anybody with fat necrosis after surgery?
I had a large fat necrosis removed on the left side of my breast that occurred right after tram flap surgery. 2 1/2 weeks later, it has swelled back out like an egg and is sore again. Like the original necrosis. I called the ps and I'm going in on Friday. It doesn't seemed infected.
Has anybody else had a fat necrosis removed and then had another appear in its place? I know the body absorbs some of it but not all of this.
Sharon
Comments
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I had a large amount of the fat necrosis removed but I have not had it return. It would really disappointment if I had to deal with it a second time! I would be very interested to hear what your plastic surgeon has to say about why it happened and what can be done to make sure it doesn't keep happening.
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cbl,
Can you tell where the necrosis was removed or did they fill it in after?
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I'm going in tomorrow to see the ps. hopefully he'll have an answer for me. It's like I now have an egg shaped boob growing out under my arm.
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Hi, could it be that it might be a collection of fluid, such as a seroma or maybe a hematoma? If so, they probably will just drain the fluid out. I had problems with both. They felt pretty hard to the touch even though they were fluid filled.
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Naomi,
You are correct. I'm just back from the PS. He drained to syringes full of fluid and what he called old blood. It didn't hurt to drain but I didn't watch. I'm not afraid of needles but don't like to watch the process. He then bound me with an ace bandage for 72 hours he said if I can stand it. If it fills up again he told me to come back in.
Did you have to have it drained more than once? Were you wrapped after?
Sharon
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Sharon, I'm so glad you were able to have it drained, and I hope to h**l it doesn't recur. But I would love to hear from others who had fat necrosis, either removed or not. I have a large area in my left reconstructed breast of fat necrosis that was actually just biopsied (go figure; I thought mastectomy would take care of THAT) but it seems to me it is conjoined with an area that has recently lost a lot of tissue (that ripply effect). SO...I hate to have it removed, as it will make my "breast" even more saggy and flat on top, but it IS very hard and uncomfortable... and anyway, I don't want to have any more surgery, I have gone over the top on that issue. Or maybe I'm just having a bad day. Anyway, I hope people with fat necrosis will chime in; I really need some input here from some folks who are in the know. help??
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I have an area of necrosis that has swelling around it, and it does ache at times. It is at the lower cleavage area. My ps said it could take a year or two to "liquefy" and be reabsorbed by my body. He said it's better to leave it than remove it and leave an even larger void. I haven't had stage II yet (DIEP) so I will see what can be done then. I may end up with small implants because there is a low area at the top of the other breast that needs to be taken care of.
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I had the fat necrosis removed, but they can fill in with fat injections if it leaves a large void. My necrosis had been there for 7 mos. already and they even biopsied it a couple mos earlier because they were concerned. This necrosis literally was there right after my tram surgergy like within a day. I'm O.K. with it not being perfect as long as it was comfortable and I can wear a bra or bathing suit. The way it was, I couldn't. Mine was right where the cup of you bra comes up under the arm. An awful place even if you don't wear an underwire.
Sharon
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HI
I have a few areas of necrosis in my left breast from the mid clevage area down to almost the bottom (6 o clock) of my breast. Though it is not visable I can feel it and it is uncomfortable when I sleep on my stomach.( one area feels golf ball sized) My ps wants o to wait it out. I haven't had stage two yet. he feels it may soften up and if we try to remove it it may leave a divet in my beautiful reconstrution. I'm not sure yet what I want to do.
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Alaina13:
Most of the necrosis I had was along the side closest to my arm and a little across the top. The part closest to my arm was about 2.5 inches by 1.0 inch and made it difficult for me to comfortably have my arm at my side. I always felt like my clothing was bunched up under my arm pit. Massage definitely helped soften the area but after a year it still was uncomfortable. The PS didn't remove all of the necrosis because I would have been significantly smaller that I wanted to be. He removed enough to keep the general size and shape that he created originally and I am a lot more comfortable than I was. The area was not filled in afterward. I am not sure how or why but it seems to have filled itself in.
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sharebear, do you know if the fat injections are done everywhere or if that's a pretty specialized thing? Somewhere, sometime, somehow, (chemobrain) I followed a link that made me think that only a few places (or Drs) did this. I'm still putting off going back to the PS... Thanks for all the info, sisters!
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My PS offerred this to me when he knew we would be removing a large necrosis. Mine was also in an area that my arm couldn't rest comfortably like cbl's above. He didn't want to ruin the shape or make it noticeable smaller. I don't know how common this is or isn't. It has worked. I did have to go back in and have some fluid drained. Two syringes full. I might have to go in one more time as I have a little more fluid build up. But it all seems much better now.
Sharon
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Hi I too have a large area of fat necrosis on my right breast the side that had cancer. Now the skin around it has turned red over the last few days. Does anyone know what this could be? My surgery was July 6th so I didn't think it could be infection. Anyone had this?
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I just had revision of my DIEP breasts, and my surgeon broke up the necrosis with some lipo and the area is soft now.
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Mine was a hard solid piece. My surgeon actually biopsied it to make sure. Then when he did my nipples, he removed a big chunk. I still have some but he didn't want to remove too much and have me not be symetrical. We're hoping what he left will soften up with time.
Sharon
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This is a really interesting topic that hasn't been discussed in depth on this board in the year+ that I've been here.
I'm a year+ post bilat diep. The cancer side definitely has a hard, uncomfortable area at the bottom around the incision. My breast surgeon did an ultrasound and said he didn't THINK it was necrosis, only a build-up of scar tissue.
I've also wondered how much of this is lymphedema related. I haven't had any problems with arm lymphedema (2 nodes removed), but it seems like the hardness varies throughout the day, being worse at the end of the day and generally not too bad at the beginning. Maybe it's my imagination, but that seems to be the pattern.
I also have a couple hollow spots at the top of my breasts that seemed to develop months after my Stage 1 surgery. Could that be related to fat necrosis dissolving? I wouldn't mind having those spots filled in, but am worried about the fat injection idea. Are they just injecting fat that's going to be dead and hard? What's the success rate of the fat injections?
I'm having my Stage 2 surgery on Monday and will discuss this with the ps and let you all know what he says.
Mary
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I'm going to see my surgeon on Tuesday to find out what is going on. The redness has gone after a week of antibiotics but now I have thickening and swelling around the incision. MaryGirl, I am interested in hearing what your ps says about lymphedema. I only had 2 nodes removed as well but some days my shoulder and arm ache. I wonder?? Let me know what the ps says about the hollow areas as I have developed these as well. I just don't like seeing any changes 4 months post surgery. Makes me nervous, every little thing now makes me think that the c is back.
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I just had my second stage DIEP at NOLA, and Dr. DellaCroce said that my flaps had slipped down. (First surgery was done elsewhere.) I had never heard of that before, but after looking at my post-op photos at several stages, it's clear that they did shift downward. He completely redid the flaps inside, and I have fullness now where there were hollows on my chest. Not only that, but my former hamburger buns are now round and full!
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Ultrasound showed 2 areas of fat necrosis in my reconstructed breast. Radiologist biopsied one - just to be on the safe side. Proved malignent for IDC again. Both lumps have now been removed and I am awaiting pathology and results from CT and Bone scans. I only had stage 1, grade 1 small tumours originally. Any one else have similar experience?
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Hi Mary,
I had GAP surgery with Dr. D in NOLA 2 years ago. I didn't develop fat necrosis, but I have had fat injections on 2 separate occasions. I had radiation on my cancer side and the fat injections didn't take very well there. I think my body just reabsorbed most of it. My injections were done to help with projection. The injected fat did not become hardened. My body just absorbed it. I'm sure Dr. D will be able to fix the hollow areas at the top of your breasts.
I haven't experienced lymphedema in my arms, but I do sometimes notice that my breasts become fuller, and sometimes uncomfortable, toward the middle of the day. At times it is painful to wear a bra. I suppose this could be lymphedema since I had 14 lymph nodes removed.
Hope your surgery goes well on Monday. I'm sure Dr. D will be able to give you fantastic results. -- Amy
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Nichola, how long ago did you have your first mast & recon? How long did it take for the fat necrosis to show up? Mine has been there since 1 week post op. but the thickening just started. Good luck with your scans, I'll pray that they are clear.
Kiki
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What exactly is fat necrosis? I had bilateral mast. with expanders. The side that had the tumour and was radiated has a line of 'fat' that is somewhat tender. The other side doesn't have this. The ps says it's fat.... and it would cost me to have it removed or to lose weight...I don't think so...so ultrasounds can be done?
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Hi All-
I had my stage 2 done with Dr D in NOLA on Monday. He didn't think there was any fat necrosis. Said that the scar tissue is just tight and that can be alleviated by stretching as you're healing. He didn't really address the lymphdema theory. I've brought it up with several doctors but they all seem to kind of shrug it off.
I did have some fat injections to fill in the hollow spots and to help with the symmetry issues. Things are still pretty swollen right now, so I can't tell how it will all come out. But so far I think the shape and symmetry of my breasts have improved.
I'll be glad when these things heal up though...ouch!
Mary
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To the top for M. Thanks to all those who contributed to this thread, as it's an important topic and hard to find information about.
Be well!
Binney
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Thanks Binney! I have this problem on my lifted breast, not the implant one. I had the surgery about 6 weeks ago and became aware of this problem about 3 weeks ago. There is a dent or divot on the outer side of the incision around the areola, and there are a couple of lumps at the bottom of that incision. The PS is treating it by pulling out the dead fat weekly and I'm doing an antibiotic cream and gauze/pad covering twice a day. There are twinges now and then but it's not painful. It's a nuisance, though, and it sure is ugly!
This morning I had a sudden flow of blood from one of the areas and it scared me. I put pressure on with a gauze pad and it stopped and is OK now. But there is a kind of hole and I can see the yellowy fatty tissue inside - ARGH! But the PS says it's OK as long as it's regular red blood, and probbly means there is healing going on.
Believe me - I have done a lot of Googling on this and I finally found something that is quite informative. The link is pretty long - hope itworks for you:
Minz
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M.
Mine was very large. It also was on the side of my breast. They actually biopsied it and it was fat necrosis. The PS removed a large chunk of it, not all of it because he did not want to make the breast appear smaller. Taking out what he did made it much more comfortable and what was left did soften up and the body is starting to absorb. He also did some liposuction on my fat pad under the breast and injected it where he took out the necrosis. It filled right in and the breast looks completely normal.
It does get better.
Sharon
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Melody, it's been a couple of years since your posting, but I'm curious to know how your necrosis/scar tissue problem was resolving itself. I'm just where you were back in Oct. '07--4 months out from a DIEP flap (actually, mine was SIEA, but same difference once it moves upstairs), and the same hard tissue in the same lower inner quadrants of both breasts. My PS said--just yesterday--that the lumps are from where he had to stitch the pedicles of fat & tissue from the abdominoplasty in to the skin above where the breasts used to be: the fat around the stitches can harden and die, creating little hard lumps, that all together feel like one larger lump. "Don't worry," he said: "It's definitely NOT cancer." But that wasn't what I was worried about. He said patience & time were the best cure. So, if you're still out there: how have patience and time been working out for you? Thanks for the response!
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Zannie, I had the exact situation in my SIEA breast, same location. It felt like one very large lump, and I believe it was, because it arose after a near flap failure---it's the part of the flap furthest from the blood supply. In my second surgery, small holes were poked into it with a lipo cannula and I think that helped it resolve over time. It's mostly gone now and does not bother me in the least. The circulation in that flap was poor from the get-go, and when things became worse at one week post-op, necrosis resulted. It's been about two years for me.
Sandy
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Hello all, i hope i'm not intruding as a male in this room, but I'm looking for some answers. My wife has not been diagnosed with breast cancer, however her mother had breast cancer. My wife has been developing fatty necrosis for the last year in her right breast, which scared her, obviously. She had the first 2 lumps of necosis removed and others seem to keep coming in different spots. She was in a lot of pain and recovery last year. Three surgerys and recovery kept her out of work for most of the year. She has recently had another lump show up now in her left breast and it is getting bigger and bigger every day. These lumps seem to show up almost over night and grow quickly. The doc keeps telling her there is not much he can do. He doesnt want to remove anymore of this necrosis, because the surgerys can cause more. She is having trouble sleeping due to the pain and she is looking for othe options. I have found online that massaging and heat compresses would help, but she is so tender in the area, that she cannot massage.
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I have recently been diagnosed with fat necrosis but I'm extremely concerned it is actually and cruelly a cancer recurrence. I know someone who got 4 opinions telling her she had fat necrosis. She was so nervous she insisted on a biopsy. It turned out to be cancer and already stage 3C when found. For 4 months doctors told her it was necrosis. I'm at the point of wanting to give up because I figure I will get cancer again anyway. I had my hair done today and although I don't love it I'm mostly concerned if I lose it again. I don't trust this fat necrosis thing!!!
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