Thank you for reaching out about your concerns with lumps and scar tissue following your liposuction procedure. It can be frustrating to deal with these issues, especially after attempting several treatments without significant improvement. The presence of lumps after liposuction can be due to uneven fat removal, the formation of fibrous scar tissue, or even fluid collections that have hardened over time. Here are some strategies that might help resolve these issues: Revision Liposuction: In some cases, additional liposuction performed by an experienced surgeon can help smooth out uneven areas. This procedure would focus on carefully removing fat around the lumpy areas to achieve a more even contour. VASER Liposuction: VASER is an ultrasound-assisted liposuction technique that can be particularly effective in breaking down scar tissue while preserving surrounding tissues. It uses ultrasonic frequency waves to gently break apart the fat cells and is known for its precision and ability to smooth out the skin. Surgical Scar Tissue Removal: For severe cases where there is significant fibrous tissue, surgical removal of the scar tissue might be necessary. This would involve excising the scar tissue directly, which can sometimes be combined with revision liposuction for optimal results. Laser Therapy: Laser treatments can help soften scar tissue and improve skin texture. Certain types of lasers stimulate collagen production and skin renewal, which can gradually improve the appearance of lumpy areas. Fat Grafting: If the lumps are due to overly aggressive fat removal, fat grafting (transferring fat from another area of the body to the treated area) might be an option to fill in depressions and create a smoother surface. It’s important to consult with a board-certified plastic surgeon who specializes in liposuction and body contouring revision procedures. Be sure to choose a surgeon with extensive experience in dealing with complicated cases of liposuction correction. They can provide a comprehensive evaluation and tailor a treatment plan specific to your needs. Given your willingness to travel for treatment, I recommend researching surgeons who are well-known for their expertise in liposuction revisions. Look for surgeons with excellent reviews, specifically from patients who have had similar issues resolved. Always check before and after photos of previous patients to assess the results. Lastly, while guarantees in cosmetic surgery can be difficult due to individual variations in healing and body response, a skilled surgeon should be able to significantly improve the appearance and feel of the affected areas. I hope this helps, and I wish you the best of luck in achieving the results you desire. Sincerely, J. Timothy Katzen, MD, FASMBS, FICS Plastic Surgeon