Do fat cells die after a year of the fat transfer to the breast?

Question

I have lumps different in sizes on my breast. One of them is very close to the surface that makes it look red. i felt that one first which made me look for others. And i found 3 to 4 like that in each breast. I dont know how long they have been there. Im hoping its just dead fat and not something else. Its been a year since sx. Can the fat die now? I would appreciate an answer. Each about 2 cm maybe.

Kenneth Hughes, MD · Answer

Cysts, lumps, necrosis, failure of the graft, and microcalcifications are the enumerated risks. Fat necrosis is more common in women with very large breasts. I am not sure that the data has been collected on rate of calcification, and then the issue becomes whether that is clinically significant. The calcification lumps are usually not an issue. It is reasonable to expect lumps to improve or soften with time. This process may take several months. Fat necrosis and oil cysts usually don’t need to be treated. Sometimes fat necrosis goes away on its own. If a needle aspiration is done to remove the fluid in an oil cyst, it can also serve as treatment.

Alan Gonzalez, MD, FACS · Answer

Hello @Optimistic529715 thank you for your question. The only way to determine what the lumps are that you are feeling is to have a MRI and to visit a mastologist to determine what the lumps are. This is due to the fact that he or she is able to accurately describe what's going on in your breasts. Best wishes! Alan Gonzalez MD, FACS.

Daniel Barrett, MD · Answer

Dear Optimistic529715,
fat viability depends a lot of surgeon technique. The fat has to be placed back into the buttocks as soon as possible so that it has a greater chance of survival. It has to be placed carefully so that not too much fat is placed in only one area.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

I would suggest getting an ultrasound and possible mammogram to check each lump. You may have some fat necrosis from the transfer, but it is best to check to make sure it is not something else.  Usually most of the fat necrosis occurs early in the first 6 months.

Mats Hagstrom, MD (license on probation) · Answer

In order for grafted tissue to remain viable or alive it needs to go through a revascularization process that typically happens within the first couple of weeks after surgery. After that point any fat that does not have a blood supply is dead and will continue along the course of necrotic tissue and the fat cells that are alive will continue to strengthen their blood supply and become permanently incorporated in the body in their new location. Small areas of necrotic fat will be absorbed without clinical significance and will not leave lumps. large collections of necrotic fat will create enough inflammation and scar tissue to become palpable lumps. The absence of having lumps after fat transfer procedure is technically dependent. if grafted fat is properly stratified through the host tissue in various layers without leaving a significant amount of grafted fat in a single location the patient will not develop palpable nodules or noticeable fat necrosis.
In order for fat to survive it needs to be surrounded by live vascular tissue and for this reason surgeons need to avoid overgrafting in any one specific area. 
If probable fat necrosis nodules are present patients can either have them surgically excised or simply live with them. patients who are of age of having mammograms should get mammograms and expect mammogram readings to be changed because of the fat transfer procedure.
Fat necrosis evolves over time depending on how much fat the body is trying to absorb.
I suggest you follow up with your provider and have him or her assess your outcome and discuss your current situation.
Best,
Mats Hagstrom MD

Do fat cells die after a year of the fat transfer to the breast?

Answers (5)