Service

Soft tissue surgery

Lumps under the skin — lipoma, atheroma, fibroma and similar lesions — are small operations that still deserve care. The aim is to remove the lesion completely, confirm the diagnosis with histology and leave as little mark as possible.

Which lesions are treated

• Lipoma — a benign lesion arising from fat tissue; single or multiple
• Atheroma (epidermoid cyst) — a cyst with a capsule under the skin, inflamed or quiet
• Fibroma and other benign connective tissue lesions
• Skin and subcutaneous lesions — anything that will not heal, changes or causes discomfort
• Soft tissue lesions of the breast area and chest wall
• Lesions of uncertain nature — lumps that need biopsy or complete excision to be identified

• Lipoma
• Atheroma
• Fibroma
• Subcutaneous cyst
• Soft tissue tumours
• Histology

Who comes to the clinic

• People who have noticed a new or enlarging lump under the skin
• Those with a long-standing lesion that has recently changed
• Anyone with pain, a feeling of pressure or discomfort under clothing
• People with a recurring, inflamed atheroma
• Those whose lesion has come back in the same place after a previous removal
• Anyone troubled by a lesion in a visible area for cosmetic reasons

How the assessment works

1. Physical examination

   The size, firmness, mobility and attachment to the skin of the lump are assessed, along with when it appeared and how it has changed.

2. Ultrasound

   This shows the internal structure, the margins, the blood supply and the tissue layer the lesion sits in. In most cases it is the only imaging needed.

3. MRI or CT, when required

   Used for large, deep or atypical lesions, and to plan the operation.

4. The plan

   The type of anaesthesia, the site of the incision and the extent of the procedure are discussed together. For small lesions this is usually a short operation with same-day discharge.

How the operation is done

Small, superficial lesions are removed under local anaesthesia: the area is numbed, the incision is placed over the lesion and, where possible, along the natural lines of the skin, the lesion is dissected out with its capsule and the wound is closed in layers.

If the lump is large, sits beneath the muscle layer or lies close to a nerve or vessel, general or regional anaesthesia may be chosen; such cases take longer and need observation afterwards.

With an atheroma, the essential point is complete removal of the cyst capsule — capsule left behind is the main cause of recurrence. When an atheroma is inflamed, it is sometimes better to settle the inflammation first and remove it as a planned procedure later.

Why histology matters

Everything removed is sent to the pathology laboratory. A small proportion of lumps that look typical turn out to have a different diagnosis, and that changes what happens next. Without a histology report, no one can say “it was only a lipoma”.

The soft tissue tumours page sets out in detail which features call for closer assessment.

Recovery

• After small procedures under local anaesthesia you can normally go home the same day.
• Keeping the area dry for the first 24–48 hours is advised.
• Stitches are removed after 7–14 days, depending on the type used.
• Returning to everyday work is usually quick; heavy physical activity is discussed separately.
• The histology result is reviewed together once it is ready.

Frequently asked questions

Updated: 21 September 2026