A case report of a patient who underwent mastectomy followed by delayed reconstruction with Transverse Rectus Abdominis Myocutaneous Flap, resulting in complete necrosis of the muscle, is presented. An epigastric flap was necessary to repair defects due to the removal of necrotic tissue. The patient presented a wide region of scar tissue, treated firstly placing an expansor and later with several procedure of fat grafting, following the lipofilling protocol. The remarkable results obtained with fat grafting technique in almost all patients we treated, led us to evaluate structural improvements of tissues by Ultrasonography also in this case.
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