Fibrosis is not a condition some people get, and some people don’t. It is usually the outcome of overzealous Liposuction basically removing all subcutaneous fat. All Liposuction will create scar tissue. If it’s sufficient amount of fat is left behind, then the fat can absorb the scar tissue and the tissues feel relatively normal. However, there is no fat left. Then the scar tissue becomes palpable and is what some people referred to as fibrosis. The problem is not so much that the body formed excess scar tissue. It is that there is no fat left. This outcome seems more common when aggressive energy devices like VASERR used. There really is no treatment that’s going to improve your outcome. Liposuction is more or less a permanent and irreversible procedure. Attempts at grafting fat may be helpful in some individuals, but typically the grafted fat does not survive well, because the graft does not have host tissue to support the grafted tissue. In order for grafted fat to survive, it has to be surrounded by live vascular tissue, and when all the fat has been removed, the underlying dermal surface or muscle fascia is insufficient to support the graft which tends to die and become fat necrosis, leaving to more scar tissue. There are no non-surgical treatments that are going to make your condition better. Some people claim ultrasound, massage etc. etc. help but I think in reality if you looked at before and after pictures you would say that those treatments more or less did nothing. There may be some areas were restoring or revising the area with fat transfer may give some improvements. Typically improving outcomes after highly aggressive Liposuction that is uneven, requires multiple sessions, and must be done by someone who has sufficient skill and experience, or the outcome can easily be made worse. Revision work is many times more difficult than primary Liposuction. Delivering consistent quality Liposuction results is more difficult than most people realize. The number of plastic surgeon truly mastered this procedure is quite small. In the end, the two variables that determine almost all plastic surgery procedures are the patient’s candidacy and provider selection. You may or may not have been a good candidate for the BBL in the first place. Your provider was a little heavy-handed with the Liposuction. Finding a provider who has the skill to walk you through the revision process may be difficult. Finding the right plastic surgeon is more difficult than most people realize. To find the right provider I suggest patient start by having multiple in person consultations with plastic surgeons in their community who seem to have a strong track record for Liposuction and fat transfer. During each consultation ask each provider to open up their portfolio and show you previous cases that they’ve worked on. Recognize that fat transfer results can look very impressive early after the procedure, but early results do not represent final long-term outcomes. Whenever reviewing before, and after pictures for fat transfer, always confirm the timeframe of when the after picture was taken. After pictures should not be taken less than 3 to 6 months from the date of the procedure in order to be representative. Weather going through a multitude of procedures for small improvements may or may not be worth the effort. In order to determine what can and cannot be accomplished with a better understanding of your candidates for revision surgery. We really need an in person evaluation with an examination. It’s also important to understand exactly what areas bother you most, what you’re trying to achieve and what you’re willing to go through to improve the outcome. There are no easy solutions here. Best, Mats Hagstrom, MD