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Updated: Aug 31, 2025

Assessment of Viability of Human Fat Injection into Nude Mice with Micro-Computed Tomography

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Published on: January 7, 2015

Large-Volume Fat Grafting: Identifying Risk Factors for Fat Necrosis.

Catherine S Chang¹, Michael A Lanni¹, Michael N Mirzabeigi¹

¹From the Division of Plastic and Reconstructive Surgery, Harvard University, Massachusetts General Hospital; and Division of Plastic and Reconstructive Surgery, University of Pennsylvania, Hospital of the University of Pennsylvania.

Plastic and Reconstructive Surgery

|August 22, 2022

Summary

Large-volume fat grafting can lead to fat necrosis, especially with volumes over 450 cc, concurrent implant exchange, or post-radiation therapy. Identifying these risk factors is crucial for patient safety and outcomes.

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Last Updated: Aug 31, 2025

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Area of Science:

Plastic Surgery
Reconstructive Surgery
Oncology

Background:

Fat necrosis is a known complication of autologous fat grafting.
Large-volume fat grafting is increasingly utilized for breast reconstruction and augmentation.

Purpose of the Study:

To evaluate the incidence of fat necrosis after large-volume fat grafting to the breast.
To identify risk factors associated with fat necrosis in this patient population.

Main Methods:

Retrospective review of 83 patients undergoing large-volume (>100 cc) autologous fat grafting to the breast.
Data collected on patient demographics, graft volume, surgical history, and outcomes.
Fat necrosis defined as palpable or imaging-detected nodules.

Main Results:

Overall fat necrosis incidence was 32.9%, rising to 47.8% in previously irradiated patients.
Increased necrosis risk associated with graft volumes >450 cc, higher BMI, and simultaneous implant exchange.
Fat grafting to irradiated breasts showed higher complication rates.

Conclusions:

High-volume fat grafting (>450 cc) increases fat necrosis risk.
Concurrent implant exchange and prior radiation therapy are significant risk factors.
Careful patient selection and surgical planning are essential to minimize complications.