Why do irregularities and lumps occur after liposuction?

Liposuction is one of the most popular body contouring procedures aimed at removing excess fat deposits. Like any plastic surgery, it carries certain risks. One of the most unpleasant complications is the appearance of contour irregularities and bumps instead of the expected smooth body shape. 

The reasons for this can vary, and understanding them is crucial to prevent such situations.

Photo: Example of unsuccessful abdominal liposuction. Contour deformity after liposuction

Causes of Contour deformity After Liposuction

Irregularities and bumps after liposuction can be caused by various factors:

• Uneven fat removal. During liposuction, the surgeon removes excess fat from specific body areas. If the fat is removed unevenly, there may be areas with residual excess fat or over-removal. The surgeon must carefully monitor the fat removal to maintain natural body contours;

• Errors in liposuction technique. Choosing the wrong liposuction method or insufficient surgeon qualifications may contribute to irregularities. For example, using traditional liposuction methods that do not consider the natural body contours increases the risk of bumps;

• Skin type and tissue condition. Skin and tissues vary among individuals. If the patient’s skin loses elasticity or if they initially have significant scar tissue, the risk of irregularities is higher. Age also plays a role—skin becomes less elastic with age, increasing the risk;

• Swelling and fibrosis. In the first weeks after liposuction, swelling is normal, which can create temporary irregularities and asymmetry. This is a natural part of the healing process. It is important to wait until the swelling subsides, which usually occurs within a few weeks, and the body contours gradually smooth out. However, in some cases, lumps (fibrosis) may form and require additional treatment;

• Non-compliance with the doctor's recommendations. Such as failing to wear compression garments, excessive physical activity, poor nutrition, or alcohol consumption.

Important! Irregularities are acceptable within the first 2-4 months after surgery. If more time has passed and irregularities persist, then it’s time to consider correction. 

How to Fix Irregularities and Bumps After Liposuction?

Depending on the causes of post-liposuction irregularities, the most effective method of correction is selected:

• With the help of lipofilling - injecting the patient's fat into problem areas. During the procedure, infiltration helps elevate the skin. In some cases, if necessary, the surgeon may create a pocket by subcision, then inject fat to smooth the irregularities and restore natural body contour.

• Massages and lymphatic drainage. These help reduce swelling, soften lumps, improve fluid circulation, and promote faster tissue recovery.

• Injection and hardware treatments (mesotherapy, radiofrequency lifting, laser, and ultrasound therapy). These stimulate collagen production and help tighten the skin, smoothing minor irregularities.

• Secondary liposuction. In some cases, a secondary operation may be required to correct contours. 

Which Liposuction Method Provides the Smoothest Results?

The main complication that patients approach me with after other doctors and methods are indentations, bumps, irregularities, and asymmetry. Thermal methods like laser or ultrasonic-assisted liposuction often result in irregularities due to the tissues' reaction to heat and the formation of more pronounced fibrosis compared to the tumescent method. Therefore, I choose the safest³ and most predictable method – vibro-tumescent liposuction, which provides the smoothest surface and minimal complications.

Vibro-tumescent liposuction is a fat removal technique combining tumescent liposuction and vibration. A special solution is injected into the target area to facilitate fat removal and minimize blood loss, followed by a vibrating cannula that gently breaks down fat cells, making the process more precise and reducing irregularities, speeding recovery.

Combined thermal methods (laser, ultrasonic, etc.) use physical properties of laser and ultrasound to destroy fat cells, coupled with mechanical tissue damage. Thermal effects not only destroy fat cells but coagulate surrounding tissues, including blood vessels, providing slight skin tightening. Unfortunately, the heating of tissues, which is an advantage, often results in subcutaneous scarring ("new collagen") and small or large burns. 

Dry classical method involves removing fat deposits with a special cannula using a vacuum. This method is the most traumatic, increasing the risk of fibrous tissue formation and, consequently, skin bumpiness.

Important! Vibro-tumescent liposuction is the safest and most effective liposuction method when performed correctly! Therefore, the surgeon's aesthetic vision and skills are crucial for achieving a beautiful result.

Sources:

1. Liposuction Complications in the Outpatient Setting: A National Analysis of 246,119 Cases in Accredited Ambulatory Surgery Facilities https://academic.oup.com/asjopenforum/article/doi/10.1093/asjof/ojad107/7453295?login=false
2. Cleveland Clinic Journal of Medicine/ Liposuction: Concepts, Safety, and Techniques in Body-Contouring Surgery https://www.ccjm.org/content/ccjom/87/6/367.full.pdf
3. Journal of Cutaneous and Aesthetic Surgery "Tumescent Liposuction: A Review" https://journals.lww.com/

Content author - plastic surgeon Valentyn Zykov

• Practicing surgeon since 1998
• I perform more than 500 operations a year
• Laureate of the 21st national program "Person of the year"
• I operate in Poland (Warsaw) and Greece (Athens)

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