Hello, I'm Dr. Jaeho Cho, Director of The Line Plastic Surgery.
"It's been a while since my liposuction, but I can still feel a firm spot when I touch my abdomen. Is something wrong?"
If a specific area still feels firm or bumpy weeks or even months after surgery, it's natural to feel concerned. Patients sometimes hear this referred to as "bio-bond," but that term can actually make it harder to understand exactly what's going on.
The short answer
"Bio-bond" is an informal term used to describe firm tissue changes felt after liposuction. Medically, this can be caused by several different types of tissue change — including Fibrosis, Adhesion, or nodules. In some cases it softens over time, but in others it can persist or remain as a depression or irregularity, so it's important to monitor how it progresses.
Why does this happen?
During liposuction, a cannula (a thin tube) removes fat beneath the skin, leaving microscopic tissue damage in the process. As the body works to heal this damage, it triggers an inflammatory response along with collagen fiber production. If this process becomes excessive or uneven, firm fibrous tissue can form between the skin and the fascia (the membrane surrounding muscle), causing them to stick together — this is adhesion.
Think of it like a scar forming where a wound has healed. The difference is that this "scar" forms beneath the skin, within the fat layer, so it's usually not visible and is only noticeable to the touch.
How common is this, really?
There's a prospective study of 75 female patients who underwent secondary (revision) liposuction[1]. Pre- and post-operative evaluations identified a range of tissue changes related to fibrosis[1].
In this study's revision-surgery patient group, depression was the most common finding, observed in 74 patients (99%)[1]. In the same group, soft nodules were found in 70 patients (95%), and hard nodules in 61 patients (81%)[1]. Adhesion — the finding closest to what's called "bio-bond" — was confirmed in 35 patients (47%), while cutaneous bursa was the rarest finding at 4%[1].
It's worth noting that these figures come from a group of patients who sought out secondary liposuction — meaning they had already noticed tissue-related issues — so this rate may differ from the general incidence among all liposuction patients.
Can surface irregularities be corrected?
There's a case study of 23 patients who developed surface irregularities after abdominal liposuction, treated with a combination of liposuction and abdominoplasty (or mini-abdominoplasty) to correct the irregularities[2]. At the 12-month mark, two independent plastic surgeons evaluated the results using an objective aesthetic outcome scale[2].
Individual variation and things to keep in mind
The degree and duration of fibrosis/adhesion can vary depending on individual skin elasticity, the treated area, the volume removed, surgical technique, and post-operative care (compression garments, massage, etc.).
While some cases soften naturally over time, others may persist as nodules or depressions requiring separate treatment.
The statistics above are based on a specific study and patient group, and may not apply equally to every patient.
If a firm area is accompanied by pain, redness, or warmth, or continues to grow larger, infection or other complications cannot be ruled out — a medical evaluation is recommended rather than self-assessment.
Three key takeaways
1. "Bio-bond" is an informal term; medically, it can be caused by several types of tissue change, including Fibrosis, Adhesion, or nodules.
2. A study of 75 revision-surgery patients found adhesion in 47% of cases, but this figure is specific to patients who sought revision surgery[1].
3. The degree and course vary significantly between individuals, and a specialist evaluation is recommended if symptoms persist or worsen.
Confirming the presence and extent of fibrosis or adhesion typically requires a physical exam and, if needed, an ultrasound. Please consult in person for an accurate diagnosis.
By Dr. Jaeho Cho (PhD in Surgery)
--- Sources
1. Mera-Cruz G, Durán H, Murillo-Romero N, Pérez M, Rubiano V, Camacho-Domínguez L. Fibrosis Management Algorithm in Secondary Liposculpture. Aesthet Surg J. 2024;44(8):859-868. PubMed 38366902
2. Borille GB, et al. Surgical Correction of Abdomen Irregularities after Liposuction: Case Series. Plast Reconstr Surg Glob Open. 2024;12(6):e5924. PubMed 39148659
This article summarizes questions around post-liposuction firmness (fibrosis/adhesion) based on research published on PubMed. Please consult a specialist to confirm your individual condition.