Tummy is lumpy and misshapen after 2 liposuction procedures. Is this a skin or fat issue? (photos)

Based on the posted photos you need full TT with muscle plication. Seek virtual consult with... Fee $8,000+

In order to make an assessment on the outcome of an operation we need to see proper before and after pictures.
If you don’t have before and after pictures then ask your surgeon to forward the ones they took. They are part of your medical record and are available to you upon request.
Based on your pictures it looks like you’re out, it’s a combination of perhaps not the best liposuction on someone who was really not a very good candidate for Liposuction in the first place.
There are four variables that determine what someone’s abdomen looks like. Each of these four variables is treated differently.
And making an assessment it’s important to differentiate with a primary, secondary, tertiary and possibly quaternary variables are that are contributing to the way the abdomen looks.
The four variables are abdominal skin laxity typically related to weight fluctuations or previous pregnancies or possibly age, excess subcutaneous fat, muscle separation from previous pregnancies and lastly excess visceral or intra-abdominal fat.
It looks to me like skin laxity is your main issue and a skin tightening operation like a full tummy tuck would’ve been a far better choice than Liposuction.
Ideally during in person consultations plastic surgeons should make quality assessments and explain what can and cannot be achieved with various treatment options so patients can make quality decisions.
Because skin laxity is probably the number one reason the patients failed to get good liposuction results it’s hard to tell how well or poorly your liposuction was done.
Further liposuction is unlikely to give you significant improvements since your skin laxity is contributing significantly to your body contour.
To differentiate how much skin laxity is contributing to your contour you can simply lift up or pull down on your skin while looking in the mirror or take a picture using the timer on your camera.
With the skin under tension you can also access the thickness of your subcutaneous fat layer far more accurately.
With loose skin most people recruit skin them by pinching it when trying to assess how much subcutaneous fat they have. this is not an accurate way to determine the thickness of the subcutaneous fat layer since recruiting inches of skin can make the fat layer feel much thicker than it actually is.
The lack of results is probably primarily due to your skin laxity and not being a good candidate for Liposuction in the first place.
The ability to see proper before and after pictures would make a big difference in ability to assess your outcome.
Consider re-posting with before and after pictures or have a few in person consultations with other local board-certified plastic surgeons.
For a second opinion consultations it’s a good idea to come prepared to bring with you the before and after pictures and The operative report from your previous procedures.
These are part of your medical records and are available upon request.
Best,
Mats Hagstrom MD