Why has it bulged again after removing the lipoma?

Swelling or bulging after lipoma removal may be caused by normal postoperative tissue edema, scar hyperplasia during wound healing, local hematoma formation, wound infection, residual lipoma tissue, or subcutaneous fluid accumulation. If any abnormalities occur, prompt medical consultation is recommended. Specific causes are analyzed as follows:

1. Postoperative tissue edema: Surgical trauma stimulates local blood vessel dilation and increased exudation of tissue fluid, leading to swelling at the surgical site. Apply ice packs within the first 48 hours to reduce fluid leakage; switch to warm compresses after 48 hours to promote resolution of swelling. Keep the wound clean and avoid pressure or squeezing.

2. Scar hyperplasia during wound healing: Excessive proliferation of fibrous tissue during the healing process can form a raised scar, causing localized bulging. Application of silicone gel may help suppress scar formation. Avoid scratching or irritating the area; laser therapy may be used when necessary to soften the scar.

3. Local hematoma formation: Incomplete hemostasis during surgery leads to blood accumulation under the skin, presenting as a firm, raised lump, possibly accompanied by distension and pain. Small hematomas can be managed with oral Yunnan Baiyao Capsules or Huoxue Zhitong Capsules as directed by a physician to promote absorption. Larger hematomas may require needle aspiration and drainage, along with cefuroxime axetil tablets to prevent infection.

4. Wound infection: Poor postoperative care may allow bacterial invasion, triggering an inflammatory response characterized by redness, swelling, pain, and fever. In severe cases, purulent discharge may occur. Antibiotic treatment under medical supervision—such as amoxicillin-clavulanate potassium tablets, levofloxacin tablets, or metronidazole tablets—is required. Additionally, the wound should be cleaned and dressed regularly to keep it dry.

5. Residual lipoma: Incomplete removal of lipoma tissue during surgery may leave behind portions that continue to grow, resulting in a soft, painless bulge. Ultrasound examination is needed to confirm residual tissue. Reoperation for complete excision may be necessary, followed by pathological examination to confirm the nature of the tissue.

In daily life, maintain cleanliness and dryness of the wound after surgery, and avoid strenuous activity or friction on the surgical area. Follow a light diet and minimize intake of spicy or irritating foods to promote wound healing. Seek immediate medical attention if the swollen area continues to enlarge, pain worsens, or fever develops, to prevent delayed diagnosis and treatment.