It is one of the more disheartening situations a liposuction patient can find themselves in: years have passed, the initial swelling is long gone, and the skin still looks wrong — dimpled, uneven, tethered in ways that were not there before surgery. Dr. Farhad Rafizadeh receives questions exactly like this on his RealSelf Q&A page, and they reflect a common and underappreciated problem in post-liposuction care.
“5 years post lipo. Is this Fibrosis? What would be the best treatment to fix this? It’s been 5 years since my lipo and this has been bothering me for a while. I’m wondering if the highlighted areas are fibrosis tissue or something else. My skin used to be so nice before, but now it’s super dimply and I absolutely hate it. I really would love to get this fixed so I can have even and smooth skin again.”
This question arrives five years post-operatively. The dimpling is established, the patient has been living with it for years, and the natural question is: is this fibrosis, and can anything be done?
Dr. Rafizadeh’s Answer
You probably had a high definition liposuction. It looks like it was a deliberate effort to define the rectus muscles. If you don’t like those results, the only solution would be fat grafting. I would need to see you in person with the before pictures and an operative report to give you the final answer.
That answer is brief but contains layers of clinical reasoning worth unpacking. The diagnosis — likely high-definition liposuction with deliberate muscle definition — changes the conversation from “how do I treat fibrosis” to “how do we correct a sculpting result the patient didn’t want.” And the solution, fat grafting, is not the same as massage therapy or ultrasound: it is a surgical procedure that replaces the missing volume. Here is what North Jersey patients need to understand about this whole picture.
What Actually Causes Post-Liposuction Skin Irregularities
Not all post-lipo irregularities are the same. The most common causes, which can overlap, are:
1. Standard Fibrosis (Scar Tissue Formation)
Every healing wound creates scar tissue, and liposuction is no exception. As the tissue heals, fibrous bands can form beneath the skin. These bands may tether the skin downward at certain points, creating depressions or a dimpled, orange-peel texture. Mild fibrosis is common in the months after liposuction; significant, persistent fibrosis that alters the visible contour is less common and warrants specific treatment.
2. Uneven Fat Removal
If too much fat was removed in one area relative to adjacent areas — whether intentionally or due to technique — the skin in the over-treated zone sits closer to the underlying muscle or fascia and may look hollowed, irregular, or tethered compared to the surrounding tissue.
3. High-Definition (Hi-Def) Liposuction Sculpting
This is what Dr. Rafizadeh identified in the patient’s case above. High-definition liposuction deliberately removes fat over and around specific muscle groups — most commonly the abdominal rectus muscles — to produce a more sculpted, athletic appearance. When the patient does not want that sculpted look, or when the sculpting is more aggressive than expected, the result can appear as deep contour lines or depressions that the patient perceives as “dimpling” or “fibrosis.” These are not fibrosis in the traditional sense: they are the absence of fat in specific anatomical zones.
Why Fat Grafting Is the Logical Fix
When the problem is missing volume — whether from over-aggressive fat removal, hi-def sculpting the patient regrets, or persistent surface irregularities — the solution is to put fat back where it is needed. Fat grafting (also called fat transfer) uses the patient’s own harvested fat cells, purified and re-injected into the areas of deficit.
For correcting post-liposuction irregularities in Northern New Jersey patients, fat grafting has several important advantages:
- It uses the patient’s own tissue. There are no foreign implants, no synthetic fillers with longevity limits, and no immunologic risk.
- It is permanent in the fat that survives. Roughly 60–80% of transferred fat cells establish a blood supply and survive long-term. The correction, once established, is lasting.
- It is customizable. Small, precise amounts of fat can be placed exactly where the contour is deficient — in a dimple, alongside a contour groove, into a hollowed zone.
- It can be combined with scar tissue release. In cases where fibrotic bands are tethering the skin, the procedure includes subcision (releasing the bands) in addition to fat placement, which together produce the most complete improvement.
Dr. Rafizadeh notes that seeing the patient in person — with photos from before the original liposuction and, ideally, the original operative report — is critical for planning a fat grafting correction. The treatment zone, the volume needed, and the technique for scar release all depend on exactly what was done originally and what remains.
What Non-Surgical Options Can and Cannot Do
For completeness: non-surgical post-lipo treatments (manual lymphatic drainage massage, radiofrequency skin tightening, therapeutic ultrasound, external vibration) are most useful in the first 3–6 months after liposuction, when the underlying fibrosis is still actively forming and can be disrupted or softened. They are much less effective for established irregularities that have been present for a year or more.
A patient five years post-liposuction with persistent dimpling is past the window where conservative therapy will produce a meaningful cosmetic result. The fibrosis, if present, is mature and dense. The volume deficit, if it is a hi-def sculpting result, is not going to fill itself in. At five years, the realistic path to smooth, even skin runs through a surgical consultation — not another round of massage.
The Consultation Process in Morristown
The starting point for any revision conversation is a thorough evaluation. At Dr. Rafizadeh’s Morristown, NJ office, a consultation for post-lipo irregularities typically covers:
- Review of the original operative notes and before photos, if available
- Physical examination of the affected area to distinguish fibrotic bands from volume deficits from skin quality changes
- Discussion of realistic expectations: fat grafting can significantly improve contour, but no correction restores the exact original tissue anatomy
- Assessment of whether there is sufficient donor fat available for harvest (usually from the abdomen, flanks, or thighs)
- Review of the anesthesia plan (fat grafting for body contouring correction is performed under local anesthesia with light sedation)
Patients traveling from Summit, Chatham, Madison, Short Hills, Bernards, Florham Park, or other Northern New Jersey communities can learn about out-of-town visit logistics on the out-of-town patient page. Patients coming from Manhattan or Westchester for a correction consultation are also welcome.
Realistic Outcomes and What to Expect
The degree of improvement from fat grafting for post-liposuction irregularities depends on the severity of the defect and the patient’s tissue characteristics. Patients who had uniform, moderate fat removal can typically achieve very smooth results. Patients who had aggressive hi-def sculpting over large areas may require staged fat grafting over two sessions to achieve the volume they want without overloading any single zone. Either way, the liposuction correction process is iterative, and patience is required: fat takes 3–6 months to fully settle and for the final result to be assessable.
Patient Before & After
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Both cases above were performed in Morristown. Even fat removal and careful technique produce the smooth contour that prevents the fibrosis and irregularity concerns described in this article.
Questions North Jersey Patients Should Ask Before Any Lipo Revision
If you are a Northern New Jersey patient considering a correction for post-liposuction irregularities, these questions will help you evaluate any surgeon’s plan:
- Do you distinguish between fibrosis (scar tissue) and volume deficit (missing fat) in your examination? The treatment for each is different.
- Will the correction include subcision to release tethering bands, or only fat grafting?
- How much fat volume do you anticipate placing, and in how many sessions?
- Do I have enough donor fat in accessible areas (abdomen, flanks, thighs) to harvest what is needed?
- What percentage of the transferred fat do you expect to survive long-term?
- Will you review my original operative notes and photos before planning the procedure?
- Is the correction performed under local anesthesia with sedation, and what is the recovery timeline?
Common Questions About Post-Liposuction Fibrosis & Correction
How do I know if I have fibrosis after liposuction?
Post-liposuction fibrosis typically feels like firm, rope-like bands or patches of hardness beneath the skin in the treated area. The overlying skin may look dimpled, puckered, or uneven. These areas often feel different from the surrounding tissue — less soft, less moveable — and do not flatten with gentle pressure the way normal fat does. If you had liposuction and notice persistent firmness, skin irregularities, or dimpling weeks to months afterward, fibrosis is a likely explanation and warrants evaluation by a board-certified plastic surgeon in Morristown or elsewhere in Northern New Jersey.
What does lipo fibrosis feel like?
Lipo fibrosis feels like hardened, thickened tissue beneath the skin — often described as lumpy, cord-like, or like a dense layer of scar tissue. The skin above it may look dimpled or uneven. Mild fibrosis feels like areas of tightness or slight firmness. More significant fibrosis produces palpable bands or nodules that may be tender to the touch, especially in the early months after surgery. By the time fibrosis has been present for several years, it is typically no longer tender but remains firm and visible.
How long does it take for lipo fibrosis to go away?
Mild post-liposuction fibrosis can soften and partially resolve within 3–6 months with consistent lymphatic massage, compression garment use, and time. More significant fibrosis that causes visible skin dimpling or contour irregularity often does not resolve on its own. If irregularities remain at the 6-month mark, non-surgical treatments are unlikely to produce the cosmetic improvement most patients want. At that point, a surgical consultation to discuss fat grafting correction is the practical next step.
Can you get rid of fibrosis years after liposuction?
Yes, but the approach changes the longer fibrosis has been present. Fresh fibrosis within the first few months responds to lymphatic drainage, ultrasound, and compression. Old, established fibrosis that has been present for years is no longer actively remodeling and will not soften meaningfully with massage. At that stage, the practical solution — the one Dr. Rafizadeh recommends for the right candidates — is fat grafting combined with subcision (band release) to fill in the deficient areas and restore a smooth, even contour.
How to fix dimpling after liposuction?
The right treatment depends on when the dimpling appeared and how deep it is. Early, mild dimpling in the first few months often responds to lymphatic drainage massage, ultrasound therapy, and compression garments. Dimpling that has persisted beyond 6–12 months, caused by scar tissue tethering the skin, is better addressed surgically. Fat grafting — transferring small amounts of the patient’s own fat back into the dimpled areas — is the most effective long-term correction available to patients in Morristown and across Morris, Somerset, Essex, and Union Counties.
How to break up fibrotic fat after liposuction?
In the first several months after liposuction, manual lymphatic drainage and therapeutic ultrasound can help break up early fibrosis by stimulating circulation and disrupting early scar-tissue formation. However, what forms years after liposuction is not “fibrotic fat” in a sense that massage can resolve — it is dense, mature scar tissue with skin tethering. At that stage, fat grafting to the affected area is a more reliable and lasting correction than continued non-surgical therapy.
Is fibrosis after liposuction dangerous?
Post-liposuction fibrosis is not dangerous in a medical sense — it does not threaten your health. It is a cosmetic concern: the scar tissue beneath the skin can leave the surface looking uneven, dimpled, or lumpy. In some cases, early fibrosis causes mild tenderness. If fibrosis is extensive, painful, or accompanied by warmth or other symptoms, discuss it with a board-certified plastic surgeon to rule out uncommon complications and determine the best correction plan.
Sources & References
- Rohrich RJ, Beran SJ, Kenkel JM, Adams WP Jr, DiSpaltro F. “Extending the Role of Liposuction in Body Contouring With Ultrasound-Assisted Liposuction.” Plastic and Reconstructive Surgery. 1998;101(4):1090–1102. PubMed
- Chacur R, Menezes HS, de Oliveira MF, et al. “Aesthetic Correction of Skin Surface Irregularities After Liposuction: A New Approach.” Aesthetic Surgery Journal. 2013;33(7):1013–1021. PubMed
- Coleman SR. “Structural Fat Grafting: More Than a Permanent Filler.” Plastic and Reconstructive Surgery. 2006;118(Suppl 3):108S–120S. PubMed
- American Society of Plastic Surgeons (ASPS). “Liposuction: Procedure Overview and Safety.” plasticsurgery.org
- Glicenstein J. “Complications of Liposuction.” Annales de Chirurgie Plastique Esthétique. 2006;51(4–5):381–388. PubMed
- Dr. Farhad Rafizadeh, MD FACS. RealSelf Q&A: “5 years post lipo. Is this Fibrosis? What would be the best treatment to fix this?” Answered August 27, 2025. realself.com
Related Reading From Dr. Rafizadeh’s Blog
- Liposuction in Morristown, New Jersey
- Tummy Tuck Recovery in Morristown, New Jersey
- The Arm Lift (Brachioplasty): Best Results in New Jersey
- What Works in Plastic Surgery
Bottom Line
Post-liposuction fibrosis and skin dimpling are not just “normal healing” when they persist for years. They are real, correctable problems — but the right correction requires understanding exactly what produced them. For a patient five years post-lipo with persistent dimpling that may reflect hi-def sculpting they did not want, the answer Dr. Rafizadeh gives is direct: fat grafting is the solution, and it requires seeing you in person with the full clinical picture before a plan can be made.
If you are a Northern New Jersey patient living with post-liposuction irregularities and wondering whether anything can be done, the first step is a consultation at the liposuction revision and fat grafting level of evaluation — not another round of massage. Dr. Rafizadeh has been correcting body contouring outcomes in Morristown for more than four decades and is available to evaluate your specific situation.
Concerned about post-lipo irregularities? Schedule a consultation in Morristown, NJ.
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