Post Lipo Hardness and Stiffness, What Should I Do?

I am 2 weeks post "liposculpture," which was both Vaser and smart lipo. I've developed bands of hard, tight tissue across my abdomen and back, where the procedure was done. They make it hard to stretch. My doctor's office says to stretch and they will go away over time,so I'm not that worried, but my doctor never said anything about them preop. What are they? They have the consistency of a taut seat belt and make it very hard to stretch. Also, I've had bloody "seromas" drained 2x so far.

Doctor Answers 6

Tight Bands Under Skin Post Liposculpture

The tight bands that you are experiencing under your skin after liposculpture is what Dr. Andy Kaczynski of Sacramento, California, refers to as organized swelling.  This is not scar tissue and I believe, if treated early, can be gotten rid of 100% of the time.  What you need to do is increase the blood supply to these injured areas to allow your body's natural healing processes to work their magic. 


In my practice, (1) I use DMSO, a liquid which helps open redundant blood vessels in your tissue as well as decreasing the inflammation causing some of the swelling.  DMSO for the body is best diluted with some products to make it okay for human tissue, as the pure stuff is used only in veterinary medicine.  Rumor has it that everyone in the Tour de France bathes in DMSO to decrease the inflammation from bicycling.  (2) Post operative ultrasound (the kind the physical therapist uses to get rid of sore muscles, not the kind that the gynecologist uses to find the baby in your uterus) converts sound waves into heat which increases the blood supply to an area and also seems to level out what semi variable fat cells remain in your tissue. 


Since you have had multiple seromas, your plastic surgeon should be consulted prior to implementation of any of the above. 

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Post Lipo Suggestions for Speedy Recovery

The tight bands are probably localized areas of edema and possibly early internal scarring but should diminish with time. Here are some suggestions besides simple stretching that has been recommended to you: Therapeutic or "lymphatic massage" may be helpful following Liposuction (Smart Lipo, Vaser, Tickle lipo, or conventional lipo) to minimize swelling but not all plastic surgeons recommend it nor is it Mandatory. Make sure your surgeon feels that you have healed sufficiently  and it is safe before doing this.  Endermologie is also very helpful after liposculpture/liposuction but again, not critical.  Although deep tissue massage following liposuction can aid in smoothing out  contour irregularities that invariably accompany this procedure it has limited effect on the final outcome and  is NOT mandatory. Some plastic surgeons recommend it to all  patients as they feel the edema resolves faster.  Ask your surgeon to show you or a significant other how to do this if cost is an issue. Typically they will have you massage toward areas of maximum lymphatic drainage ( for example groin or armpits) A low sodium diet and no heavy exercise especially lifting for the first 4-6 weeks may also be helpful.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 59 reviews

Your experience is not that uncommon for that type of liposculpting you had done.

Unfortunately, seromas, scar tissue and hematomas etc... are not that uncommon with the type of procedure you had done since it is more common with laser and ultrasound lipos.  Stick with your doc to help you through this rough time.  It will get better with time. Most will still turn out just fine.  Sincerely,

David Hansen,MD

David Hansen, MD
Beverly Hills Dermatologic Surgeon
5.0 out of 5 stars 29 reviews

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Stiff tissues after liposuction

It is not uncommon to have stiffness of the tissues after liposuction as the passing of the cannula into the tissue will cause bruising of the tissues and these tight bands can form. They are essentially scar tissue and with time, massage, stretching and heating pads, they get better. Not all patients get them, but the larger the amount of fat removed and the larger the amount of post op fluid collection there is, the higher the chance of it occurring.

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Tissue fibrosis is common after liposculpture.

Tissue fibrosis is common after liposculpture.  I inform all of my patients before surgery that they will have some amount of fibrosis (excess scarring beneath the skin) and will need to have seromas drained even though I leave drains in place to help minimize them.

Continue following your doctor's advice and instructions and things should resolve in time.

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If you have questions after liposculture/liposuction, check back with your doctor.

It is best to check back with the doctor who did your procedure if you have questions post liposuction.  If you are still unsatisfied or concerned, get a second opinion from a well respected liposuction surgeon in your area.

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These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.