How can I treat fat necrosis 3 years after BBL?

Based on location it is very unlikely that lump is related to fat grafts transfer and consecutive fat necrosis/fibrosis. It is unlikely that plastic surgeon who knows anatomy would place fat grafts so deep. MRI of the pelvis would be the best way to find out what is going on. Hope this helps.

Three years after a BBL, the hard lumps, pain, and paresthesia you describe could indicate fat necrosis, which aligns with your BBL history and may be located under the sacrospinous ligament. To treat it, consult a board-certified plastic surgeon and confirm the diagnosis with imaging studies. Discuss options like surgical removal, steroid injections, or massage therapy. Professional evaluation is essential for appropriate care and relief.

Dear lizzy168,
I understand your concern. However, without a proper assessment, it would be difficult to determine what is wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Unfortunately, Fat Necrosis is a fairly common complication of some techniques used in BBL surgery! Many of these chop shop, assembly line plastic surgery shops who do the whole procedure in 2-3 hours are typically injecting large blobs of fat which all dies and turns into fat necrosis. I have been doing BBL surgeries since 1997. The technique of Micro Fat Droplet Fat Grafting Is what I have always used and have never had Fat Necrosis.

If you didn’t have firm nodules in your buttocks before your BBL and you do after, then the firm nodules are most likely due to the BBL and are most likely representative of fat necrosis.
Whether the fat necrosis should be surgically removed or not is something you should probably discuss with your plastic surgeon.
Palpable or symptomatic fat necrosis is a direct reflection of how the Procedure was performed.
When good technique is used fat necrosis will develop but does not result in symptomatic palpable nodules.
Symptomatic fat necrosis is usually due to having had too much fat injected in a small area. In order to minimize symptomatic fat necrosis, grafted fat needs to be stratified in a number of thin layers.
Removing fat necrosis is not always indicated or appropriate.
Best,
Mats Hagstrom MD