Can lumpy skin from fat transfer be smoothed?

Some of the fat has probably resorbed with time so it is not regular under the skin.  The acne scars will also make the skin less regular.  You should try doing Ulthera to the areas.  Ulthera is deep ultrasound.  We have found that if patients have any sort of nodules under the skin - such as silicone, radiesse, or fat, that the deep heat of the ultrasound helps to soften and flatten the area.  May take 3-4 treatments.  I would not go to surgery as a first option.

I'm so sorry you are having this experience. A plastic surgeon with expertise in fat grafting would not have left you lumpy. The result could be a smooth, beautiful and permanent result. Fat grafting can help acne scars, but not all types of acne scars. If a person has superficial scarring, and all ready has a full face, fat grafting is not the answer. laser skin tightening, microdeeling and possibly juvederm could help.At this point, I would seek out the expertise of a plastic surgeon with extensive experience in fat grafting to try to correct your problem.   

This can be difficult to correct if the fat is very superficial.  With weight gain your face can get larger. Sometimes microliposuction can help.

Lumpiness after fat transfer can be improved upon. An examination is needed to determine what is the cause, Possible fat necrosis, or irregular fat survival, very superficial injection of fat to the dermis. Sometimes A CT scan or MRI is needed.Surgery might be the only alternative to improve on the condition.Fraxel is not going to wok nor any other non invasive procedure. wasting money