Which procedure would help remove lumps caused by laser liposuction? 3 years post op (photos)

It’s understandable that you’re concerned about the irregularities and firmness you’ve experienced following your procedures. Fibrosis after aggressive liposuction can be challenging, as it creates hardened scar tissue beneath the skin, resulting in indentations or lumps.
To address fibrosis, treatment often involves multiple approaches, such as therapeutic massages, radiofrequency treatments, or even injections specifically designed to break down dense fibrotic tissue. Occasionally, carefully performed revision surgery, possibly combined with fat transfer, might be considered to smooth out irregularities, although this requires an experienced surgeon skilled in managing post-liposuction complications.
Since your tissue has already proven difficult to penetrate, minimally invasive methods like radiofrequency-assisted lipolysis (e.g., BodyTite) or ultrasound-assisted treatments could help soften fibrotic tissue and improve the contour.
Ultimately, a thorough in-person evaluation by a surgeon experienced in complex revision liposuction cases is necessary to determine the most effective strategy tailored specifically to your situation.
I hope this helps you understand your options better. A consultation with a specialized surgeon would definitely provide more personalized insights.
— Güray Yeşiladalı, MD

Fibrosis, or firm areas, in the soft tissue following liposuction, especially with laser is not uncommon as inflammation and swelling is part of the healing process. However, this should usually resolve after several weeks or a few months on its own. Hard, outlined areas that persist for years are due to scar tissue under the skin which may have resulted from improper laser application, fluid and blood collection (which is highly irritating to the soft tissue) or technical misadventure. If non-invasive maneuvers such as massage, steroid injection (not recommended), or external ultrasound are not successful, you may need another procedure.

Liposuction alone may not be enough since there is scar tissue that is not amenable to it, as in your case. Internal ultrasound (VASER) and/or radiofrequency (BodyTite) have helped in certain cases but in extreme cases, the scar which is manifested as a capsule of tissue under the skin may be needed to be removed by direct excision to get the overlying skin and soft tissue to look and feel right. Good luck and look for a qualified plastic surgeon who has a large volume of body contouring cases in his or her experience since this is more than a run-of-the-mill situation.

Based off your limited photo - looks like there is irregularity defects from the liposuction(s) prior and being that you are low body fat as a baseline - this is a difficult problem (skinnier BMIs have more imperfections show post liposuction so the surgeon needs to be very meticulous).
Multi-modalities to try to fix this, 1. try to work your core (pilates reformer, weight lifting) helps reduce some fat in the area and possibly contract some of that skin, 2. increase protein intake and lower fats and carbs, 3. try lipo again but also to fat graft back some fat to areas where there seems to be more taken out; also if the surgeon you seek has some skin tightening modality that can be used invasively at the time of the revision lipo, 4. after all else fails, either be ok with it and live with it or go more invasive - potentially a mini lower abdominoplasty can help reset the lower abdominal skin and flatten this out for you but at the cost of a smiley lower abdominal scar.