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What Is Fat Necrosis?

Mary McMahon
Mary McMahon
Mary McMahon
Mary McMahon

Fat necrosis is the destruction of fat cells inside the body. It is usually benign, but it can be a symptom of a more serious underlying problem. People often report to the doctor for treatment because it results in the formation of a hard lump at the site of the destroyed cells and the patient may think that the lump is a tumor or another cause for medical concern. Treatment for fat necrosis varies, depending on the location and the underlying causes.

In fat necrosis, fat cells are broken down by the body, usually in response to trauma. It can happen after surgery, as a result of physical stress, in the wake of radiation therapy, and in association with chronic diseases like pancreatic disease. As the cells break down, a mass of rubbery tissue can form. This lump will be palpable to the patient if it is near the surface.

When fat cells are destroyed within the body, it is known as fat necrosis.
When fat cells are destroyed within the body, it is known as fat necrosis.

A common site for fat necrosis is in the breast. Patients usually view lumps in the breast as a cause for concern and may seek medical treatment when they identify the unusual deposit of tissue. Other areas where this condition can arise include the thighs, where a lump will also be palpable, and in the fat that surrounds the kidneys. In this last case, the necrosis will usually be identified by a doctor during other diagnostic testing involving the kidneys such as an imaging study.

Because of their high concentration of fat cells, breasts are a common site for fat necrosis.
Because of their high concentration of fat cells, breasts are a common site for fat necrosis.

In the case of lumps in sites like the breast and thighs, it is not uncommon for the skin above the site of the necrosis to become mottled or lumpy. The patient may feel pain or heat in the area as a result of inflammation, and sometimes discharges develop. Treatment for fat necroses can include warm compresses along with anti-inflammatory medications to reduce the pain and swelling associated with the lump. In the breasts, the lump may be biopsied if a doctor cannot confirm that it is caused by fat necrosis through medical imaging such as mammography.

Treatment for fat necrosis may include warm compresses.
Treatment for fat necrosis may include warm compresses.

When the fat around the kidneys is damaged, it is indicative of kidney disease. The patient will need treatment for the kidney disease, including monitoring of kidney function. Another type of fat necrosis can be seen in newborns after traumatic births. The newborn may be worked up for signs of undiagnosed complications from the birth and treatment will be provided to address the lump of scar tissue that forms at the necrosis site.

How Long Does Fat Necrosis Last?

Fat necrosis is relatively common after breast reconstruction for breast cancer. While it can be painful and a cause for concern, it is a benign complication. 

Fat necrosis has been known to mimic tumor recurrence and as such, a doctor should monitor it. However, if your doctor confirms the presence of fat necrosis, you can expect it to run its course within two to three years.

Can Fat Necrosis Be Treated?

In most instances, fat necrosis is harmless and if left alone, the body will break it down on its own. Depending on the severity, this process could take anywhere from a few months to a few years.

Fat necrosis in the breasts may be diagnosed through mammography.
Fat necrosis in the breasts may be diagnosed through mammography.

In some cases, it’s not possible to conclusively diagnose fat necrosis, and treatment or further testing may be needed. If you start to notice the lump getting bigger after an initial diagnosis of fat necrosis, you should immediately consult your doctor. 

Surgery is typically avoided to treat or diagnose fat necrosis since this can be a leading cause of it in the first place. 

However, you may need an operation if any of the following situations occur:

  • The original biopsy was insufficient to confirm a diagnosis of fat necrosis
  • The fat necrosis is painful or tender to the touch
  • The lumpy area continues to grow and does not go away promptly

What Type of Treatment Options Are There for Fat Necrosis?

It's possible for fat necrosis to happen in the wake of radiation therapy.
It's possible for fat necrosis to happen in the wake of radiation therapy.

If it is decided that you need treatment for fat necrosis, the routine surgery required will be an excision biopsy. This operation removes the damaged tissue, and doctors can choose to perform it with a local or general anesthetic. There is minimal scarring involved that will fade over time.

Another treatment option is a vacuum-assisted excision biopsy. After receiving a local anesthetic, a small cut is made on the skin. A vacuum device attached to a probe goes into the cut. The vacuum sucks tissue through the probe into a collecting chamber until removing all of the fat necrosis.

In less severe cases of fat necrosis, if surgery is not required, but pain persists, your doctor may prescribe pain relief medication like paracetamol or an anti-inflammatory drug such as ibuprofen.

How Do I Know If I Have Fat Necrosis?

As the most common location for fat necrosis is in the breast, most patients see their doctor out of fear of possible breast cancer. 

Your GP will examine you but most likely refer you to a breast clinic for further testing. These tests include a mammogram, ultrasound scan, or biopsy. In some instances, it’s possible to diagnose fat necrosis right away. 

However, fat necrosis is often confused with breast cancer even by experienced radiologists. If they can not eliminate breast cancer as a possibility, they will perform a biopsy. 

Typically, after a biopsy, there will be a definitive diagnosis of whether it is fat necrosis or something else.

Can Fat Necrosis Cause Cancer?

Fat necrosis in the breast is a benign condition and has not proved to cause or develop into cancer. While it can be painful and last a few years after diagnosis, fat necrosis is a harmless condition that will break down over time.

Other cases of fat necrosis can be indicative of an underlying condition in some cases, but they do not cause cancer. 

What Is the Most Common Cause of Fat Necrosis?

The most common cause of fat necrosis is trauma, particularly to the breast tissue during surgery. The trauma disrupts the oxygen supply to fat cells, leading to cell death. The result is lumps of tissue in the breast area.

Other types of fat necrosis occur in the body. These are also typically caused by some type of trauma that kills cells. 

Radiation treatments in breast cancer patients can also cause fat necrosis. It is also common in other breast cancer treatments, such as a lumpectomy or a biopsy.

It has also been known to occur in other breast-related procedures. The most common of these are breast reduction or reconstruction surgery, removal of breast implants, and in some cases, breast augmentation. 

The average age of fat necrosis patients is 50 years old.

Mary McMahon
Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a TheHealthBoard researcher and writer. Mary has a liberal arts degree from Goddard College and spends her free time reading, cooking, and exploring the great outdoors.

Learn more...
Mary McMahon
Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a TheHealthBoard researcher and writer. Mary has a liberal arts degree from Goddard College and spends her free time reading, cooking, and exploring the great outdoors.

Learn more...

Discussion Comments

anon995793

They think I have this in the top of my arm. I don't know why and it I just getting bigger and bigger. They don't know what it is or why it is or what to do to stop it.

anon971335

My daughter had fat necrosis due to trauma at birth which went away, but 10 years later, she has had to have an operation and the necrosis has returned but only where she had her OP. I'm just wondering if yet again, it's due to her body being put under stress again.

anon359491

About two months after my back surgery, I had what I called a "sweet spot". It felt like a small lump/bruise on my lower back and is painful. It's a bit off to the side where my scar is. My doctor said it was fat necrosis due to the drain he put in after surgery. He gave me lidocaine patches to wear. I hope they help.

anon317126

I have necrosis in my lower abdomen and the doctor doesn't want to do anything about it. Are you all telling me that this approach is dangerous?

anon280752

I have fat necrosis below my belly button wound from having gallbladder surgery. I'm relieved it's only that. I can't believe people are comparing it to cancer. Mine was caused by the surgeon hitting the blood supply to the fat during surgery. It became the size of an orange and very sore and hot but it burst and now dead fat has been coming out for 15 days.

I was treated for an abscess for two weeks as my doctor misdiagnosed it. Again, I'm relieved because that is poison.

I was only diagnosed after refusing more antibiotics from the A&E doctor and demanded to see a surgeon, so I saw two doctors and two surgeons who all said it was an abscess. I was gowned up, the cannula in and ready to go for another general anesthetic (just four weeks since my last op) when my surgeon turned up by my bedside with a scalpel in hand and punctured it again and removed more fat. He had luckily heard my name mentioned and was in the hospital on a Saturday evening and as he used to be a fat surgeon, knew what it was. Most people who get problems with it are overweight, but not all. It is now tiny and leaking a little. I think of it as my own liposuction.

anon259541

Really? Are you people reading the same article I just did and responding? If so, why are you trying to horrify people when it says that fat necrosis in the breast can be treated with warm compresses and anti inflammatories? Let's try that first before we make it a terminal disease like some of you are doing.

anon233142

I am suffering from fat necrosis in my thigh. I was hit by a hard object that caused trauma. A second degree burn developed, and what we thought was the swelling associated with second degree burns turned out to be hematoma and fat necrosis. I just had the cysts drained off fat and blood using syringes yesterday. It is scary. I really hope I get well.

anon209955

I had a lumpectomy and radiation in my left breast many years ago for breast cancer. A couple of years ago I decided to have a breast reduction in my left breast to match the size of my right breast. I then developed fat necrosis in the reduced breast. There was no pain but I was very scared about the lump. I had a sonogram and a needle aspiration and my doctor says no further treatment is necessary. The lump is still there but I can live with it knowing it's not cancer.

yournamehere

So what exactly causes fat necrosis? This sounds like such a scary thing, I want to know how to avoid it! I know that I would be terrified if I ever found out that something like that was happening in my body.

It just sounds so frightening -- necrosis means that something is rotting, right? Well, if anybody knows more about this topic, please let me know, because I would love to hear more about the symptoms and warning signs of traumatic fat necrosis, as well as some more about treatments.

Thanks!

EarlyForest

It's kind of hard to decide which one is worse when you find that the lump in your breast -- a fat disease or cancer.

I know a lot of women are really scared when they find a lump in their breast, and aren't really relieved to find out that it's necrosis, since necrosis can be just as scary and even more painful in some cases than a tumor.

I know there are treatment options, like a fat necrosis induced breast reconstruction, and that fat necrosis is much easier to treat than cancer, but still, I don't know that women with fat necrosis have it any easier. They can experience the same physical and psychological pain of losing part of their breast, and they can also undergo the same stigma that all women do when they have problems with their breasts.

So to all women out there with necrosis in your breast, I really sympathize with you and applaud your courage. Undergoing something that serious is something I can only imagine.

rallenwriter

I've heard that you can sometimes get fat necrosis after a cosmetic surgery.

For instance, the other day I read an article about a woman who had fat necrosis after a tummy tuck. The woman in the article had an infection after her tummy tuck surgery, and had massive necrosis. I think that she wasn't exactly sure what was going on to begin with, so she left it for a while, thinking that it was just normal post-operative wound pain, so it got really bad.

I think that she eventually had to go in for emergency surgery because the infection was causing her to go septic. Kind of made me rethink ever getting any kind of reconstructive surgery...I mean, I think I would do anything to avoid the risk of necrosis like that!

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    • When fat cells are destroyed within the body, it is known as fat necrosis.
      By: fotoliaxrender
      When fat cells are destroyed within the body, it is known as fat necrosis.
    • Because of their high concentration of fat cells, breasts are a common site for fat necrosis.
      By: Khorzhevska
      Because of their high concentration of fat cells, breasts are a common site for fat necrosis.
    • Treatment for fat necrosis may include warm compresses.
      By: happytotakephoto
      Treatment for fat necrosis may include warm compresses.
    • Fat necrosis in the breasts may be diagnosed through mammography.
      By: Tyler Olson
      Fat necrosis in the breasts may be diagnosed through mammography.
    • It's possible for fat necrosis to happen in the wake of radiation therapy.
      By: jovannig
      It's possible for fat necrosis to happen in the wake of radiation therapy.