What caused discoloration after fat transfer & how can I help it? (Photo)

Question

I had an explant with simultaneous fat transfer to the breast about 7 months ago. This discoloration appeared shortly after the surgery and has never gone away. The discoloration was on both breasts at first and the area was firm. After a while the texture became soft again and the discoloration went away on the right breast but the left one is still discolored. Does anyone know what caused this or how I can help it??

Brian Bassiri-Tehrani, MD · Answer

This is a good question. What you are describing is likely bruise that eventually remained pigmentated in your skin. Sometimes this eventually goes away. Things like topical arnica can help with this. If no improvement is seen after a longer period of time, light or laser therapy can help with the pigment, depending on your skin type.

John LoMonaco, MD, FACS · Answer

I've had this occur in my own patients, and it is most likely hemosiderin staining, which is a product of old blood from surgery being absorbed.

Topical creams and gels can help prevent darkening over time, but in some cases may not remove the entire discoloration.

Laser treatments can also help. You may need several sessions session depending on how dark the stains are. Laser therapy may significantly improve the appearance but still may not remove the darkening 100%.

Bryan Curtis, MD · Answer

Discoloration after fat transfer can be due to various factors, including bruising and swelling. To help minimize it, try applying cold compresses in the initial days and warm compresses later on. Avoiding sun exposure and following post-operative care instructions from your surgeon are crucial. If concerns persist, consult your surgeon for guidance.

Connie Hiers, MD, FACS · Answer

The discoloration is probably the pigment from red blood cells that was released in that area from all the trauma of surgery. It may yet still improve. Laser treatments for vascular issues might be helpful.

Mats Hagstrom, MD (license on probation) · Answer

I’m guessing the discoloration is based on inflammation from fat necrosis which in turn was probably due to grafting technique. 
Prolonged inflation can cause discoloration esp in individuals who are prone to hyperpigmentation. The other explanation could be hemosiderin deposits if there was a lot of blood in the grafted fat or if there was bleeding from the procedure.
Delivering consistent quality liposuction and fat transfer results is more difficult than most people realize. The number of plastic surgeons who actually mastered this procedure, or in the minority.
Provider selection is very important and is one of the most important variables in getting consistent quality outcomes.
At this point your best bet is to be patient and give yourself plenty of time. Love, Liposuction, and the fat transfer results are final by six months. For individuals who have a discoloration issue with the results may continue to change and evolve for quite a bit longer.
You might experience continued improvement for another year.I suggest getting baseline pictures and taking new photographs every three months to document if you’re getting progress.
Having fat transfer in conjunction with explantation is not always ideal.
One of the biggest problems is that patients have no reference for fat transfer results.
Without having baseline pictures of what your breast look like without implants it’s hard to appreciate fat transfer results.
Continue following up with your provider or schedule in person. Second opinion consultations if you feel like you’re not getting the care you need.
My best guess is your provider grafted too much fat in a single area, and this caused excessive fat necrosis leading to prolonged inflammation, which caused your skin to react with hyper pigmentation.
Best,
Mats Hagstrom, MD

What caused discoloration after fat transfer & how can I help it? (Photo)

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