Late instantaneous development of lump after SculpSure, could it be a fat cell hyperplasia?

SculpSure has the potential to create "nodules," which are essentially fat cells that are being broken down and trying to stick together. As stated by others, increase massaging, use NSAID's and use warm compresses. Also make sure you are staying adequately hydrated, increase water intake.
The delay in appearance is due to the rate at which your body is breaking down the fat cells. There are several reasons why you may have gotten one this time, but not the previous treatment. There is unfortunately no way to tell exactly the cause.
In the trials, most nodules resolved in under 3 months, with proper care. Follow up with your provider to have an exam of the area and seek further recommendations. 

Lumps occur not infrequently following sculpsure treatments. This occurs because of the destruction of the underlying fat cells. An inflammatory reaction occurs which causes these lumps to form. These lumps can be seen within a few days to up to 1 month following the procedure. Gentle massage and heat will help the lump diminish.

It is possible to get some lumps after having a SculpSure procedure.  This is usually due to swelling and inflammation as your body breaks down and mobilizes the destroyed fat cells.  Massaging the lump can help speed up the resolution and anti-inflammatory (NSAIDs) can help reduce the swelling.  Check with your doctor to address any concerns.  
To my knowledge fat cell hyperplasia has not been reported with SculpSure though it has been reported with CoolSculpt.

Lumps ( from fat death or fat necrosis )after sculpsure are not uncommon . Every case is different and if you were to be advised to spend 10-15 min a day  of massaging the treated areas perhaps this could have been avoided. It also depends if you had some previous surgeries, C section, abdominal surgeries, plastic intervention in the treated area ( in these cases this could be a result of residual fibrotic tissue). In any case deep massage, warm compresses are the only options you have. I would call my MD and ask to evaluate and decided on when the next treatment should take place.
Time is the main factor. Give it 4-6 months and if still not resolved and do bother you a sonogram could be considered.

Lumps can appear after SculpSure treatment in any area even if you have treated the area before. It is fat cells which have died and have inflammatory cells around them to allow them to leave the body. Massage the area, and you may use heat or cold packs to help your lymphatics eliminate the cells. They will go eventually. Good luck!

Areas of induration (painful lumps) can develop after a SculpSure session, even if you have not had them previously from SculpSure.  Massage the area for 5-10 minutes 3-4 times/day and apply either hot or cold compresses, whatever feels better.  It should resolve over time.Good Luck!

Lumps after SculpSure can appear several weeks (up to 6 weeks in our experience) as the body cleans up the inflammatory debris, and debris from dead fat. The body may respond to a clump of dead fat by sending collagen producing cells (called fibroblasts) to build collagen around the lump and try to wall it off.
Do not be discouraged. This is still early. But it will require diligent massage. We recommend massage for 2-3 minutes when you are using the bathroom, instead of longer sessions twice a day. Then you won't forget. Warm compresses (NOT microwaved) or a warm bath can also mobilize the white blood cells that clean things up.

Thanks for sharing your question. I can appreciate your concern.

A possible explanation to your condition is: that the treated fat is undergoing the destruction process. The timing is in the normal time-frame for this to appear. Warm compresses and massage will help the process. Usually this is not a permanent condition. 
Finally, make sure that your doctor is aware of your process. She/He should be able to guide you best in your care.
Wishing you the best in your journey

IMPORTANT DISCLAIMERIt is difficult to say what is exactly happening with your case without a physical examination, testing or having done your surgery. It is imperative that you have a thorough examination by a board-certified surgeon. Only then, you may weight better the options to fix your current concerns.

it could just be either inflammation of the fat, or its breakdown. I will bet that it will get much smaller over the next few months. Gentle massage should help. It could be a lymph node if it is your inner thigh. you can show it to your doctor, who should be able to tell with an in-person examination.david berman md