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Hi DL I have fat necrosis in one of my partially reconstructed breast, which is on hold as my cancer returned and I am in the middle of radiation. My plastic surgeon is not concerned with the unpleasant hard spot cause he will remove it when it comes time to finish the reconstruction process. Fat necrosis usually occurs around an incision site, and I've been told that you should gently massage the tissue anytime after a surgery has healed to help keep the tissue soft. Since I still have my tissue expanders in until I complete radiation, I had to be warned of what could possibly occur with them in.  I can develop little hard spots in the tissue around my expander.  It is a risk, but I know my plastic surgeon will remove any hard spots when we do the final surgery. The only way to get rid of the necrosis is to have it surgically removed - and yes the spots can grow larger - as PJ said it is due to a lack of blood circulation to that area.  I beleive that it is never to late to start massaging it, but it will not make it go away, just help prevent it from getting bigger.  See you surgeon, he will probably do like a lumpectomy to remove the dead tissue.  As far as I know the necrosis poses no real threat, it's just unpleasant to have hard breast.  So make sure that if you do go the removal route to massage the tissue as soon as the incision has healed. Good luck to you! Angi