Bumps, Lumps and Roping After Smart Lipo: Is This Normal?

I had Smart Lipo on my upper arms 6 weeks ago, and I'm horrified by the lumps and bumps on the underside of my arms. I look disfigured and I'm scared it will not improve. I've been massaging the areas daily, sometimes to the point of bruising my arms since it is such a tender area. I don't really see a consistent improvement. Would Endermology or Velasmooth treatments help? How about Tri Active treatments? When should I expect improvement, or should I accept the fact that there won't be any?

Doctor Answers 11

Upper arms and inner thighs are DANGER ZONES for liposuction

The thin skin in the upper arms and inner thighs make these areas very risky for liposuction compared to other areas of the body where the skin is thicker and more elastic. These two areas should be approached with a very conservative procedure consequently (or not done at all if the skin is too loose). Massage and time are your best allies now that the surgery has already been done. The other treatments probably won't make it any better than massage, time and mother nature. You won't know what your final result will be like until the 4-6 month mark. Good luck with it.

Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

Arms-Smartlipo-effective, but time, compression and use of foam assists smooth result

I have found Smartlipo of the arms to be very effective and in many instances a "wow".  Of course, the patients who may benefit from this have to be carefully selected and informed of the procedure, the phases of recovery, and the realistic expectations for a good outcome.  The patient with good skin tone and localized fat of the inner arm and over the deltoid/triceps area are the best candidates  I have been amazed at the results on older patients in their 60's, who have good skin retraction and shrinkage if the laser is properly and safely used for skin tightening  of the inner arm skin.  I have even used it on weight loss patients who, in the past, I would have recommended an arm lift.  I have always disliked, what I term, a "zipper scar" of the inner arm that is permanent when an arm lift is performed.  I fatty, flabby, flapping arm is replaced with a smaller arm that is not contoured as naturally, as I can achieve with Smartlipo, and the real downer is the permanent zipper scar that still requires clothing to hide!  I have found that the use of Topifoam/Epifoam is essential in contouring the arm skin during the early recovery phases of this procedure.  To control the skin re-draping and edema/bruising.  The less bruising, the less likelihood of lumps from small collections of blood.  The pressure from the foam helps the skin to adhere to the underlying muscle.  At approximately 3 to 4 weeks post-op, I advise the patients to start muscle building of the arms, so the skin will have more "fill", but muscle "fill" and definition, rather than fat. 

What you have at 6 weeks sounds normal and it is advisable to wait for 6 months to 9 months to 1  year to see the final result.  Compression and massage are essential  Ultrasound may also be used to break up the scar tissue and help improve circulation.  I also like the Clarisonic Pro with the Body Brush to promote circulation in the shower and you will love this device, as it will massage the soft tissues as well as exfoliate the skin. 

Christine A. Petti, MD
Los Angeles Plastic Surgeon
4.2 out of 5 stars 20 reviews

Lumpiness Is Often Normal

Although you're 6 weeks out from your SmartLipo procedure, it's still far too soon to assume you'll need a revisionary treatment or that your results are permanent. Lumpiness is a normal part of the healing process after liposuction and may take up to 12 weeks to resolve completely. See the surgeon who performed your SmartLipo to learn more about what you can expect and what you can do to facilitate the best possible outcome. Good luck!

Kevin M. Johnson, MD, FACS
Spokane General Surgeon
4.3 out of 5 stars 17 reviews

Bumps, Lumps and Roping After Smart Lipo: Is This Normal

Thank you for submitting your question. I am sorry you are feeling disappointed with your surgery. Swelling after liposuction will last for many weeks after surgery. Hard lumpy areas are common in the first several weeks after lipo but rest assurred they will dissapate in 6-12 weeks. Final results take 6-12 months. Continue to use your contour garment, massage the hard areas , external ultrasound and lymphatic massage will help to decrease swelling. I would not recommend massaging the arms to the point it is bruised; this is causing more trauma and swelling. to the area  Discuss your concerns with your Plastic surgeon.

Jeff Angobaldo, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 108 reviews

Lumps and bumps after Smart Lipo of the upper arms

Small lumps and bumps are normal after Smart Lipo procedure. They are scar tissue and typically presents up to 6 months after the procedure. These are small areas of scar tissue under the skin. However, it should not look disfiguring.  If it is disfiguring likely it is due to over resection of the fat. However, it is still early in your recovery process. Messaging and ultrasound treatments should help to loosen up the scar tissue. Good luck.

Mytien Goldberg, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 5 reviews

Wait Several Months before Doing Anything Dramatic after Smart Lipo

As with most of the comments thus far, it is best to wait several months to see if first they will resolve before having anything dramatic done to the area. Having said that, in 2014, many of us would be adding on a radiofrequency treatment course with one of the many RF devices out there to try to smooth the area somewhat.  You can use VelaShapeIII, Venus Legacy, Pelleve, Exilis, EndyMed 3Deep, or the Alma Accent or VShape — all may help some and make things better sooner. I would tell you to check with your doctor to see if they offer any of these treatments.  And again, as with any procedure, you need to make sure before getting into it that the person doing it is skilled and experienced — and in this case, only board-certified dermatologists and plastic surgeons well-versed in lasers and liposuction should be doing these, in my opinion.

Michael Gold, MD
Nashville Dermatologic Surgeon
4.0 out of 5 stars 18 reviews

Liposuction swelling - Los Angeles

Active massage will help the areas noted as the lymphatic system improves with time.  I would continue massage and continue to have your surgeon monitor the results. Raffy Karamanoukian Los Angeles

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 94 reviews

Six weeks is too early to judge Smartlipo results

Arms can be a problem area, but I have had very good results with Smartlipo in this area.  Some swelling after 6 weeks is normal.  It will look like "lumps and bumps".  Usually your surgeon can tell if the amount you have is within normal limits.  It is too early to judge the final result at 6 weeks.  How much swelling you have depends on how much was done and how you heal.  Soft tissue massage can be useful to help dissipate the lumps.  I can't tell without an exam, or at least a photo, to what degree you have lumps and if they are likely to go away.  One thing for certain, they should continue to improve as the tissue softens and heals fully.

Daryl K. Hoffman, MD
San Jose Plastic Surgeon
4.6 out of 5 stars 16 reviews

This is one very real challenge with underarm/arm surgery unfortunately

While many people can turn out great when they do liposuction on the arm area, it doesn't always turn out that well. It is this reason that makes my rate of arm liposuction very low. In order to be a good candidate, you need to have excellent elasticity and the surgeon has to be very careful while doing the procedure or you will have problems afterwards.

You may benefit from Endermologie or VelaShape treatments, but I'd try them quickly or you will lose some beneficial recovery time. Hopefully, your surgeon will offer these for you at a discount given the challenges you have had.

Joel Schlessinger, MD
Omaha Dermatologic Surgeon
4.8 out of 5 stars 40 reviews

Lumps after SmartLipo

At 6 weeks, having lumps and bumps can be very normal. They typically dissipate in time, up to 12 weeks, with your best results even 6 months after that. Give it time. We do use VelaShape post lipo to assist in the process.

Emerico Csepanyi, MD
Newport Beach Physician
4.3 out of 5 stars 6 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.