The Treatment of symptomatic Fat Necrosis: A Review

Published:November 23, 2022DOI:



      Fat necrosis (FN) is a well known complication in plastic surgery. Excision of symptomatic FN has been the gold standard but often results in contour irregularities which require subsequent treatment. Different alternative surgical and non surgical management strategies have been described, however, currently no guidelines exists. This literature review aims to provide an overview of available treatment options and current management standards to support clinical decision making.


      A literature search in the databases PubMed, Embase (via Ovid) and Web Of Science was carried out to identify eligible articles. The search strategy included combinations of the following terms: “Fat necrosis “AND (treatment OR management OR therapy). 6 articles discussing or reporting management strategies of fat necrosis in a plastic surgery context were included.


      A variety of techniques were used to manage symptomatic fat necrosis. Asymptomatic or small lesions can be treated conservatively. Oil Cyst and moderate sized areas of symptomatic FN can effectively be treated by aspiration, ultrasound-assisted liposuction or needle aeration. Calcified and large areas of FN require excision and debridement of necrotic fat tissue


      At present, there is no consensus on the management of symptomatic fat necrosis. The authors propose a new classification system to aide guidance of management of symptomatic FN.


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