“I had a bilateral mastectomy with fat transferred but now notice two lumps in that area,” wrote a MyBCTeam member. “After an ultrasound, they told me it was the fat that died and caused the lumps. It still freaks me out to feel a lump in my breast again, and I want it removed! Has anyone else experienced this?”

Fat transfer to the breasts, also known as autologous fat grafting, has gained popularity as a natural alternative to implants for breast augmentation (enhancement) as part of breast reconstruction surgery. This procedure can bring about positive changes in both your appearance and how you feel about yourself, but it also has some risks. One of the possible problems is that you might develop firm lumps in the area that was treated.

Hard lumps are not common after fat transfer to the breasts, but they happen occasionally and may raise alarm. Lumps can form when some of the donor tissue doesn’t get enough blood. The fat deposits that don’t survive turn into hard scar tissue that may or may not go away with time. Your doctor can determine if the lumps are something more serious by doing an ultrasound or, in rare cases, a biopsy (when a tiny piece of breast tissue is taken for examination by a doctor to figure out if cancer is present).

Fortunately, there are ways to manage these lumps in your breast tissue, both at home and with medical help. Sometimes, hard lumps require medical interventions like liposuction or revision surgery. A qualified plastic surgeon, along with your oncology team, can help you determine the best way to address the issue.

1. Wear Compression Garments

Compression can help reduce discomfort, minimize swelling and complications, and keep your breasts in place as they recover from surgery. Your surgeon can advise you on the right type of support to wear immediately after and in the weeks following surgery. Shop around for comfortable sports bras to wear until you’re cleared to go back to regular bras or underwires, which may be a while.

Supporting the grafted fat will encourage proper healing. In addition, sleep on your back in a slightly elevated position to reduce swelling and help the transferred fat survive.

2. Be Careful When Treating Yourself

You may assume that heating pads and massages would help loosen hard lumps, but they’re not necessarily safe after surgery. Avoid using hot or cold compresses without checking with your doctor first, as these can affect the delicate healing process. After surgery, reconstructed breasts may be desensitized to feelings of hot and cold. As a result, you may be at higher risk of burns or frostbite from household heating pads and cooling packs.

You should also hold off on self-massages unless your health care provider says otherwise because you don’t want to risk displacing grafted fat. Once your incisions heal, your doctor may recommend massages and can show you the proper technique.

3. Wait It Out

In some cases, the lumps may resolve by themselves over time as the body adjusts to the transferred fat. You may no longer notice smaller lumps after the swelling goes down (about six to eight months after surgery). Taking it easy and letting your body heal naturally is important. However, medical intervention may be required if the lumps don’t go away or get worse.

One MyBCTeam member said, “I had lumps in my breast after fat transfer. They appeared after a week. It’s been three months since the fat transfer, and all my lumps have reabsorbed.”

4. Address Pain and Discomfort

You may need pain medication for uncomfortable lumps during the healing process. Take your prescribed medications on schedule to avoid unnecessary pain. You may also want to discuss over-the-counter medications and lifestyle changes with your doctor to determine what’s safe and most appropriate for you during the healing process. For example, strenuous exercise isn’t a good idea right after surgery and may make pain and discomfort worse.

5. Consider Surgical Revision

When the lumps are more pronounced or other treatments don’t work, fine-needle aspiration, liposuction, or a lumpectomy may be considered. These procedures remove excess fat and help sculpt the breasts to a more desirable shape. Sometimes, revision surgery may be needed to address persistent or extensive hard lumps.

During revision surgery, the surgeon can remove and redistribute the affected fat to create a smoother, more even contour. The decision for revision surgery should be made in consultation with a board-certified plastic surgeon specializing in breast procedures.

One MyBCTeam member shared, “My lump was high above the muscle area. It had been a month since my transfer, and I had started back at the gym. I think this caused it to shift around. Of course, it was New Year’s, so I couldn’t get in to see anyone. I called the next morning, and my oncologist wanted it checked. I had an ultrasound done that afternoon and was told it was fat! For once, I was happy to hear I have fat and nothing more! (It’s still there, too.)”

Is Another Procedure Necessary?

No one wants to undergo unnecessary surgery, which can lead to stress, particularly if you’re still in the midst of treatment. But sometimes, it’s necessary to have a revision surgery or other follow-up procedure. “Mine turned out to be benign cysts. There are at least four of them, and they keep getting bigger. I am going to ask that they be drained or removed when I have my next appointment,” shared a MyBCTeam member.

You may need another procedure if you have:

• Cosmetic concerns — If hard lumps affect how your breasts look and if you are not happy with them, you may want to consider having a revision.
• Discomfort or pain — If the hard lumps cause discomfort or pain that significantly affects daily activities or quality of life, you may need surgical procedures to ease these symptoms.
• Functional issues — In rare cases, hard lumps may cause problems, such as interference with breastfeeding or the development of infection or inflammation, so you may need revision surgery.
• Persistence of hard lumps — You might need more treatment to achieve the desired results if the lumps don’t go away on their own despite your best efforts with at-home treatments. Some lumps can become calcified and thicken over time, putting you at risk for rupture if they’re not removed.

Although it can be worrisome to find new lumps, following up with your health care team right away will give you peace of mind and the best chances of a favorable outcome.

Talk With Others Who Understand

MyBCTeam is the social network for people with breast cancer and their loved ones. On MyBCTeam, more than 64,000 members come together to ask questions, give advice, and share their tips with others who understand life with breast cancer.

Did you experience hard lumps from fat necrosis or oil cysts after breast reconstruction? Did you have follow-up plastic surgery to correct breast lumps or deformities? Share your thoughts in the comments below, or start a conversation by posting on your Activities page.