Breast augmentation with autologous fat injection is becoming increasingly popular. This article aims to describe bilateral liponecrotic pseudocysts after injection of fat into the breast. A 42-year-old woman presented with palpable indurations and pain with pressure. She also showed abnormalities on her breast cancer screening. The woman underwent mammography, magnetic resonance imaging, and pathologic confirmation to evaluate the breast abnormalities. These radiologic examinations were consistent with liponecrotic pseudocysts on both sides. Bilateral lumpectomies were performed through an inframammary approach. Histologic examination of the specimens showed fat necrosis and dystrophic calcification. Autologous fat grafting to the breast is not a simple procedure and should be performed by well-trained and skilled plastic surgeons. During the surgery, caution should be exercised.
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