But, at you own risk!

With the clamp, I sometimes use surgical tape to prevent full closure and this gives alot more relief, also the clamp part I will put swabs and surgical tape to cushion against my skin.

I wonder with another clamp, you could clamp the stalk and cut it with a scalpel. I've always got everything out, sometimes you have to adapt to what's in front of you. Or try and pull it with your fingers.

[marcod]

just to say that I removed an other one...easier than the first one it took maybe 40 minutes. My wife couldn't support me while I was cutting (she almost collapsed...) but at the end she put me the glue on the wound, so...much better result that the first.
I have at least 10/15 other lipomas on my arms, which i would like to remove, than I will start with my legs. There it could be more problematic since they are much less moveable and they seem to be much more connected with the tissues around. No chance to put my finger under the lipomas, there...
How can I upload fotos??

marcod

[lippohippo]

15c looks slimmer for breaking it up: http://www.swann-morton.com/pdfs/range_1.pdf
going to stick to the no.11 for the initial cut though.

[Drav]

than I will start with my legs. There it could be more problematic since they are much less moveable and they seem to be much more connected with the tissues around.
marcod

The legs will be easier, your doing single arm with a clamp, compared to do that legs will be a breeze.

[Drav]

15c looks slimmer for breaking it up: http://www.swann-morton.com/pdfs/range_1.pdf
going to stick to the no.11 for the initial cut though.

Looks very usable, all we need now is some tool to pull them out!

[Drav]

Seems to have all gone quiet! Hopefully you guys are all still with us! Anyway got one of these coming;

http://www.ebay.co.uk/itm/281114972183? ... EBIDX%3AIT

Think it might be usable will need to get hold of it to see. Unfortunately, I cant test it out on me.

Was watching some of the youtube videos, the way some slash the skin multiple times with abandon to make a 1inch long gash, I could never do that.

[marcod]

In total I removed 6 lipoma: the first 2 on my left arm, one of my right arm, 2 on my right leg and one on my left leg.

first lipoma on my left arm: I was alone, worked with a clamp, it took a long time and I glued alone, and the scar is a bit large, but with the time for sure it will improve

second lipoma on my left arm: I worked with a clamp cutted alone, but my wife helped me with the glue; after 10 days the scar is barely noticeable!This is the way to go. I hope I will have the same results again.

third lipoma on my right arm: I did the cut in the direction elbow-hand (while on the left arm I did trasversal) because the lipoma were longer in that direction. The problem is, please Drav confirm, you can angle the scalpell just parallel to the cut, so you spear the lipoma on the left and on the right side of the cut but not in front or on the back. If I try to move the scalpell on the front or on the back of the cut, the sharped edge of the scalpell will hurt the skin and, even worse, can make the cut longer.
So in the end I had to work a lot in order to reach the lipoma in the "front and back" areas and I did a lot of squeeze job, the clamp was toot tight for a long time, and now my arm is fine but it was blue for three/four days...
Scar a bit large but still ok.
So next time I will make the cut perpendicular to the direction in which the lipoma is longer.

fourth lipoma on my right leg close to the knee: very easy job with 2 hands and the lipoma was moveable like the ones on my arms, I did it maybe in 20 minutes. Scar is really small not as the second one but it will improve

By the way: if I compare the scars I have from former lipomas' surgery... there is no competition...mine are much better

fifth lipoma on the upper side of my right leg: and here the problems started...
It wasn't so moveable as the first 4. I spear the lipoma a lot and the lipoma came all out but not with the "stalk", so I didn't have a good feeling with that.
The first 4 went out at last with the "stalk" and I knew for sure that they were all out but with this..., I checked and there was nothing to squeeze out anymore but still...was different.
Well, after cutting and spearing and squeezing, looking forthe last pieceof lipoma attached to the tissue below with the stalk, my leg didn't look nice and also the cut was longer than usual (7mm).

sixth lipoma on the upper front of the right leg: the lipoma was even less moveable than the fifth. When I did the first cut, I had the impression to entered directely in the lipoma and not just through the skin. I used the scalpell for 2 hours (Drav, you are right, with the time you loose sensitivity and I cut with less precaution the more the time was passing by)...and that was the third lipoma in that night...
No stalk...and I used the last half an hour trying to remove the lipoma which was attached to the skin...with all the scalpell inside the hole...blade basically parallell to the skin, but at the end I was cutting my skin from inside so... I gave up. Touching the area around the cut now, I feel what I think is still lipoma connected with the skin. The lipoma was big and it was pushing a lot, so I still happy that it is pretty gone but I don't know if I can live with that rest inside.
I don't know if it will dissolve (since there's no stalk which "feeds" the lipoma) or if it will grow back.

Before I cut an other one like the last two lipoma, I want to be sure to know how to divide the lipoma from the skin, suggestions are welcome.


An other problem: the glue
Drav, I don't know how you close your glue holder, but my liquidband optima can not be closed, and it dried in one hour! Basically I had to use one applicator for each lipoma, which is quite expensive. Do you have any suggestions? In the meanwhile I bought stripes...

[lippohippo]

9th or 10th removed thus far. i'm awaiting more scalpels. thanks for the tweezer link. i might try that as well as needle tweezers. all lipo removed were under 2cm thus far.

making the initial cut is easier but it still takes me like 20min to make it -- i'm still paranoid and take my time. one has been soft and just squished out; one was harder than the others but didn't take that much to pop out.... but the rest, the rest were knotted fibrous with chunks of occasional fat. those take forever: from 1-6 hours to remove. the problem is that the hole is too small.

i still find using a file-blunted needle more effective in softening it than a scalpel. 16gauge is too big 18g is a bit too small but 17g is great. the needle-eyed side a sewing needle works great. scalpel is good for cutting some of the inside's internal fibers. it's annoying ... you cut through the external fiberous sac, soften the insides up via stabbing, then, try to loosen the sac from the skin and shift the lipoma so that you can repeat the process in another section of the lipoma. this is repeated over and over and over. you think that it would have more of an effect from new shifted locations .. it doesn't.

i use a toenail scrapper to seperate the skin from the outside of fibrous sac -- it helps with mobility and removal. i find that if the sac isn't cut up enough (by that i mean, cutting it in at least 50%+) the lipoma will not come out. what i define as the fiberous sac looks like red strands of fiber going in the same direction.

i use butterfly bandages and topical 'new skin' liquid bandages over the wound

i made a diy lipo suction cannula. it looks like something mcguyver cobbled something together in monkey island -- made it out from a aqua pump tubing, bike pump needle, string and a gluegun; it's a proof of concept. no go!. the dr in that video must be using a twin cannula as there is no way suction itself would work wholly it did in that video with my lipomas. saved me from having to buy actual cannula adapters and what not.

i'll see how it goes with smaller scalpels and tweezers but i figure that there is no way to do my back lipomas given the time, awkwardness and hardness of previous ones. i also have a 1/32 drill bit on order (1/16 was too big but it work soso by hand. it also tended to hurt occasionally).

what i'm wondering ... is if it is possible to inject anything into them beforehand (days or the night before) to soften them up. that would make things IMMENSELY easier. i've tried injections of saline and vita-c, but that tends to make things inflammed for the next day which would be all the more painful to operate under .. which i wouldn't do.

[Guest]

thought of a $10 idea: http://www.ebay.ca/itm/New-21pc-Micro-D ... SwF1dUTxTP

hand operated, push down and it turns, so it's more controllable than electric-powered. i would only use this when inside the fiberous sac(and only after stabbing it till it's softened) as it would pull too much and too uncontrollably. there are other selfdescribed handrills that look more easier to use 1handed(http://www.ebay.ca/itm/New-21pc-Mini-Mi ... Swu4BVleHi), but i don't know if they operate similar to the one i got: pushingtotwist, not manually twisting. (https://www.youtube.com/watch?v=-z6_YFBQu_g). i stuck to what looked like she was using in the vids.
might cover the entrance with latex/plastic and cut a small hole so that the drill piece won't accidently rub against the sides. (ouch)
stuff won't probably come in till after xmas though.

(also, i saw a $20 vein finder on ebay)

[Guest]

This is an intriguing thread. I have hundreds of these things on my body from my neck to my knees. About 50 or so really bug me and would like to try taking some out on my own.. Unfortunately, a few of them are larger, between 2-5 cm. (the largest being a regrowth from a failed excision on my shoulder almost 9 years ago.. big scar too, almost twice the original size now). I'm thinking about starting small with a pea sized one.. Blood and guts don't bother me, but the threat of pain makes me kinda woozy. Everyone seems to talk about icing the area to numb the skin, but I want to throw this one out there.. http://www.drnumb.com/
Apparently there are some rip off versions of this, so it's best to order direct from their website, instead of amazon.. One of it's uses is actually listed as "minor surgery". You leave the cream on for 2 hours and it numbs the area. It's a lidocaine based cream which is identical to what is typically used for injections with this type of surgery. This product will absorb somewhat into the bloodstream and lidocaine in high doses can be fatal, so it would probably be best to limit its use to a small surface area per operation. This seems like a no-brainer to me, so i'm surprised nobody has brought it up before when describing self-surgery for lipomas. Anyone tried this before? I'm curious if it penetrates to the deep nerves of the skin, or if it is more effective on the surface.. (It seems to be most popular for tattooing/tattoo removal.) Hope to learn more from you brave few...