Hello LK1223. Thank you for your question regarding the hard lump you've noticed six months after undergoing ultrasound liposuction on your abdomen. Thank you for providing detailed pictures and a history of your procedure. It's great to hear that there has been some reduction in the size of the lump after compression garments and lymphatic massages, but I understand your concerns about its persistent nature. The lump you're describing could be due to several factors: Scar Tissue Formation: This is a common occurrence after liposuction where the body's healing process leads to fibrous tissue buildup. Seroma or Hematoma: These are accumulations of fluid or blood, respectively, that can occur after surgical procedures. While these typically resolve with time, persistent cases might require medical intervention. Underlying Muscle Protrusion: Given the location and the firmness, there is also a possibility that what you're feeling could be related to the underlying muscle structure. Diagnostic Steps: Ultrasound or CT Scan: To accurately determine the cause of the lump, further imaging with an ultrasound or CT scan is advisable. This will help identify whether the lump is due to scar tissue, fluid accumulation, or other anatomical issues. Treatment Options: For Scar Tissue: If the lump is indeed scar tissue, injections of steroids or 5-fluorouracil (5FU) can help dissolve the fibrosis and reduce the lump. For Seroma or Hematoma: Persistent fluid collections might need to be drained with a needle under sterile conditions by your surgeon. Diet and Exercise: If the mass is related to residual fatty tissue or deeper visceral fat, enhancing your weight loss efforts through diet, exercise, or medications like Ozempic or Zepbound may provide improvement. Consideration for Tummy Tuck: If the issue is due to underlying muscle or fascial weakness, especially below the belly button, a tummy tuck might be considered to tighten and flatten the abdominal muscles and fascia. Next Steps: Follow-up with Your Surgeon: It is crucial to keep your surgeon informed about this issue. They can provide specific recommendations based on your individual case and the results of further diagnostic tests. Seek a Second Opinion: If you feel unsure about the advice or treatment plan from your current surgeon, seeking a second opinion from another board-certified plastic surgeon can provide additional insights and reassurance. Your proactive approach with compression and massage was appropriate, and continuing to monitor the lump while exploring these diagnostic and treatment options will be key to resolving the issue. I hope this information helps, and I wish you the best of luck in addressing and resolving the hard lump post-liposuction. Sincerely, J. Timothy Katzen, MD, FASMBS, FICS Plastic Surgeon