Mr. Onur Gilleard
Qualifications & Experience
Mr Onur Gilleard is a distinguished consultant plastic surgeon on the GMC specialist register. He previously held an NHS consultant post at St Bartholomew’s Hospital in London, specialising in skin cancer and microsurgical reconstruction. In 2021, Mr Gilleard transitioned from the NHS to dedicate himself fully to private practice, allowing him to focus exclusively on providing personalised, high-quality care to his patients. He is recognised as an expert in laser treatments, having conducted research and developed advanced treatment protocols using cutting-edge laser technology to optimise both clinical outcomes and cosmetic results.
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The Short Version
- The short answer: there is no non-surgical treatment with good evidence that reliably removes a lipoma.
- Why: a lipoma is a solid growth of fat tissue inside a capsule, not a pocket of fluid. There is nothing to drain and nothing that dissolves it predictably.
- Steroid injection, fat-dissolving injections, HIFU, radiofrequency ablation, laser lipolysis and topical creams are all offered online. None of them is used at this clinic, and none has evidence behind it for this lesion.
- Liposuction is the one non-excision option with a genuine, narrow role — and it leaves the capsule behind, which is why recurrence after it is common.
- Leaving it alone is a real option. A small, stable, painless lipoma often needs nothing done to it at all.
- What changes that: growth over weeks to months, size above 5 cm, depth below the fascia, an unusually firm or fixed lump, or pain without another explanation.
The Honest Answer, First
Most people who search for a way to remove a lipoma without surgery are hoping for an injection, a cream or a device that makes it go away. It is worth stating plainly what a consultant plastic surgeon who removes three to five hundred of these a year will tell you in the room.
At present, there is no non-surgical treatment with good evidence that reliably removes a lipoma. If it is causing symptoms, growing, or bothering you cosmetically, surgical excision remains the most predictable and effective treatment.Mr Onur Gilleard, Consultant Plastic Surgeon
That is not a sales position. The rest of this page explains why it is true, what each of the advertised alternatives actually does, and the one alternative that is genuinely worth considering — which is doing nothing.
Why a Lipoma Cannot Be Dissolved or Drained
This is where most of the confusion starts. A lipoma is frequently described online as a fatty lump, which makes it sound like something soft that could be broken down or drawn out with a needle. It is not.
A lipoma is a solid accumulation of fat tissue, not a fluid-filled sac. Draining it does not remove it. What has to come out is the fat tissue itself and its capsule — the thin membrane that surrounds it and separates it from the tissue around it.
The capsule is the reason every incomplete method fails in the same way:
If the lipoma is removed but part of the capsule is left behind, there is a greater chance that residual lipoma tissue remains within or attached to that capsule. Those remaining cells can slowly proliferate, leading to what appears to be a recurrence. In many cases, this is technically persistent residual tumour rather than a completely new lipoma.Mr Onur Gilleard
That single mechanism explains the numbers. After complete excision with the capsule, recurrence at this clinic runs at under 1%. After liposuction, which cannot take the capsule, published recurrence sits at 30–50%.
What Gets Offered Online, and Where Each One Falls Down
Each of the following appears in search results as a lipoma treatment. We asked Mr Gilleard directly whether any of them has a role, and whether the clinic offers any of them. The answer was no in every case.
| Advertised as | Offered here | The problem with it |
|---|---|---|
| Steroid injection | No | Not used, and there is no convincing evidence it works. Claims that it shrinks a lipoma by a set percentage are not traceable to a reliable source. |
| Fat-dissolving injections (deoxycholic acid, phosphatidylcholine) | No | Designed to break down loose fat cells. A lipoma is an organised growth inside a capsule, which is a different problem. |
| HIFU (high-intensity focused ultrasound) | No | No established role in lipoma. |
| Radiofrequency ablation | No | No established role in lipoma. |
| Laser lipolysis | No | No established role in lipoma. |
| Creams and topical treatments | No | Nothing applied to the skin surface reaches a growth sitting in the subcutaneous layer beneath it. |
Two problems run through all of them. None removes the capsule, so anything that appears to work tends to be temporary. And none produces a specimen, which matters more than it sounds: at this clinic every lipoma that is removed goes for histopathological examination, to confirm the diagnosis rather than assume it. A treatment that destroys or shrinks a lump without leaving anything to examine also removes your chance of finding out what it actually was.
That is rarely a problem. It is occasionally the whole point — something other than a simple lipoma turns up about once every five years here.
Liposuction: The One Real Alternative, and Its Limits
Liposuction is the only non-excision technique with a genuine role, and it is a narrow one. It is used here one to three times a year, essentially only for diffuse lipomas on the back where the patient particularly wants to avoid a longer scar, and it is used to reduce bulk rather than to cure.
Liposuction for lipomas can sound very appealing because the scar is smaller. But the reality is it doesn’t work well. You can’t remove the lipoma completely, particularly the capsule, so the chance some of the lipoma remains or the lipoma comes back is high. For most lipomas, I recommend a small surgical excision through a carefully placed incision. This gives the best chance of complete removal, allows the tissue to be examined if needed, and usually leaves a fine scar that fades well over time.Mr Onur Gilleard
The scar argument is also weaker than people assume. Fat tissue delivers through an opening smaller than the width of the lump, so an excision scar is usually shorter than the lipoma is wide. The trade is not “big scar versus no scar”. It is a fine line that fades, against a smaller entry point with a materially higher chance of the lump returning and no tissue sent to the laboratory.
The Alternative That Is Actually Worth Considering
If you came to this page looking for a way to avoid an operation, this is the section that matters.
Asked directly whether lipomas are over-treated, Mr Gilleard’s answer was yes. A lipoma that is small, stable, painless and not bothering anyone often needs no treatment at all. Surgery is a balance between the benefit of removing something and the fact that every operation creates a scar. Where the lump is not causing a problem, that balance frequently favours leaving it.
In practice, people have lipomas removed for two reasons: the lump is uncomfortable, or they do not like how it looks. Both are legitimate. Neither is compulsory. If a lipoma has sat unchanged on your forearm for six years and you only notice it when someone else does, watching it is a reasonable, considered decision rather than a failure to act.
It is also worth knowing that if your GP has told you the NHS will not remove it, your GP is right. Lipomas are not routinely removed on the NHS without clear functional symptoms. That is a funding threshold, not a comment on whether yours matters.
When Watching It Is Not the Right Answer
Leaving a lipoma alone is only reasonable once someone has established that it is a lipoma. These are the features that move a lump from “watch it” to “have it looked at properly”, and any one of them is enough:
- Larger than about 5 cm
- Sitting deep to the fascia, or with edges that are not clearly definable on examination
- Growing over weeks to months rather than staying the same for years
- Firm, irregular or fixed rather than soft and mobile
- Persistent pain with no other explanation
- Any diagnostic uncertainty at the time of examination
If a lump is large, deep, growing quickly, unusually firm I investigate it with imaging before considering surgery.Mr Onur Gilleard
Where imaging is indicated, ultrasound is the first test and is done in-house at 101 Harley Street, often on the same day. MRI is preferred where the lesion is deep, large, or where the ultrasound is inconclusive.
What the Operation Actually Involves
Because “surgery” sounds heavier than it usually is: a straightforward lipoma excision takes around 45 minutes under local anaesthetic. You are awake, you feel pressure rather than pain, and you walk out afterwards.
The lipoma is removed with its capsule through an incision placed to sit as discreetly as possible, the specimen goes to the laboratory, and the wound is closed with sutures — out at five to seven days on the face, ten to fourteen on the trunk, twelve to fourteen on the lower leg. Most people return to light daily activity within 24 to 48 hours and hold off strenuous exercise for two weeks.
Full detail on cost, sites and what is included is on the lipoma removal page. If you are still deciding whether to do anything at all, the wider guide to lipomas covers when removal is worth it, and how size changes the operation covers the larger end.
Frequently Asked Questions
Can a lipoma be dissolved with an injection?
No. Fat-dissolving injections such as deoxycholic acid are designed to break down loose fat cells, whereas a lipoma is an organised growth of fat tissue held inside a capsule. This clinic does not use injections of any kind to treat lipomas, and there is no good evidence that any of them reliably removes one.
Do steroid injections shrink a lipoma?
Steroid injection is not used for lipomas here, and there is no convincing evidence that it works. Figures circulating online claiming a specific percentage of shrinkage are not traceable to a reliable source, which is why no such number appears on this page.
Is there a cream that removes a lipoma?
No. A lipoma sits in the subcutaneous layer beneath the skin, and nothing applied to the skin surface reaches it. Topical treatments are not offered for lipomas at this clinic.
Can you just drain a lipoma with a needle?
No. A lipoma is a solid accumulation of fat tissue rather than a fluid-filled sac, so there is nothing to drain. The fat tissue and the capsule around it have to be removed for the lump to go.
Is liposuction less invasive than having a lipoma cut out?
The entry point is smaller, but it does not remove the capsule, so a significant proportion of lipomas treated this way come back. It is used here only occasionally, mainly for diffuse lipomas on the back. An excision scar is usually shorter than the lipoma is wide, so the difference is smaller than most people expect.
Will a lipoma go away on its own if I leave it?
It is unlikely to disappear, but many lipomas stay much the same size for years. If yours is small, soft, mobile and painless, leaving it alone is a reasonable choice. What matters is that it has been examined once, so that you are watching something known rather than something assumed.
Will the NHS offer me a non-surgical option instead?
No. The NHS does not routinely remove lipomas without clear functional symptoms, and there is no non-surgical treatment for it to offer in place of that. Removal for comfort or appearance is normally self-funded.
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