Cutaneous fistula of the breast: A complication of cosmetic autologous fat transfer.

Autologous fat transfer is a growing cosmetic procedure which is most often well tolerated with generally low rate of complications, the majority of which occur in the immediate post-treatment period. The procedure has been more recently applied to the breast as an alternative to traditional prosthetic augmentation. We present a case of a delayed cutaneous fistula, which occurred 18 months following fat transfer procedure, in a 34-year-old female. The patient presented with increasing pain and dermal erythema. Mammographic appearance evolved from a typical thin-walled liponecrotic cyst to a dense mass with an obscured margin. Sonography showed complex cystic and solid components, with an elongated tract extending to the draining fistula at the dermis. The fistula and symptoms ultimately resolved following antimicrobial therapy and conservative treatment. Physicians and patients should be aware of this uncommon potential complication.