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In Beverly Hills and Los Angeles, patients frequently seek evaluation for soft tissue lumps beneath the skin. The most common of these is a lipoma, a benign tumor composed of mature fat cells. Although lipomas are non-cancerous and typically slow growing, accurate diagnosis is essential because other subcutaneous nodules—such as cysts or malignant tumors—can appear similar. Dr. Raffy Karamanoukian, a board-certified plastic surgeon, specializes in the diagnosis and minimal-scar removal of lipomas using precise surgical techniques designed to minimize visible scarring.

Lipomas usually present as soft, mobile, painless masses located just beneath the skin. They commonly develop on the neck, shoulders, back, arms, thighs, and occasionally the face. On examination, lipomas feel rubbery and move freely over underlying structures. In contrast, epidermal inclusion cysts are generally firmer and may display a central punctum. Cysts contain keratin material rather than fat and are more prone to inflammation or infection. Malignant tumors such as liposarcomas are rare but must be ruled out. Concerning features include rapid growth, firmness, fixation to deeper tissues, or associated pain. When necessary, imaging such as ultrasound or MRI is used to confirm the diagnosis and evaluate depth before surgery.

Early diagnosis simplifies treatment. Smaller lipomas are easier to remove, require smaller incisions, and reduce the risk of skin stretching or contour irregularities. Delayed removal may allow continued growth, which can necessitate a longer incision for safe excision.

Facial lipomas require particular attention due to visible location and nearby nerve structures. Lipomas on the forehead, temple, jawline, or cheek must be removed with careful dissection to protect motor and sensory nerves. Dr. Karamanoukian applies detailed knowledge of facial anatomy to ensure safe removal while placing incisions along natural skin creases or relaxed tension lines to reduce scar visibility.

Body lipomas are often less visible but may cause discomfort, pressure, or interference with clothing and activity. Larger lipomas on the back, shoulders, or thighs can create contour deformities if not removed properly. Traditional excision techniques may involve incisions equal to or larger than the diameter of the mass. In contrast, Dr. Karamanoukian performs minimal-scar lipoma excision, using a small, strategically placed incision to dissect and remove the encapsulated tumor intact. Because most lipomas are well-defined and separate from surrounding tissues, they can often be delivered through incisions shorter than the tumor’s width.

This technique reduces tissue trauma and supports improved cosmetic healing. Layered closure further optimizes scar appearance and reduces tension on the skin. Careful management of the surgical pocket also helps prevent postoperative depressions or contour irregularities.

Most lipoma removals are performed as outpatient procedures under local anesthesia, with or without mild oral sedation. Surgical time typically ranges from 30 minutes to one hour, depending on size and location. Patients return home the same day and usually resume normal daily activities within one to two days. Strenuous activity may be limited temporarily to promote proper healing.

All excised tissue is routinely sent for pathological examination to confirm the diagnosis. This ensures that the mass is benign and excludes rare malignancies.
Postoperative care includes wound monitoring and suture removal within one to two weeks when applicable. Dr. Karamanoukian may incorporate post-treatment laser therapy to improve scar quality. Laser treatment can reduce redness, improve texture, and support collagen remodeling during scar maturation.

Lipomas are benign but should be evaluated if they enlarge, become symptomatic, or change in consistency. Early assessment allows for simpler surgery and smaller scars. Through accurate diagnosis and minimal-scar surgical technique, Dr. Raffy Karamanoukian provides effective lipoma removal for patients in Beverly Hills and Los Angeles, emphasizing both medical precision and controlled cosmetic outcomes.