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Does Post-op Fat Necrosis of Breast Tissue Usually Resolve?

I am three months post-op from anchor lift/implants. I had a negative mammogram one month prior to surgery. I now have two areas of probable fat necrosis per ultrasound, one is 7 mm and the other is 2 cm. Breasts came out great and the lumps are not visible, but I can feel them and I am concerned that these two areas will not resolve on their own without intervention.

Is this common? Will it likely resolve? Is there anything that can be done other than excision? I also read about these causing an inflammatory process. Thanks so much.

Doctor Answers 18

Fat necrosis after breast surgery

Fat necrosis is very common after any surgery in fatty tissue - whether after breast lift, liposuction, etc.  Fat necrosis is a condition where bruised fat cells have died and the body's normal reaction (inflammatory process) to remove it is felt as a lump.  It takes time for the body to totally remove it: 3-6 months is not unusual.  In some cases, the lump will form a firm scar, which could be removed surgically if need be.  For the time being, you should follow your surgeon's advice and just give it time.

Austin Plastic Surgeon
5.0 out of 5 stars 6 reviews

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Fat Necrosis following Breast Procedures

It’s not unusual for patients who undergo breast lift or breast reduction surgery to develop areas of fat necrosis. This occurs when globules of breast tissue lose their blood supply and undergo necrosis. This results in lumps and bumps beneath the skin which are well circumscribed.
These lesions are often the source of significant anxiety and for this reason are rigorously investigated. It’s not unusual for patients to undergo ultrasound and mammography to evaluate these lumps.
In the vast majority of patients who have fat necrosis, resolution occurs without surgery. These lesions induce an inflammatory response which results in their dissolution. In some cases massage may be helpful, but even with this maneuver the majority will take 3 to 6 months to resolve.

Does Post-op Fat Necrosis of Breast Tissue Usually Resolve?

Thank you for the question.

Fat necrosis may gradually decrease in size (may even liquefy and drain)  spontaneously. Other times, resection of the unhealthy tissue is necessary. If resection is undertaken it should be done in a conservative fashion avoiding removal of surrounding healthy tissue.

 I hope this helps.

Fat necrosis

Fat necrosis usually resolves on its own especially if it is a small area.  If it does not, they can sometimes be removed.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 18 reviews

Fat necrosis after breast augmentation with lift

Fat necrosis (dead fatty tissue) can develop in breasts after an augmentation and lift.  If these areas become symptomatic (painful) you may consider having your surgeon biopsy or remove the tissue.  If there appears to be changes on your mammogram that are suspicious, you should also have these areas biopsied.  It is not unusual for this to happen after surgery as it is caused by a disruption in the breast's blood supply.

Consult with a board certified plastic surgeon for a complete examination and review of your treatment options.

Best wishes,

Dr. Bruno

William Bruno, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 162 reviews

Fat Necrosis after Augmentation-Lift

Fat necrosis is not unusual after a breast lift procedure and is rarely problematic.

They will likely resolve with time.

Continue to monitor with your surgeon. If they persist longer than a year, you could opt to have your surgeon remove them for you, if there presence disturbs you or you feel they interfere with your breast self-examination.

Paul C. Zwiebel, MD
Denver Plastic Surgeon
4.0 out of 5 stars 14 reviews

Fat necrosis is a risk of any breast lift procedure.

Fat necrosis is a risk of any breast lift procedure and will often become softer with time.  I am glad that you love the appearance of your breasts after surgery.  Give it some more time and see how things are in a year.

Richard H. Fryer, MD
Salt Lake City Plastic Surgeon
5.0 out of 5 stars 121 reviews

Fat Necrosis of Breast Tissue After Surgery

Fat necrosis is uncommon if the breast tissue is handled properly and the breast has good blood supply and adequate tension. If it develops, one needs not worry as most self resolve. A surgeon should keep a close follow up to make sure an infection does not set in as this in compromised tissue. Messaging will help but time is the most important determinant, usually 6 months.

Post-operative fat necrosis is not ideal, but may not be a problem

Small areas of fat necrosis following breast reductions are not uncommon. This can also happen with breast lifts that are performed with the same type of anchor-style incisions. It is possible that these small areas of scarring improve over time, but it is also possible that they remain unchanged. If your breast imaging studies have documented their location and size, and the studies are confident that these areas are fat necrosis, then intervention is neither necessary nor recommended. Fat necrosis, while not ideal, is unlikely to be dangerous unto itself. I would not be concerned about late inflammation- I have not seen this in my practice. As long as your areas of fat necrosis are documented by imaging, you should be fine. My recommendation is to discuss this with your plastic surgeon to get a first hand recommendation for your particular situation.

Lump on breast after breast lift and breast augmentation - plastic surgeon

Fat necrosis is a non-specific sign seen on mammogram that may represent transient post surgical changes.  Your surgeon should keep a close eye on these areas to ensure that they do not represent any cystic or tumorous process.  If it is indeed fat necrosis, it will most likely disappear or turn into fibrosis. 

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 57 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.