Fat necrosis - does this require surgery to fix?

Dear tbrunette93,
fat necrosis is a possible complication of fat transfer. In case of larger necrosis, It shouldbe removed to prevent further complications. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Fat necrosis is transferred fat that has failed to fully integrate and to the subcutaneous fatty tissue and become hard due to a lack of blood supply. It can be removed and replaced with a fresh fat, transfer to prevent a depression or contour irregularity.

Fat necrosis means that fat tissue died and it is replaced with scar. If area of fat necrosis is close to the skin it clinically manifests as a dent. The only way to correct is to use filler (if area is small) or a fat grafts. Hope this helps.