Lumps and Bumps Excision for Face and Neck

What are lumps and bumps?

Lumps and bumps are localised swollen areas that occur on or under the skin. Infections, tumours, body’s response to trauma, or injury cause lumps and bumps. Bumps can be caused due to acne, cysts, boils, moles, lipomas, skin rash, or skin cancer.

Lumps are commonly called as tumours which can be benign or malignant. Benign tumours are non-cancerous and do not spread to other parts of the body and may include cysts, nodules, lipomas, haematoma, hemangioma, and papilloma. Malignant tumours are cancerous tumours which include breast tumours that invade the surrounding tissue and spread to other parts of the body.

What are lymph nodes?

Lymph nodes are soft nodules of tissue and they are a part of the lymphatic system. Lymph nodes help to identify germs, infections, and other foreign substances that invade our body. They are found throughout the body and become swollen from infection or other inflammatory conditions of the body.

Diseases of the lymph node may be caused due to infection, inflammation, an abscess or cancer. Some of the diseases of the lymph nodes are

  • Lymphadenopathy – Refers to swelling or enlargement of one or more lymph nodes occurring due to local or systemic conditions or diseases. Lymphadenopathy can be localized or generalized
  • Hodgkin’s disease – Cancer of the lymph tissue found in the lymph node that may spread to spleen, liver, bone marrow and other organs
  • Lymphadenitis – It is an infection of the lymph nodes and is a common complication of bacterial infections

Enlarged or swollen lymph nodes are frequently found in the neck, armpit, under the jaw or chin, behind the ears and on the back of the head.

Swollen lymph nodes are diagnosed by physical examination to check palpable lymph nodes for size, texture, and tenderness and other features.
Pain medications such as ibuprofen and acetaminophen may be prescribed to relieve pain and to reduce the swelling. Infections are usually treated with antibiotics and anti-viral medicines. Cancer of the lymph node is treated with chemotherapy, radiotherapy, or surgery.

What are lipomas?

Lipomas are slow growing tumours that arise from fat cells. They are soft or rubbery, round, movable and flattened and are found under the skin. They are most common non-cancerous tumours occurring in adults. They usually grow in the face, neck, shoulders, back, or arms and may develop between 40 and 60 of age.

How are lipomas treated?

Treatment for lipomas is usually not required, unless the tumour becomes painful or restricts the movements. The common non-surgical treatments for lipomas are as follows

  • Steroid injections such as xylocaine and triamcinolone acetonide
  • Liposuction and lipolysis is performed to remove the lipoma without causing scars
  • Antibiotics are given to reduce pain

The disadvantage of lipolysis and liposuction is that the lipoma will not be removed, but will only be reduced in size and there could be chances of recurrence.

Some of the techniques in surgical removal of lipomas are

  • Enucleation: The lipoma is removed through surgery and is enucleated (removal of nucleus) through the incision using a curette
  • Surgical excision: In this procedure a hemostat or Allis clamp is used provide grip to remove lipoma. Hemostat or clamps are attached to the lump to provide traction for easy removal of lipoma
  • Narrow hole extrusion technique (skin punch): Skin punch creates a narrow hole in the lipoma from which a curved hemostat is inserted and the lipoma is removed