Lipoma & Skin Lesion Removal in Johannesburg
A lipoma is a soft, benign lump of fat cells that sits just under the skin. They are harmless, but many people want them removed because they are growing, catching on clothing, uncomfortable, or simply in a visible place. Most lipomas, sebaceous cysts and other small skin lumps can be removed in Dr Marais's consulting rooms under local anaesthetic in well under an hour — no hospital admission, no general anaesthetic, and you walk out the same day.
Performed by Dr Pieter Marais at Johannesburg Surgical Hospital, Randburg, Johannesburg.
What it involves
Lipoma removal is a straightforward excision. The skin over the lump is numbed with local anaesthetic, a small incision is made directly over it, the lipoma is freed from the surrounding tissue and lifted out whole, and the wound is closed with fine sutures. Sebaceous (epidermoid) cysts are removed the same way, but the whole cyst wall must come out or it will refill. Suspicious moles and skin lesions are excised with a margin and sent for histology.
Lipomas are the most common soft-tissue lump in adults. They are slow-growing, soft, mobile under the fingers and usually painless. They occur most often on the back, shoulders, neck, arms and thighs. They are not cancer and do not turn into cancer — but a rare malignant fat tumour (liposarcoma) can look similar early on, which is why anything deep, fixed, rapidly enlarging or larger than about 5 cm is imaged before it is touched.
Sebaceous cysts (more correctly epidermoid cysts) are the other very common lump. They sit in the skin rather than under it, often have a small central punctum, and can become red, hot and painful if they get infected. An infected cyst is drained first and removed formally a few weeks later once the inflammation has settled — trying to excise a hot, infected cyst leaves a worse scar and a higher chance of it coming back.
The in-rooms procedure itself is quick. You arrive, the area is cleaned and draped, and local anaesthetic is injected — that stings for a few seconds and is the only part most patients feel. From there you feel pressure and movement but no pain. Small lipomas take ten to fifteen minutes; larger ones twenty to thirty. You walk out afterwards, drive yourself home, and go back to work the same day if you want to.
For patients in Randburg, Northcliff, Weltevredenpark, Fairland and the surrounding suburbs, having this done in the rooms at Johannesburg Surgical Hospital is considerably cheaper than a theatre booking — there is no theatre fee, no ward fee and no anaesthetist fee. Very large lipomas, lumps sitting deep to muscle, lesions on the face where the cosmetic result matters most, and anxious or paediatric patients are still better done in theatre, and Dr Marais will say so upfront.
What actually drives the cost is worth understanding before you compare quotes. An in-rooms excision has three components: the specialist consultation, the procedure itself, and the laboratory's histology fee (billed separately by the lab, not by the practice). Size and site move the procedure fee — a 2 cm lipoma on the back is quicker than a 6 cm one over the shoulder blade, and multiple lumps in one sitting are priced together rather than individually. A theatre case adds three further line items: theatre time, the hospital's day-case fee, and the anaesthetist. That is why the same lump can differ several-fold in price depending on where it is removed. Most medical aids reimburse part or all of an in-rooms excision as a specialist procedure; the practice issues a written quote with the relevant procedure codes before booking so you can check it against your plan.
When it's indicated
Have any lump assessed if it is growing, painful, tethered to deeper tissue, hard rather than soft, has appeared quickly, or is discharging. Those features are unusual for a simple lipoma and need to be excluded properly. Otherwise removal is elective — done because the lump bothers you.
The approach
Dr Marais's rule is simple: any lump that comes out goes to the laboratory. Even when it looks and feels like a textbook lipoma, histology confirms it. That is what separates a proper surgical excision from having a lump removed by someone who doesn't send specimens.
Recovery
You go home immediately. Keep the dressing dry for 48 hours, then shower normally. Expect mild aching for two or three days — paracetamol is usually enough. Sutures come out at seven to ten days (or dissolve, depending on the site). Avoid gym and heavy lifting for a week if the lump was over a moving area like the shoulder or back. The scar is a fine line the length of the lump, which fades over six to twelve months.
Lipoma & Skin Lesion Removal FAQ
- How much does lipoma removal cost in Johannesburg?
- Removing a lipoma in the consulting rooms under local anaesthetic costs a fraction of a theatre procedure because there is no theatre, ward or anaesthetist fee. Most medical aids reimburse part or all of it as a specialist procedure, and histology is billed separately by the laboratory. The practice gives you a written quote before booking so there are no surprises.
- Does lipoma removal hurt?
- The only painful part is the local anaesthetic injection, which stings for a few seconds. After that the area is completely numb — you feel pressure and pulling but not pain. Afterwards there is mild aching for two to three days that simple painkillers handle.
- Will a lipoma come back after removal?
- Not if the whole lipoma with its capsule is removed, which is the point of a proper surgical excision rather than liposuction or squeezing. Recurrence at the same site is uncommon. Some people are simply prone to lipomas and grow new ones elsewhere over the years.
- Do lipomas need to be removed?
- No — a lipoma that is not growing and not bothering you can safely be left alone. Removal is recommended when it is enlarging, painful, catching on clothing or a bra strap, restricting movement, cosmetically unacceptable, or when the diagnosis isn't certain.
- Could my lump be something serious?
- The vast majority of soft lumps are benign lipomas or cysts. Features that need urgent assessment are a lump that is hard, fixed to deeper tissue, growing quickly, painful at rest, larger than about 5 cm, or sitting deep to the muscle layer. Those are imaged (ultrasound or MRI) before any surgery. Everything removed is sent for histology regardless.
- What is the difference between a lipoma and a sebaceous cyst?
- A lipoma is a lump of fat sitting under the skin — soft, mobile, painless, with normal skin over it. A sebaceous (epidermoid) cyst sits in the skin itself, moves with the skin, often has a tiny central dot, and can discharge cheesy material or become infected. Both are benign and both are removed as a small in-rooms procedure, but the cyst wall must be removed completely or it refills.
- Can it be done in the rooms or do I need theatre?
- Most lipomas, cysts, moles and skin lumps are done in the rooms under local anaesthetic. Theatre is preferred for very large or deep lipomas, lesions on the face where the cosmetic result is critical, multiple lesions in one sitting, children, and patients who would rather be asleep.
- Will there be a scar?
- Yes — a lump cannot be removed without an incision, and the scar is roughly the length of the lump. It's closed with fine sutures, sits in a skin crease wherever possible, and fades from pink to a pale line over six to twelve months. Keeping it out of the sun and using silicone gel for the first few months improves the final result.
Discuss lipoma & skin lesion removal with Dr Marais
Send a short enquiry and the practice will be in touch during weekday office hours. Consultations take place at Johannesburg Surgical Hospital.
Next procedure
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