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

Question

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.

Richard J. Bruneteau, MD · Answer

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.

William Bruno, MD · Answer

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

Richard H. Fryer, MD · Answer

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.

Raffy Karamanoukian, MD, FACS · Answer

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.

Vincent N. Zubowicz, MD · Answer

Fat necrosis after breast lift or reduction is occasionally seen. It, by itself, is no a health problem but a lump in a woman's breast is always a source of concern. Almost always the lump will gradually dissolve, usually over several months. If a lump persists, most patients would want it removed. This can usually be done with local anesthesia. It is seldom required.

Otto Joseph Placik, MD · Answer

Fat necrosis in the breast is extremely common and occurs in the absence of surgery as well. Generally, in the absence of an open wound, no intervention is advised for a minimum of 6 months. Typically we advise patients to wait at least 6 months after breast surgery before imaging the breast. In some instances, the areas of fat necrosis resolve and in others they persist. We generally do not treat these unless they are causing a particular problem or have a questionable appearance on mammogram.

Tom J. Pousti, MD · Answer

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.

Steven Wallach, MD · Answer

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

Adam David Lowenstein, MD, FACS · Answer

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.

Pat Pazmino, MD, FACS · Answer

The combination of a breast lift with implants can add volume to breasts and change the shape and position of the breasts in one setting. One known complication is fat necrosis in the breast tissue. This may present as a firm mass or can also present as redness and possible drainage from the incision. If it is a small area of fat necrosis, your body will break down this tissue and it will resolve. If it is a large area, you may best be served by a small operation which would consist of removing the dead tissue and rearranging the remaining part of your tissue into an aesthetic result. This may be a collocated surgery. Be sure that you're working with a board-certified plastic surgeon was great till of experience and breast augmentation and breast lift.

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Does Post-op Fat Necrosis of Breast Tissue Usually Resolve?

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