Skin tightening, Kybella, more lipo? What would you do to correct the lumps and unevenness on abdomen due to bad lipo? (photo)

Pending a formal evaluation, you may be a good candidate for a Revision Liposuction. You need a formal evaluation by an expert in body shaping and contouring to determine what is best. Its likely you will need skin removal and fat grafting to get improvement.
The best in body contouring not only removes fat with energy devices like VASER ultrasound but also internally heats the skin with radiofrequency devices such as Renuvion (J-Plasma), InMode BodyTite, and ThermiRF to heat the undersurface of the skin and tighten it at the same time as fat removal. These combinations are called 4D HI-DEF VASER Liposuction and can only be done by a well-trained body contouring specialist. At the same time, fat should be harvested and purified, with PRP and stem cells added, and then injected into muscles, indentations and cellulite to get body shaping and contouring. For a Brazilian butt lift (BBL), we inject the fat into the buttock for contouring and lifting, but fat can also be used in areas such as the chest/breast, arms/shoulders, calves and face. Cellulite should also be treated with a combination of Cellfina, subcision, and/or fillers such as Bellafill, Renuva synthetic fat, or Sculptra. If skin is very loose before surgery, then it will need to be removed: tummy tuck/abdominoplasty for lower abdominal skin; breast lift for excess breast skin; and/or a brachioplasty for loose arm skin. Overall, you need a full assessment, but simple liposuction alone will not tighten skin and needs a combination of various methods -- fat removal, skin tightening, defining, fat grafting, skin removal -- to get the best in body contouring and body sculpting. See an expert. Best, Dr. Emer.

Kybella is worthless. Once in a while a little tweeking after liposuction is needed to smooth out areas that are uneven or wavy. It is done under local and easy to undergo. Skin tightening with Bodytite RF is done at the same time for best results. Always give your doc a chance to improve the results with a touch up procedure. It is only fair and logical. He/she probably will only charge for the operating room fees or something that is reasonable. Fat that is dislodged or free floating during the liposuction process can settle in pockets that appear lumpy or bumpy or sometimes it is scar tissue developing which just needs a little cortisone shot to dissolve. If you go to another doc to improve the results then you must expect to pay full price as a new patient. Touch up lipos can be done as early as 4 months post op the original procedure in many cases.

Dear vampirebarbie,
I would have to examine you but it appears that this is a contour irregularity after liposuction.  This happens often when areas the undergo liposuction are not feathered appropriately. The good news is that it can be fixed and I have done so with good results before. 
While there is always a chance for contour irregularities with liposuction, someone who takes their time and uses the appropriate sized cannulas should give you a superb result. I have all my patients wear compression garments and I use multiple sized cannulas to feather out the result.
Daniel Barrett, MD

I would not recommend more fat removal, but you could consider fat grafting and even Sculptra injections to try to improve smoothness. I would suggest fat injections for the deeper areas, and then follow with Sculptra about 3 to 4 months later.

Thank you for your photo. You appear to be a good candidate for a mini-tummy tuck to help resolve some of the lumps and uneveness of your lower abdomen. This should be combined with revision liposuction and fat grafting into the individual depressions to improve your general contour. When performing liposuction on thin or athletic patients, the surgeon should take extra care in using smaller cannulas at a deeper level to avoid creating these contour abnormalities. Hope this helps!Johnson C. Lee, MD

Board-Certified Plastic Surgeon

 Correcting poorly done liposuction comes down to three different options.  Revision liposuction, fat transfer or a combination versus excision  of the affected area.  If you have skin laxity then excision of the lower abdomen with a full tummy tuck would be a perfect solution since you only had your lower abdomen treated. Correcting poorly done liposuction it is difficult and often not possible.  This is especially true for people who have been over treated.  It's hard enough to start with a smooth contour and maintain a smooth contour.  Starting with an uneven contour and creating a smooth contour is very very difficult.  Usually some improvements can be made with revisions.  Best, Mats Hagstrom MD