A few days after traditional breast reduction surgery some patients may begin to drain a clear liquid with a yellow or brownish color. This may be due to fat necrosis. The blood supply to fat is always poor and many events around the time of surgery can interfere with this. For example a patient may have excessive swelling, pressure or congestion in then surgical area. In more serious cases fat necrosis is caused by an abscess (collection of pus) or hematoma (collection of blood).
The inadequate blood supply causes some cells to die and release particles of fat. These drain to the surface. The remaining tissue may become hard or calcified. Fortunately fat necrosis is uncommon . The larger the breast the more likelihood there is that fat necrosis will develop.
Besides the drainage, these patients may develop a hard nodule under the skin. A small hole will appear above this, often in the line of the incision. Some patients may run a slight temperature and in severe cases the blood supply to the overlying skin is damaged. This may result in necrosis (death) of the skin.
In small areas the treatment is to keep the area clean and express any liquid fat that may develop. The healing is delayed and may take several weeks. If the area is large the process can be speeded up by surgical exploration. Large areas of fat necrosis may impair the final cosmetic result.