Necrosis

There are different types of necrosis. Necrosis of the remaining breast skin is probably more likely to occur at the time of mastectomy than with delayed reconstructions, but even with immediate reconstructions this is usually not a problem. With regard to a flap used for breast reconstruction, I do not think there is a big difference in flap necrosis rates with immediate versus delayed reconstructions. There are different types of necrosis. Necrosis of the remaining breast skin is probably more likely to occur at the time of mastectomy than with delayed reconstructions, but even with immediate reconstructions this is usually not a problem. With regard to a flap used for breast reconstruction, I do not think there is a big difference in flap necrosis rates with immediate versus delayed reconstructions.

If necrosis was removed and there is still hardness, then it is most likely from either 1) additional / remaining fat necrosis, or 2) edema (can feel hard, especially likely in radiated tissue). In either case, resolution is likely without additional surgery if you wait long enough (may take 1-2 years), although breasts will be smaller in either case. If pain is present, and fat necrosis is still present, then surgery to remove the rest of the dead fat may be indicated.

Richard M. Kline Jr., M.D. If necrosis was removed and there is still hardness, then it is most likely from either 1) additional / remaining fat necrosis, or 2) edema (can feel hard, especially likely in radiated tissue). In either case, resolution is likely without additional surgery if you wait long enough (may take 1-2 years), although breasts will be smaller in either case. If pain is present, and fat necrosis is still present, then surgery to remove the rest of the dead fat may be indicated.

Richard M. Kline Jr., M.D.