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DEAR DR. ROACH: I have a large lipoma. I read that liposuction is an easy way to remove them. Is this true? — N.E.

ANSWER: A lipoma is a benign fatty tumor. They’re very common and usually removed only if cosmetically important. They can become so, especially when they get large.

The standard treatment is open surgical removal. Liposuction has been used successfully for the treatment of larger lipomas, but a recently published research paper maintains that further investigation is required before liposuction becomes an accepted option. I have seen occasional cases of lipomas that have required more extensive surgery than my patients were expecting, so a less-invasive option would be welcome.

Liposuction has been used routinely for treatment of gynecomastia (enlarged breast tissue) in men.

DEAR DR. ROACH: I am a 69-year-old female with a few minor varicose veins. They don’t cause any symptoms; they’re just a little unsightly. My dermatologist offered to treat them, but I wonder if I should be seeing a vein specialist instead. Your thoughts? — C.H.

ANSWER: Cosmetic treatment of varicose veins can be done by a dermatologist, a vascular surgeon or other professional. There are several different procedures that can be effective. If your dermatologist is experienced, I think that would be fine, but a vein specialist is more likely to be experienced in multiple techniques. Without symptoms, there is no reason besides cosmetics to treat them. Symptomatic varicose vein treatment is normally covered by insurance, but asymptomatic treatment usually is not.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to or send mail to 628 Virginia Dr., Orlando, FL 32803.

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