After tissue-based “autologous” breast reconstruction, in some rare circumstances, the fat in the flap may not have received enough blood flow. Over a period of time, the fat may be replaced by scar tissue that can feel like a hard lump. The lump might be the size of a pea or it could even be more of a larger and hard mass. Typically, this lump isn’t noticeable until 6-8 months after surgery when the swelling from the tissue flap has subsided. This is known as fat necrosis.
Sometimes smaller regions of fat necrosis can diminish or disappear on their own. However, larger areas of fat necrosis can be uncomfortable and painful causing distortion in the shape or texture of the breast.
What do I do if I am experiencing signs of fat necrosis in the tissue flap?
To properly evaluate a lump that might be fat necrosis, your doctor may suggest you get an imaging scan, such as a high-resolution ultrasound. Fat necrosis lumps are not cancerous, however, it may be hard to distinguish the difference between breast cancer and fat necrosis on a mammogram. In some cases, a biopsy is needed.
What is the treatment of fat necrosis in the tissue flap?
If your doctor confirms that the lump in your breast is fat necrosis – the only option is to have it surgically removed. A plastic surgeon will either cut or suction out the area of fat necrosis using liposuction. A benefit of using liposuction is that it’s less likely to create a divot in the spot where the fat necrosis was removed. However, if the excision of a fat necrosis region leaves a divot in your breast, your plastic surgeon may rearrange the internal tissue to fill it in.
In some cases, your plastic surgeon may recommend fat grafting to help add volume after the fat necrosis is removed. Another option would be to have a minor flap reconstruction to fill in that small area.
Talk to PRMA about your options!
Fat necrosis is most common after tissue-based reconstruction, although, it can also develop after other types of breast surgeries, radiation therapy, or a breast injury.
If you are interested in learning more or want to schedule a consultation please call us at 800-692-5565 or complete our virtual consultation form here.
“To me, this number represents how many strong women I’ve had the pleasure of knowing and hopefully helping in their breast cancer treatment and reconstruction journey,” shares PRMA Plastic Surgeon, Dr. Ramon Garza III.
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