I like to regularly read through various self-help forums to understand the patient’s point of view on the types of procedures we perform. (Laser Lipo, SmartLipo) I believe in doing so, it can help fine tune our procedures, prepare us better for responses to patients with similar experiences, and help us perform overall better customer service.

One of the common complaints I have continually come across was lumps and bumps patients have experienced post laser lipolysis. Many seem somewhat traumatized by the bumps, others state their physicians have given them no explanation or even treatment for the lumps.

Let me first preface that this is in no way comparable to the lumps and tracts after traditional liposuction for reasons we’re all well aware of. In fact, many of our patients are coming in to have those lumps and tracts removed with laser lipo. Patients need to be well educated about the healing process of the lymphatic system, underlying tissue layers, the remaining layer of fat post laser lipolysis, and that lumps can be part of that process for some. How many lumps remain visible after the healing process has been completed (6 months or more) is dependent upon how much fat was left underneath the skin from the procedure, how aggressive the procedure was (amount of fat removed and severity of manipulation), and how the area was treated during the healing process. These lumps can be pockets of just fat, or consolidation of scar tissue and body fluid, even seromas that require regular draining until gone.

It doesn’t matter if the device used was a lipo lysing laser or the ultrasound Vaser, lumps can occur and tend to be more operator dependent than anything. No surprise to any of us, I noticed with many physicians I talked with experienced more lumps at the beginning of their training and had to bring many patients back for touch-ups. These physicians tell me that as their experience level increased they began to see fewer lumps and attributed the reduction to technique enhancements from training with more experienced physicians, choices of suction devices and cannulas, aggressiveness of suction post lysing, and post treatment regimens.

Because you can’t rush a physician’s level of experience, what you can do is offer your patients methods to help keep the lumpy bumpies away. These treatments can be started as early as 2 weeks post-procedure or as early as tolerated by your patient.

Here are some of the laser lipo remedies that we currently use or have been suggested to me by others.

• Proper garment fitting
• Placement of large foam surgical pad across abdomen under garment to disperse pressure evenly
• Lymphatic massage, or deep tissue massage, by an experienced massage therapist
• Use of a roller ball. We like the Omni roller ball suggested to us by our dear friend Dr. Richard Goldfarb (thanks Rich!)
• Ultrasound therapy
• VelaShape, or comparable device. We give our patients 2 free sessions with every laser lipo procedure. We like the blending of the infrared, radio frequency, roller motion and suction to help our patients smooth out and tighten the skin.
• Endermologie
• Use of a small cannula to excise the areas of fat (plastic surgeon suggested)

More theories and suggestions are welcome!

Author: Paula D. Young RN runs internal operations and training at Young Medical Spa and is the author of the Medical Spa Aesthetics Course, Study Guide, and Advanced IPL & Laser Training course for medical estheticians and laser technicians.

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