36-year-old woman had a 9 x 9.5 cm lipoma of the left chest/underarm area. Local anesthetic was used. The lipoma was removed through a #11 puncture wound, power-assisted liposuction to soften and debulk, followed by removal with surgical dissection and extraction under direct vision. Complete removal was confirmed. A drain was placed for one week. The patient is seen two weeks after the procedure. There has been no recurrence in two years.