Minimal scarring from giant intramuscular lipoma excision with the harmonic scalpel

ABSTRACT

Lipoma is the most frequent benign mesenchymal tumor. Giant intramuscular lipomas, defined by a measurement greater than 10 cm in any dimension, reside deep to the fascia and originate within the muscle layer. Traditionally, the length of the incision required for excision is equal to or greater than the diameter of the giant intramuscular lipoma. However, because of injury to the surrounding tissues from excessive traction and thermal injury from the energy delivered by the device, long and noticeable scars with a hypertrophic tendency develop, resulting in patient dissatisfaction. Although some esthetically-favorable methods have been reported, including liposuction and liposuction-assisted excision, these methods did not sufficiently excise lipomas, and led to a higher recurrence rate. In contrast, the ultrasonic harmonic scalpel can excise large and deep-seated lipomas with minimal scarring. The ultrasonic harmonic scalpel requires a shorter incision, and it provides a sufficient view of the surgical field, thereby avoiding unnecessary traction applied to the skin and reducing surrounding tissue injury trauma, which results in hypertrophic scars.