Seven Surfers Grew Matching Fatty Lumps Right Where Their Boards Press Into Their Chests

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A team of California dermatologists gave the growths a name, liposurfomas, after documenting them in seven surfers.

The condition is getting fresh attention after SurferToday revisited the case series on Oct. 8. The research itself is not new. It appeared in 2024 in JAAD Case Reports, an open-access journal of the American Academy of Dermatology. The name is a play on lipoma, the familiar fatty lump that sits under the skin, and the cases suggest that a single repeated posture can leave a visible mark on the body.

The report was written by Paytra A. Klein, Dr. Ronald J. Barr, Dr. Natasha A. Mesinkovska and Dr. Jeffrey A. Klein. Mesinkovska is vice chair of clinical research in the UC Irvine Department of Dermatology, and Barr is a professor emeritus of dermatology at UC Irvine. Jeffrey Klein, a dermatologist in San Juan Capistrano, California, is credited with inventing tumescent local anesthesia, a numbing method now widely used in liposuction.

Every patient had growths on both sides of the body, on the lower chest and upper abdomen near the ribs, rather than a single lump on one side. The patients whose ages were reported ranged from 41 to 55, and at least three were men. SurferToday describes the condition in long-term shortboard surfers, who paddle lying flat on their stomachs.

The masses could be large. One 55-year-old man had two mobile growths, each about 10 by 12 centimeters. A firmer nodule, about 2 by 3 centimeters, inside the growth on his right side became tender during and after surfing and eased after a week out of the water. Doctors biopsied it and found dense fibrous tissue and collagen with trapped islands of fat, and no significant inflammation. The authors classify the growths as fibrolipomas, benign lumps that mix fat with fibrous tissue.

The authors proposed that the growths result from “chronic repetitive low-intensity trauma” caused by prone paddling. With every stroke, the board presses into the same area of the lower chest. Over years, that steady pressure and friction may prompt the body to build up extra fatty and fibrous tissue.

That explanation is an inference drawn from the pattern of cases, not something the report proved. A series of seven patients cannot establish cause and effect, and there was no comparison group of surfers without the growths. Still, the matching placement on both sides of the body fits the idea of a mechanical cause.

Ordinary lipomas are a different matter. The National Library of Medicine’s MedlinePlus describes a lipoma as a noncancerous growth of fat cells that usually grows slowly and feels soft and movable under the skin. What sets liposurfomas apart is their location, their symmetry, and the shared sporting history of the people who had them.

Surfers have long been known to develop another pressure-related lump called a surfer’s knot. According to SurferToday, these typically form on the knees, feet, and toes of surfers who kneel to paddle, but case reports show they can appear on the chest as well.

A 2019 report in Clinical Case Reports described a 43-year-old man who had surfed for about 20 years and developed painful lumps on both sides of his lower front chest, with pain while surfing. MRI showed nodules rich in fibrous tissue, and doctors made the diagnosis based on the imaging and his surfing history. A 2022 case in Archivos de Bronconeumología involved a 34-year-old man who had surfed for more than a decade and had masses over the lower ribs on both sides, worse on the right. After the right-sided mass was removed, the tissue showed fibroblast growth and collagen deposits.

Both reports note that most surfer’s knots improve or disappear once a person stops surfing. Liposurfomas, by contrast, contain a substantial amount of fat bound up in fibrous tissue. SurferToday reports that they may shrink during long breaks from the water, yet several of the patients in the series were bothered enough to seek removal.

Of the seven surfers, three had the growths surgically removed, two had tumescent liposuction, and two declined treatment. The dense fibrous tissue made liposuction more difficult than typical fat removal.

A 44-year-old man saw about a 50% improvement after his first liposuction. He kept surfing, the growths grew slightly over the next 12 months, and a second procedure produced a better result. In a 41-year-old man, a photo taken 10 weeks after liposuction showed the growths had become smaller. The two patients who declined treatment did so partly because the growths could return if they kept shortboarding. Padding, wetsuits and less time in the water were raised as ways to reduce pressure on the area.

The authors described the long-term outlook as appearing benign, but malignant change has not been ruled out. No one knows how many surfers have these growths, and the condition is likely under-recognized.

Anyone who notices a new, growing, painful, or hard lump should have it checked by a clinician, since many different conditions can cause chest wall masses. A diagnosis of liposurfoma depends on a medical exam and, in some cases, imaging or a biopsy.

It is a name proposed in 2024 for benign fibrolipomas, growths of fat and fibrous tissue, found on both sides of the lower chest and upper abdomen in seven surfers.

Why do doctors think surfing is involved?

The lumps sat where the board presses during prone paddling, and all the patients were surfers. The link is suspected, not proven.

The authors described the long-term outlook as appearing benign, but malignant change has not been ruled out. Any new or changing lump deserves a medical evaluation.

How are they different from surfer’s knots?

Surfer’s knots are mostly fibrous nodules that usually improve after a person stops surfing. Liposurfomas contain substantial fat mixed with fibrous tissue.

Yes. Surgical removal and liposuction have both been used, though fibrous tissue makes liposuction harder, and the growths may return with continued shortboarding.