How can I fix these pockets and rippling from smart lipo years ago? (Photo)

Question

Yes i had smart lipo years ago and I addressed these issues years ago with just dr but he then went out of business. What can be done for these areas? Anything less invasive than liposuction. And if that’s needed what is the recovery Have ripling hard areas in pelvic area then two pockets ( bubbles) that are hard on each side of my belly button

Anna Chacon, MD, FAAD · Answer

Hi, thank you for sharing your photos and explaining your history. I can understand how frustrating it must feel to still be dealing with these irregularities years after your procedure — especially after already trying to address them.

What you’re describing — rippling, firm areas in the pelvic region, and hard “bubble-like” pockets near the belly button — is often related to post-liposuction contour irregularities. After procedures like Smart Lipo, uneven fat removal, scar tissue formation, or fibrosis (thickened internal scar tissue) can create firmness, waviness, or localized pockets.

The “hard” feeling you describe is commonly due to fibrosis rather than active fat. Over time, scar tissue can tether the skin unevenly, creating that rippled or bubbled appearance.

If you’re hoping to avoid another surgical liposuction, there are less invasive options that may help depending on the underlying cause:

Subcision – A minimally invasive technique that releases scar tissue bands under the skin. This can improve tethering and smooth rippling.

Radiofrequency microneedling or RF treatments – These can help soften fibrosis and stimulate collagen remodeling.

External ultrasound-based treatments – Sometimes used to break up scar tissue.

Targeted steroid injections – In certain cases of thick fibrosis.

Fat grafting – If there are true depressions, adding volume strategically can smooth contour irregularities.

If revision liposuction is needed, recovery is typically shorter than the initial procedure, but it still involves swelling, compression garments for several weeks, and about 1–2 weeks of social downtime. Full settling can take a few months.

The key first step is determining whether the issue is:

Residual fat

Scar tissue/fibrosis

Skin laxity

Or a combination

Each requires a slightly different strategy.

Please know that post-lipo irregularities are more common than people realize, and there are ways to improve them. The right approach depends on what’s structurally happening beneath the skin — but in many cases, improvement is very achievable without repeating aggressive surgery.

How can I fix these pockets and rippling from smart lipo years ago? (Photo)

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