Why Do I Still Feel Tenderness (Extreme), Aching, Pain & Hardness 11 Weeks Post-op?

I still have fairly strong pain & tenderness 11 weeks after reduction/lift from 34E-F to a C. I had compromised blood flow w/ nipple wounds that are almost resolved. My right breast especially feels hard, painful & very uncomfortable, like there is a large ball stuck in in. PS says it will resolve w/ time (1 year+), calls it "fat thickening" and won't tell me more. Reading on the Internet, it sounds like fat necrosis(?) If so, can it cause pain & discomfort like this & for how long??!! :(

Doctor Answers 3

Hardness at 11 Weeks after Breast Reduction

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   Hardness 11 weeks after breast reduction could be fat necrosis.   Given your areolar compromise this is more likely.  You may need additional resection of that area in the future, but waiting may not be a bad idea for now.  Kenneth Hughes, MD Los Angeles, CA

Prolonged breast pain after reduction

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Without benefit of exam, and based on your history, it sounds like you indeed have fat necrosis.  It is hard to say if it will or will not resolve on its own.  The pain/tenderness should go away, except if the lump is in an area that contacts a bra or something etc.

If the mass does not resolve, the question is what to do with it, and when.  Generally, the longer the better, within reason.  Usually around the 1 year mark.  The blood supply must be good and you must be healthy.

On the other hand, be sure that your tenderness is not due to infection, so be sure to keep in touch with your ps.

Fat necrosis

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It sounds like fat necrosis.  It will improve with time but if it is golf ball sized or larger it will get better but it will likely not resolve completely.  I would encourage you to wait for several months to see how much it improves unless the pain is unbearable.  Delaying going back for another operation will give it a chance to resolve on its own which may occur and if not will make it easier to to determine what needs to be removed at the next operation. 

Jeffrey Thaxton, MD
Charleston Plastic Surgeon

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