How Common Is Necrosis After Breast Lift

Breast lifts are a popular procedure that help women with sagging breasts feel more confident in their bodies. But what happens if your breast lift goes wrong?

Breast lift necrosis is a rare but serious condition that can occur after undergoing this procedure. It occurs when the skin of your breasts dies due to complications during or after surgery—and it can cause a lot of pain and other problems, including infection, severe scarring, and even permanent deformity.

In this article, we’ll consider signs of necrosis after breast lift and how to prevent necrosis after breast lift.

How Common Is Necrosis After Breast Lift

Breast fat necrosis is a non-cancerous breast condition that forms when there’s damage to fatty breast tissue. Women of any age can develop breast fat necrosis in any area of the breast, but middle-aged women with larger breasts may be most at risk. 

Breast fat necrosis is harmless, but you’ll want to check with your doctor to rule out any chance of breast cancer.

Causes of Breast Fat Necrosis

The breast consists of milk-producing glands and ducts surrounded by fatty tissue. Lumps can form in this tissue when the breast is damaged or injured. Any procedure that disrupts the breast’s fatty tissue can lead to breast fat necrosis, including:

  • Breast reconstruction
  • Injecting fat into the breast from other parts of the body (called lipomodelling)
  • Breast biopsy
  • Radiation therapy‌‌

While your body typically replaces damaged breast tissue with scar tissue, sometimes the fat cells end up dying. If they do, a greasy fluid is released and collects into an oil cyst, which feels like a lump in the breast. Women who undergo surgery can end up with breast fat necrosis up to 10 years after having a procedure.

It’s important to note that if you’ve been diagnosed with breast fat necrosis, it doesn’t mean you have a higher risk of developing breast cancer.

Signs Of Necrosis After Breast Lift

Breast fat necrosis typically feels like a round, firm lump to the touch. Some women experience tenderness, bruising, or dimpling in the area where the breast fat necrosis appears. Sometimes it can pull in the nipple.

When you undergo a breast reconstruction that involves autologous reconstruction (using a flap of tissue from a different part of your body), the fat in that piece of tissue may not have sufficient blood flow and end up dying. Breast fat necrosis from the procedure may not become noticeable until months later.

Smaller breast fat necrosis formations can dissolve or go away without further treatment. However, some can become large and painful enough to distort the look and feel of the breast.

Diagnosing Breast Fat Necrosis

You may notice the lumps when performing a self-breast exam at home or come across them during a general inspection of your body. The skin may look redder or thicker around the lump. While it’s typically not painful, it’s a good idea to see a doctor about any unusual lumps in your breast.

With a physical exam, your doctor may not be able to distinguish the symptoms of breast fat necrosis from cancer. If this is the case, they may recommend that you undergo diagnostic imaging (like an MRI) so that they can get a better look at the shape and texture of the lump.

They may also suggest getting a biopsy to take a sample of your breast tissue to confirm whether there are cancerous cells in the area. 

How To Prevent Necrosis After Breast Lift

Because smoking limits blood flow, avoiding secondhand smoke before and after surgery is the primary recommendation for avoiding fat necrosis. Post-BBL patients should adhere strictly to their doctors’ orders regarding sitting and standing. It will help you avoid putting unnecessary strain on the treated area.

Choose a plastic surgeon who is board certified and has extensive experience with fat grafting if you want to reduce the likelihood of complications. Dr. Buford says, “I haven’t seen a tremendous amount of variation in terms of potential for fat necrosis in specific areas of the body.” However, he does observe a difference in the threshold for the amount of potential for volume grafting in each area. “The buttocks, as you might guess, store a lot more fat than, say, the breasts or the face.”

In terms of treatment, you can choose between doing nothing and (very rarely) undergoing surgical removal. Dr. Buford explains that firm lumps caused by fatty necrosis often disappear on their own or can be directly massaged to break them down. If fat loss is causing contour changes, additional localized fat grafting could be used to fill in the voids. Most oil cysts can be drained via needle aspiration.

Treatment for Breast Fat Necrosis

If your doctor confirms a diagnosis of breast fat necrosis, they may recommend waiting to see if it resolves without treatment, especially if it’s small and not causing you discomfort. It can take several months for the breast fat necrosis to break down.

Your physician may recommend that you have surgery to remove the growth if:

  • A biopsy can’t clarify whether you have breast fat necrosis
  • You experience pain because of the breast fat necrosis
  • The breast fat necrosis doesn’t go away or gets bigger

To remove the fat necrosis, a surgeon will cut out the damaged or dead tissue. Before the operation, they’ll provide you with a local or general anesthetic. You may end up with a small scar, but this typically fades as time passes.

Liposuction is another option for removing the fat necrosis. Your surgeon will use a local anesthetic and make a small cut into your skin. They will then insert a vacuum device and use imaging as a guide to remove the dead and damaged tissue.

Having liposuction reduces the chances of having a divot in the area where the damaged breast tissue has been removed. If you do end up with some dimpling or other unevenness in the breast, your surgeon may fill in the area by performing a small flap reconstruction or using fat injections to add volume.

You should continue monitoring any changes to your breasts that happen before or after you receive treatment for breast fat necrosis. Let your doctor know about any concerns you have about the overall health of your breasts.

Fat Necrosis After Fat Transfer

A fat transfer procedure involves removing fat from one area of a patient’s body – usually a place where there is excess or unwanted fat such as the abdomen or inner thigh – and then injecting it back into the body in order to smooth, enlarge or alter the appearance of a different area.

It is often carried out on the face to enlarge the lips, plump up cheeks or reduce the appearance of deep lines and grooves. Elsewhere on the body it is commonly used on the breasts and – in more recent years – the buttocks.

There are three stages to the fat transfer procedure:

  • The fat is removed through the use of thin cannulas
  • The fat cells are washed and filtered
  • The fat is injected back into the body

Depending on the area and volume of fat to be transferred, the operation can take place under local or general anaesthetic, and can take up to two hours. Patients should expect to wait up to six months to see the final results of a fat transfer procedure.

THE PARTICULAR RISKS OF BBL

There is one form of fat transfer that has come under particular fire from the medical community – the Brazilian Butt Lift (BBL) or buttock fat grafting.

Using the fat transfer procedure, this operation involves the injecting of fat into the buttocks in order to enlarge or fill out the area.

Despite following the same procedure as other forms of lipofilling, the BBL is regarded as a highly dangerous cosmetic surgery. Complications following a BBL procedure have, according to BAAPS, “ranged from severe bacterial infections including MRSA and Pseudomonas, tissue dying (necrosis), scarring, wound ruptures (dehiscence) and abscesses – among others.”

In addition to this, 1 in 3,000 operations have resulted in the death of the patient, making it the deadliest cosmetic surgery currently available. Death from BBL is caused by the accidental injection of fat into large veins, which then travels up to the heart, lungs or brain.

The situation was brought to a head in 2018 when two British women died from the procedure. This media attention surrounding these cases caused BAAPS to call for its members to cease providing the operation in October that year.

However, in October 2019 BAAPS announced that they were launching a formal review into the safety and techniques of buttock fat grafting. Though the official stance is still for members of the organisation to not offer the procedure, this may change in the future.

FAT TRANSFER SIDE EFFECTS AND THE RISK OF FAT NECROSIS

Aside from the particular risks of BBL, other forms of fat transfer also have side effects and potential risks. In the days following their surgery, patients can expect to experience:

  • Bruising and swelling
  • Temporary numb feeling
  • The appearance of small scars at the injection site(s)

While the above is normal, and your doctor should discuss these with you prior to your surgery, there are also more serious side effects that can indicate that the procedure has gone wrong. These include:

  • Fat necrosis – the death of fat tissue
  • Blockage of a blood vessel
  • Haematoma – the collection, or pooling, of blood under the skin
  • Pneumothorax – when air leaks into the space between your lungs and chest wall
  • Large and obvious scars
  • Asymmetrical disfigurement or distorted appearance due to overfilling

In the worst cases, blood clots can travel to lungs or fat could be injected into the wrong sites, causing a risk of fat necrosis

Fat necrosis occurs when an area doesn’t have the correct blood supply and then dies off, causing the area to turn black. It can lead to hard, round lumps forming under the skin, or the skin may appear dimpled and uneven. This can be particularly alarming to the patient if the fat necrosis occurs in the breast, however there is no link between fat necrosis and cancer.

As fat necrosis is a well-known complication of the fat transfer procedure, and you should discuss the risk of developing the condition with your doctor ahead of your surgery.

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