As anyone who has worked with Photoshop knows, even with its latest Content Aware Fill technology employed a repair like this one will most often result in a 'pixel-smudge', not a seamless repair as I was able to accomplish in Lightroom.

However, Lightroom's Spot Removal tool seems to have an Achilles heel. I found that when I'm on a roll repairing each and every little bit of schmutz I can find in an image file, after a while Lightroom seems to substantially slow down and then, ultimately, choke. (Damn.) I won't bore you with "why" this happens here; I intend to provide you tips for repairing your images painlessly.

Here's my workaround:
Lightroom does a remarkable job of fixing imperfections in high contrast areas but it slows down when it's used "too many times" in one photo file. So…
1) I save Lightroom's spot removal magic for the repairs I'm not able to make in Photoshop first.

2) Open the image you want to repair in Photoshop CS5+. (You really do need CS5's equally remarkable Content Aware Fill technology to do the initial repairs here.)