At one year post-op, your healing is essentially complete, and any soreness or "little knots" are unlikely to get better or resolve. This is due to the areas of dead fat that have turned into scar tissue, not because you failed to have massage therapy.Not all of the transplanted fat heals and survives, and any dead fat cells or globules turn into scar tissue or areas of fat necrosis that can feel firm or like "little knots." This is not harmful, but can be uncomfortable and visibly irregular. (BTW, this is why I do not endorse fat grafting for breast augmentation, as scar tissue, "little knots," or microcalcifications can confuse the diagnosis of breast cancer on mammography. Though radiologists can often identify the differences between dead fat calcifications caused by fat grafts that do not survive, from dead fat caused by cancer, I am unwilling to risk the lives of my patients by fat grafting their breasts.) Since buttocks do not develop beast cancer, this area of fat grafting does not have this concern!Massage would not have increased fat graft survival, nor will it be helpful now that healing is complete. The best I can offer is reassurance that soreness is not of concern unless it is accompanied by redness, swelling, or purulent drainage (pus) indicative of infection. Best wishes! Dr. Tholen
