fat necrosis

fat necrosis

fat necrosis Has anyone had fat necrosis following a recon? I had diep in April. There is a hard purply area that I was worried about, when I saw the PS consultant last week he said it was fat necrosis. He didn’t seem particularly worried about it, just told me to keep massaging scars and surrounding area. I don’t see him again now until Sept to finalise lift and reduction on the other side etc.

Does anyone know whether fat necrosis needs treatment or can it be left? At the moment it is leaving a hard ridge on the top of the recon at the cleavage area and is a bit mis-shapen. Is it likely to settle down anymore or will it need further surgery? Cannot seem to find out much about it on the web anywhere.


Hi serenity05,

I had necrosis If your PS has not given you appointment until Sept I would think he is not worried and would follow his advice about massage. If you have any worries before this date I would advise talking to breast care nurse.
My necrosis meant my PS saw me every week but it was bad. So follow the advice of PS and nurse as they will know you and everyone in your care will want the best for you.

I don’t know if you have been advised about anything to rub in, but my PS suggested Bio Oii available at Boots or on line. However, check first they do not mind being rung.

Big Hugs and I hope your feeling better and necrosis settles down

Treakle xxx

Hi Serenity I am now two years post tram flap. An area of fat necrosis appeared very quickly after the op. It was on the side of the recon just under the arm. when I asked my surgeon about corrective surgery he told me to be patient and that reconstructions keep improving up to two years after the surgery. I didn’t believe him at the time but I do now! The shape of the reconstruction has softened and rounded and perfectly matches the reduced breast on the other side. The necrosis is still there but now seem to be deep within the breast - a hard lump on examination. The only problem now is junior doctors thinking it might be a recurrence! The oncology registrar send me for ultrasound six months ago - just to check it was nothing untoward - it wasn’t!

Wishing you all the very best


Thank you ladies Glad there’s nothing major to worry about, I’ll keep an eye on it though. The worst thing is that it’s right on the area that’s going to be the cleavage and it’s a bit of a weird shape at the moment, but everyone keeps telling me that it’s early days - guess I’ll just have to be patient. Mine is not actually on the new recon tissue, it’s on the bit above where the mast scar was so that part had rads on it 18 months ago - maybe that’s why it’s gone a bit peculiar?

Just have to wait and see I suppose.

Best wishes


Hi Serenity

I think you may have answered a problem I have had. I found a hard ridge at the top of my recon in February, I also had a DIEP but in July last year. I panicked and saw the breast surgeon who said it was nothing and I asked my PS when I went to have a nipple adjustment and he said the recon was fine. He said I could feel the edge of the recon against my ribs but as I can only feel it in that area I wondered why. I’ll ask him next time I see him if it is fat necrosis.


Fat necrosis seems to be quite common, but as you said some doctors think it is a lump and possibly suspicious. I know today my onc told me that the 'lump" he had just removed from new recon breast, which he thought suspicious is just fat necrosis. In fact this is a reason my PS has said he does not like using lipo as the fat often gets reabsorbed and becomes a hard lump resembling a cancerous lump. It may be his excuse who knows for not wanting me to have this done.

Mrs T x

Hi Ladies

I’m a bit late on this thread, but I haven’t spotted this one before.

I too have fat necrosis following a Tram Flap in late 2005. It’s right on the edge of the Tram beside the breast bone which makes wearing a seat belt particularly painful so I have to have a thin cushion between me and the belt. I had an ultra sound confirming the necrosis and some was drained off, but as it resembled thick silicone (which also proved what it was) my surgeon decided to leave the small area, he didn’t seem unduly worried either.

I saw my Oncologist today for a routine check and she confirmed the above saying that it can be a problem and very painful, especially when you keep prodding it, which we all do don’t we?! She said local reccurence is rare after such an op, but if there are any changes they will see me again, I have an appointment with my surgeon in December so they are keeping an eye on things.

Reading the above has certainly made me feel better too.

All the best to you all


Hi all, i had a back flap reconstruction, and just over a week later the area round where the nipple had been had died, as my surgeon felt it would take too long to heal (he thought i would need chemo) then he performed another op to remove the dead skin and stitch the good skin onto the back skin that makes up my nipple area (apparently they leave enough skin under the old breast skin in case this happens) this has made the nipple area appear bigger, but the scars will fade one day, and they will make sure that both nipples look as cosmetically good as they can. i was also told by my surgeon when he took to the stitches out not to rub the area too hard, so i haven’t touched mine with anything, to be honest, i’m scared of hurting it! know that sounds daft, but i protect this with my life! i don’t see him again till october, but i don’t really have any worries.

lots of love

Alison xxx

Glad I just spotted this thread, I too have fat necrosis, I seen my BS 3 months ago and he said it was nothing to worry about to would disapear with time. He said something about your own body eating it !!
I am due to see him again next monday, and although I don’t think it’s reduced much ,it’s not as tender as it first was. I will be intresting to hear what he says.
(I had tramp flap recon dec 2006).


Hi serenity,
We met at The Haven, I’d just had my DIEP. I had fat necrosis too, which got worse before it got better, my PS wasn’t bothered. It’s gradually softened, but I think I’ll always have some. 2 years on and all is well!
Best wishes, Helen

Hi Helen

lovely to “see” you again. Glad to know all is well with you. I still have the fat necrosis as well as hypertrophic scarring - recon not as pretty as I’d hoped but better than nothing there at all! Still early days yet. Still waiting to have adjustments to the other side and the cherry put on top! lol

best wishes