Fat Necrosis

Simbobby
Simbobby Member Posts: 140
edited May 2019 in Breast Reconstruction

I am two months out from tram flap reconstruction in both breasts. The flap portion is soft and warm. But both upper breasts are very hard and very tight. They feel harder than when I had tissue expanders in (which ultimately got infected, hence the tram flap)

The PS said it’s fat necrosis. Has anyone else had the problem and did it go away or get tweaked in subsequent surgeries. They seem to be getting worse and are beginning to get visibly lumpy.

It is uncomfortable but not painful. PS said to wait at least two months to heal before any revision surgery.

Just interested in what others have experienced.

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Comments

  • vlnrph
    vlnrph Member Posts: 1,632
    edited May 2019

    My post-DIEP area of necrosis under my arm along the side of the chest is stable, palpable and was noted by each radiologist on my annual MRIs when I was having those. Some of it may have come about because I had axillary dissection due to micromets on the edge of the sentinel node, not seen until complete pathology was done.

    It is not likely to go away so don't expect that. I wonder whether you might have scar tissue from the infection/failed implants. Did the same plastic surgeon do all your operations?

    The tops are where I had fat grafting after several months to fill in some 'dents'. That was a liposuction procedure from my hips performed under conscious sedation. You are probably still healing especially since the initial reconstruction attempt did not go well. Hopefully the long ordeal you've been through will wrap up soon!

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  • Simbobby
    Simbobby Member Posts: 140
    edited May 2019

    Thanks Vin,

    Thanks for the response and you are right. The PS was not too concerned because he said I am still healing . He won’t do revisions until fourmonths after the original reconstruction. (So 2 more months to go).

    I really want to get this wrapped up this calendar year so I can retire. I just don’t want to have to pay another out of pocket deductible next year. I haven’t yet signed up for Medicare so not sure how good or expensive that coverage will be. My treatment so far has gone into the hundreds of thousands of dollars and I fear being wiped out financially before getting a chance to retire.

    I see by your DX that you have been at this a long time. Hope your feeling well and thanks for sharing your experience

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  • Flynn
    Flynn Member Posts: 307
    edited May 2019

    I had my bilateral diep on April 1st. I do have a hard area on one side. My PS says he usually leaves necrosis alone so as not to cause an indentation. He also said that it could improve in the next couple months. Sometimes he injects fat over it to smooth things out if needed.

    Mine sounds much smaller than yours but emotionally I was unprepared for the possibility of walking around with a lump in my breast as i'm trying to put bc behind me. In the diep thread, I did read about some people being advised to massage the necrosis and having success. Maybe you want to go back a few pages and check out what they said.

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  • LAstar
    LAstar Member Posts: 1,574
    edited May 2019

    I had a walnut-sized area of necrosis after my SGAP. I also had areas of swelling. The swelling responded to massage, but the necrosis did not and was sore when I massaged it. I wanted it removed during my Stage 2 surgery but the surgeon did not do anything about it. I've heard of women keeping the necrosis. For me, the necrosis worsened over time and the breast shrank 2 cup sizes over the next 3 years. I was concerned about health effects of keeping the necrotic tissue, so I had the breast re-reconstructed with a DIEP. I had no necrosis the 2nd time and the breast is fine. I've heard of women having tissue from the armpit flipped over to provide extra tissue to replace necrosis on the outside of the breast. My necrosis was near the sternum so harder to fix.

    Also expect oil cysts which are small lumps that eventually resolve on their own. My cohort of flap reconstruction gals all seem to get them around the 1-year mark.

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