Breast augmentation after fat transfer - could necrotic tissue be removed? (Photos)

Question

Hello, I had a breast fat transfer at 20 years old to help fix my tuberous breasts and the plastic surgeon also cut some of the constricted tissue to improve the shape. l was reasonably happy afterwards but knew it might take 2 rounds to have my ideal breasts around the one year mark I noticed a hard lump that has since been diagnosed by breast ultrasound as fat necrosis likely due to my surgery so that has completely changed my plans. I will not be getting another fat transfer but my questions are if I go the breast implant route will a surgeon be willing to remove the necrotic tissue at the same time he gives me implants? This is a large, noticeable lump. It has been almost 4 years since surgery but I am now single and have lost about 30 pounds that I had gained after surgery so it’s more bothersome now. Also, I have a stomach tattoo that complicates things. If i get breast implants without a lift will my stomach tattoo end up on my breasts? Do I need a lift?

Harry T. Haramis, MD, FACS · Answer

In my experience, breast augmentation after fat transfer (and vice versa) is common.

Depending on where the hardened tissue is, it may be removable from underneath, during breast augmentation.

Abdominal tattoo should remain separate below the breasts.

An exam and consultation with a plastic surgeon is recommended to confirm this as well as discuss your options and expectations.

Daniel Barrett, MD · Answer

Dear Maryanned22,

it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Gerald Minniti, MD, FACS · Answer

The fat grafts help enlarge your breasts to the point where you can now safely do a breast lift, which I believe would be requisite if you were to go forward with implants. If the fat necrosis is cystic, it can be managed non-surgically with a simple needle aspiration. If it is solid, then the best way to remove it is via a breast lift. If you don’t want a lift, get another round of fat grafting.

Connie Hiers, MD, FACS · Answer

The lift will not change your tattoo, and the area of fat necrosis can probably be removed when implants are inserted.  You did not say exactly where this fat necrosis is, so an examination is needed to be certain of how much could be removed safely.

Camille Cash, MD · Answer

Depending on the location of the fat necrosis it should be able to be addressed during a lift.  If you are only considering augmentation it may or may not be feasible to have it removed.  Neither procedure should bring the position of your tattoo onto the breasts.  See a board certified plastic surgeon near you to learn more.

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