Abstract: To analyze the diagnosis and treatment process of four patients with non-tuberculous mycobacteria (NTM) infection after autologous fat grafting for breast augmentation, providing a reference for clinical management of this condition. All four patients were female, developing inflammatory reactions such as skin redness, swelling and pain 14–24 days after autologous fat grafting for breast augmentation. The secretion specimens were identified as NTM in all cases, including one case of rate Mycobacterium wolinskyi. This patient presented with scattered erythema on both breasts, an erythema ulceration on the inferomedial aspect inner of left breast with minimal purulent secretions and palpable induration around other erythematous areas without significant skin temperature or tenderness. Breast ultrasound revealed multiple hypoechoic areas bilaterally, with the largest measuring 21 mm × 25 mm on the left and 25 mm × 20 mm on the right. Based on NTM infection treatment guidelines, combined with surgical debridement, puncture drainage, sensitive antibiotics and traditional Chinese medicine (TCM) topical applications, all four patients were cured. For patients with NTM infections after autologous fat grafting for breast augmentation, surgical debridement, puncture drainage, multidrug antimicrobial therapy and adjunctive TCM topical applications demonstrates favorable efficacy.