If i want to be seen for a lipoma on right upper arm that i think is growing were do i go what's the first step to take?

Start with reg doc: Just start with your regular doc. Depending on the size and location of the lipoma, it should be fairly straightforward to remove. They will likely set you up with a surgeon to have it further evaluated and removed.

Primary md: Depending on insurance plan whether you need referrals to specialists you can first see primary md, and he will refer you to dermatologist or surgeon for removal.

Referral: Depending on your insurance… You may need to see your family doctor for a referral to a surgeon. Sometimes you can see a general surgeon directly.