after effect of breast reduction surgery

[evmil]

4 months ago I had breast reduction surgery.  Everything went well. I had final visit with PS last week.  I asked about a slightly swollen area on one breast with orange peel skin.  She was not concerned and suggested I massage as it was most likely lymphatic blockage due to scar tissue. I looked orange peel skin up on the net to find it can be a symptom of inflammatory breast cancer.  I have no pain, no swollen glands and tissue removed was clear. I feel quite sure mine is a result of surgery but wonder what you feel?  How long should I massage?  Will massage work after 4 months?  Or should I have it investigated?

[Howard Rosenberg, MD]

The most likely cause of this problem may be fat necosis (a scar tissue nodule formed in reaction to death of fat) from the reduction surgery.  Peau d'orange (orange peel skin) is a sign of inflammatory breast cancer which may not be picked up on mammography.  You undoubtedly had a pathologic examination of the removed breast tissue from your reduction surgery.  I would obtain a copy of this pathology report.  This major biopsy of your breast tissue should reveal if there is anything disturbing about the condition of your breast tissue.  For further reassurance, you might consider obtaining the opinion of a local general surgeon (pathology report in hand).  That surgeon can advise you if a biopsy of the area is warranted.  Over the years, I have seen several patients who had similar conditions or lumps post breast reduction.  Some of these patients were ultimately seen by a general surgeon who biopsied the tissue.  All of these patients turned out to have benign fat necrosis.

[evmil]

Thank you so much.  Most helpful and reassuring advice.

[evmil]

Is fat necrosis likely to disappear with time?  Is massage helpful?  Is further surgery an option?

[Howard Rosenberg, MD]

Fat necrosis generally is accompanied by scar tissue formation  and in my experience the lumps do not disappear.  They are not dangerous and can be surgically excised if bothersome.

[belleangel]

I had breast reducction a year ago. I had a mammogram just last week, this reveled a huge fat necrosis from top of my areola to underneath my breast with a pea shape lump that bother me a lot. My HMO insurance paid for my BR. Would my plastic surgery remove this death tissue? he has to? or do I have to go to a general surgeon for this? My Family doctor said that is not dangerous but I have to be agree what my PS wht to do about it. The Insurance would recognise this as a condition that have to be solve and pay for or I  have to go by my own expense?

thanks!!!