From the Research
For excision of a lipoma on the forearm, a minimal one-third incision is recommended, as it provides a cost-effective, reliable, and cosmetically pleasing method for lipoma removal, with low complication rates and good cosmetic outcomes, as demonstrated in the study by 1. This approach is preferred because it allows for complete removal of the lipoma while minimizing scarring. The incision should be made parallel to the long axis of the forearm, which aligns with natural skin creases, and should be long enough to allow for adequate exposure and removal of the lipoma. Some key points to consider when performing the excision include:
- Local anesthesia with 1-2% lidocaine with epinephrine (1:100,000) should be administered before making the incision
- Blunt dissection should be performed to separate the lipoma from surrounding tissues, taking care to preserve neurovascular structures
- The incision placement should consider the location of the lipoma, nearby structures, and optimal cosmetic outcome
- Following excision, the wound should be closed in layers using absorbable sutures for the subcutaneous tissue and non-absorbable sutures or staples for the skin. It's worth noting that other studies, such as 2 and 3, have proposed alternative techniques, including combined liposuction and excision, and the use of a Z-incision design, but the minimal one-third incision method proposed by 1 is a more recent and higher-quality study, and is therefore recommended.