Xanthoma Removal Surgery

A little behind on this post: at the end of October, I had a xanthoma (or it could have been a lipoma, or a fat deposit - the jury is still out on what exactly they wanted to call it) removed from under my left eye. This was the fourth fat deposit that I have had removed or treated in my 48 years. They are pesky things that show up on various parts of your body if you live with high cholesterol. They show up small, in the beginning, and if left alone they grow sometimes to a painful or an esthetically displeasing size. 

I had one removed from the tendon in my right elbow when I was in my early 20’s, a xanthoma removed from my eye lid in my mid-20’s, a large (bigger than a golf-ball) fat deposit removed from my neck a couple of years ago, and now this last deposit from under my left eye. The surgeon called it “a mobile orbital mass, firmer but consistent with orbital fat” in his post-op notes. Regardless of what you call it, the surgery to remove it might be similar to what happened here.

I am usually nervous about any procedure that puts me under general anesthesia because I just never know how my heart will behave during the drug-induced “nap”. This time, it didn’t help that the anesthesiologist did not agree with the surgeon on what type of anesthesia I should be under: the anesthesiologist wanted a light anesthesia, where I am coherent and talking back but not remember much and the surgeon wanted me “completely out”. The surgeon won, eventually, and I agreed with him (general anesthesia is usually my least favorite kind), considering how he went in to get this fat deposit: he had to make an incision behind my cheek’s skin, in my internal lower lid. He recommended general anesthesia so I would not move during the procedure and cause any other complications. And I agreed, although I am sure I didn’t have much choice if I wanted the surgery. 

I had a black eye for a couple of weeks and I still feel some firmness in that area, possibly from the scar tissue, but the visible bump is gone from my face, so I consider this a success. The deposit he pulled out was small compared to the ones I have had removed in the past - the one I had removed from my eye lid of the same eye when I was younger was probably the smallest. This year’s “fat mass” was actually made up of two pieces measuring 0.8 x 0.7 x 0.4 cm and 1 x 0.5 x 0.4 cm, so anywhere between half and one full centimeter each. 

I originally went to a dermatologist for this growth but he would not touch it because it was too close to my eye, so he sent me to an ophthalmologist. I tried to make an appointment directly with an oculoplastic surgeon, but the clinic would not have it. They said I need to see a regular ophthalmologist first and let them decide if I need a surgeon. I told them it’s useless and pleaded to please let me skip a useless step and make the appointment (in the same clinic) with the right specialist, but they would not budge! 

So, I went to a regular ophthalmologist who decided my vision was just fine and who ended up referring me to their coworker who is an oculoplastics surgeon who finally performed the procedure. I tell you, the mystery and the maze of the medical world never ceases to surprise and bewilder me ... 

Here are the before and after pictures and if you can’t really tell where the bump was (under my left eye in the picture to the left) you’re not alone. It was not very visible but it was palpable and I knew it would only grow bigger, having had the experience of at least two other ones that got enormous and prevented function in either my elbow or my neck. To prevent scarring too badly when it ended up being much larger, I decided to take care of it now. The surgeon agreed.

In the first picture, you can see it under my eye, closer to my nose. Click the picture for a larger view.

Just another procedure that us, FH folks, might have to tackle. 

Much health, all!