Liposuction is often perceived as a minor undertaking, relative to other popular plastic surgeries—and it’s easy to see why. Zero skin is removed. There’s no manipulation of muscle or bone. And most of the heavy lifting is done with a cannula rather than a scalpel. In reality though, lipo is an invasive surgical procedure—delivering transformative results and a commensurate healing period.
The rigors of your recovery will depend on the scope of your procedure. “Smaller areas of lipo, like under the chin, will likely require a shorter procedure and less anesthesia, [begetting] a quicker, less severe recovery [than that which comes with] more extensive body work involving energy,” explains Dr. Dallas Buchanan, a board-certified plastic surgeon in Tampa, Florida. He’s found that incorporating radiofrequency, ultrasound, or plasma during surgery—forms of energy used to facilitate fat removal or to tighten the skin—can alter the typical course of recovery following lipo. In the short term, he says, “the addition of heat usually causes a coagulation effect on the tissues, which limits bruising and bleeding.”
Skin-firming devices can, however, prolong or otherwise complicate the downtime for some folks, he explains. In Dr. Buchanan’s experience, “the energy can create temporary nodules and skin-contraction issues that take a long time to heal completely—sometimes three to six months or more—so patients have to be very patient with their long-term recovery,” he explains.
Since every case is different, you’ll want to ask your lipo surgeon about the nuances of your procedure and how they might influence the aftermath. Dr. Buchanan also reminds us that aftercare instructions are tailored to the individual, so your post-op paperwork may not perfectly reflect what we’ve outlined here. While our timeline can prepare you for what to expect following lipo, once you’re in the throes of recovery, it’s crucial to follow your doctor’s directions to a T.
Day one post-op
Dr. Buchanan describes day one post-lipo as “an acute recovery day.” If your procedure was done under general anesthesia, expect to feel groggy for about 24 hours. Plan on having a designated caregiver with you for at least this length of time.
What’s normal
Odds are, you’re going to look and feel pretty beat up—and that’s completely normal. Treatment areas may be tight and stiff, and your skin could look shiny or feel itchy as it heals. You may have drains in place for a week or more. Your incisions are bound to be a little leaky. Your sore, swollen, bruised body will be squeezed into compression garments, around the clock, save for when you’re showering. All told, “this can make for a rough and emotional few days in the beginning,” says Dr. Buchanan.
He recommends waiting a day or two before taking your first post-lipo shower. “If you try right after surgery, the hot water, combined with some light-headedness and likely some labile blood pressure, can have disastrous outcomes, like passing out in the shower,” he says. “Usually by 48 hours, patients are more clearheaded and safe.” (Every surgeon has a different take on post-op showers, so discuss timing with your doc.)
You should be able to walk independently and handle most of your basic hygiene, but “depending on the areas treated and the extent of your procedure, you may need assistance with compression garments, drains, and hair washing,” notes Dr. Jonathan Brower, a board-certified plastic surgeon in Providence, Rhode Island.
In an effort to minimize the need for narcotics, surgeons will commonly start patients on a non-opiate pain medication regimen prior to surgery and have them continue it for a week or two after. Occasionally, patients will still need a short course of low-dose oxycodone, to manage the discomfort of early recovery. If you’re taking narcotic pain meds, prepare for some brain fog, bloating, and constipation. Getting up and walking around your home, for even just 5 or 10 minutes every hour, can help counter constipation while also preventing post-op blood clots.
“Resting during this phase is good, but patients should absolutely get up and ambulate, to help with circulation,” says board-certified New York City plastic surgeon Dr. David Shafer. He encourages patients to return to their usual activities as soon as they feel comfortable, since with lipo, “there’s no risk of popping sutures or incisions opening.”
From a psychological POV, “some patients do experience temporary buyer’s remorse if the recovery is not what they were anticipating or if they don’t see results right away,” Dr. Shafer adds. “This resolves as the patient enters the later stages of recovery, begins to feel better, and realizes the results of the surgery.”
What’s not normal
If patients develop hematomas—accumulations of blood under the skin—it’s usually within the first 24 to 48 hours, says Dr. Brower, so keep an eye out for asymmetrical bloating and black-and-blues during this window. While it’s normal to have significant bruising and swelling in areas of suction—and even beyond treatment zones—pain, puffiness, or discoloration that are more pronounced on one side of the body should be reported to your surgeon ASAP.
Other red flags include fever beyond post-op day two, confusion, shortness of breath, chest pain, asymmetric calf or ankle swelling, severe pain that can’t be controlled by prescription meds, and unusual drain output. “It’s rare for a drain to put out ‘too much’ volume after liposuction, but the quality of the fluid is important,” Dr. Brower tells us. “It should be a thin red, pink/orange, or yellow fluid. Dark, clotted blood or white/brown fluid should be evaluated by your surgeon.” Generally speaking, if anything seems off, trust your gut and call your doctor.
One week post-op
By now, “you should be starting to feel more like yourself and doing regular daily tasks while still avoiding strenuous physical activity like exercise and lifting,” says Dr. Buchanan. At your follow-up visit, your surgeon may remove your stitches and/or drains. (Fair warning though—sometimes docs will leave them for another week or so, depending on the particulars of your procedure and recovery.) Patients with desk jobs are considering heading back to work around this time. Once you’re off all narcotic pain meds, you can start driving again.
What’s normal
“Patients will have some persistent soreness at one week—typically managed with non-opiate medications only—but swelling and bruising will predominate,” Dr. Brower says. The more extensive your lipo procedure, the more pronounced the swelling will be. “In cases of lipo to the legs, swelling can be especially challenging to control,” he adds.
You’re still wearing compression 24/7, but garments should be fitting easier now, says Dr. Buchanan, who recommends foam dressings, like Topifoam, for the first two to three weeks, until bruising has resolved. However, he points out, plastic surgeons’ garment requirements can run the gamut, with some making them entirely optional and others insisting on strict compression for six months or more. “No one protocol has been proven to be superior, so it’s best to defer to your surgeon’s instructions,” he says.
Dr. Shafer warns that too-tight garments can be counterproductive to recovery, restricting blood flow and injuring the skin. “Patients should be aware of lines of tension, especially along seams, which can dig into the skin,” he adds.
At this early stage, skin is still in the process of contracting, so don’t stress over laxity. “Skin can take weeks to months to fully tighten,” Dr. Brower says. You may also notice some lumpy or uneven areas—what doctors call contour irregularities—and this too is totally normal.
What’s not normal
If pain, drainage, or swelling are increasing rather than abating, call your surgeon.
“Sudden difficulty breathing, accelerated heart rate, and unilateral or asymmetric swelling in the legs could be signs of a blood clot,” Dr. Shafer tells us. “If these symptoms occur, notify your doctor right away.”
Low-grade fevers can creep up during this time, usually due to poor lung function, notes Dr. Buchanan. If your temp climbs above 101℉ or 101.5℉, tell your surgeon. While infection is uncommon following lipo, any sort of pus-like drainage from your incisions or obvious asymmetric redness around the incisions also warrants a call to your surgeon.
Related: Plastic Surgeons Say the Best Liposuction Outcomes Have These 4 Things in Common
Two weeks post-op
Pretty much everyone is back to work and managing routine to-dos without any trouble at this point. Our doctors say it’s safe to have sex too, if you’re up for it. “Common sense is important during this period,” says Dr. Brower, with the rule of thumb being: “If it hurts, don’t do it.”
What’s normal
Dr. Buchanan calls the two-week mark “a big turning point for patients.” You’re free of stitches and drains, and your bruises have all but faded. Swelling is still significant, but you may be able to transition to a more comfortable compression garment at this time. If you haven’t started lymphatic massage, now would be a good time, says Dr. Shafer, as “lymphatic massage during this phase can speed up the resolution of swelling and help smooth the skin.” Dr. Buchanan has patients book three to five sessions per week over the first one to four weeks post-lipo.
Your incisions are healing and may appear red/dark and raised. “During the first six to eight weeks, the body is producing collagen, to glue the skin back together,” explains Dr. Shafer. “Over the next six to eight weeks, as the collagen reorganizes, scars flatten and redness resolves.” Silicone-based scar gels and vigilant sun protection can help them fade faster.
Assuming you feel well and bruises have disappeared, your surgeon may clear you for gentle cardio exercise and light weights.
What’s not normal
“Still requiring pain medication at two weeks would be very abnormal,” Dr. Buchanan says. Ask your surgeon to help wean you off whatever drugs you may still be taking.
While bleeding and infection are less common now, says Dr. Browser, “blood clots in the legs, seroma [a buildup of fluid], contour irregularities, and persistent skin laxity remain potential complications.”
If seromas occur, they typically present around two to four weeks after surgery, he adds. “Technologies like VASER, BodyTite, and Renuvion can increase the risk of certain minor post-op complications, including seroma, which may require additional or more frequent visits to your surgeon’s office,” notes Dr. Brower.
Bear in mind, your outcome is still very much evolving at two weeks, so don’t panic if your current shape isn’t what you initially envisioned.
One month post-op
“At one month, patients should feel 95% back to normal,” says Dr. Shafer. “There will still be some swelling and incision care, but activity is unrestricted.”
What’s normal
You’re still more swollen than you’d like, but bruising should be long gone. While you’re not in any real pain, you may notice “some odd sensations, like burning, tingling, and crawling,” says Dr. Buchanan—all normal signs of nerve regeneration. Your surgeon can prescribe medications if the irritation is severe, he adds, but it usually abates on its own without treatment.
What’s not normal
“Seromas, contour irregularity, and skin excess are the most common complications one month after surgery,” says Dr. Brower. If you’re unhappy with some aspect of your appearance, talk to your surgeon, since they’ll want to monitor and photograph your concerns. What’s more, “nonsurgical maneuvers, like massage, can improve mild contour irregularities,” he says—and they’re most effective early on. Again, it’s still too soon to consider revision procedures.
Six weeks post-op and beyond
You can resume your usual fitness routine—both cardio and weights—but ease in and pay close attention to how you’re feeling in the moment and after training. It may take weeks of incremental baby steps to get you fully back into the swing of a presurgical workout program.
What’s normal
You’re still in the process of healing, and swelling has subsided by only about 50%, but “at six weeks, we get our first hint of what the final contour might look like,” says Dr. Buchanan.
Many patients choose to retire their compression garments—or use them only as needed, like after working out. Others, having grown accustomed to the support they offer, aren’t quite ready to quit them.
You may still have some numbness or skin sensitivity at the surgical site; this can linger for months, Dr. Brower points out.
In the coming months, you’ll see “swelling finally resolve as lymphatic channels reestablish, skin tighten up as collagen remodels, and your incisions continue to fade,” Dr. Shafer says.
What’s not normal
Now that you’re a couple of months out of surgery, persistent pain or any sort of discomfort that holds you back from daily living is considered a red flag.
Aesthetically speaking, “if patients have issues with outcomes at six weeks, I evaluate them and listen to those concerns, of course—but once again, I remind them that probably by three months, those concerns will resolve on their own or change altogether,” says Dr. Buchanan.
While surgery may seem like a distant memory, you’re technically still recovering—your body is working out remaining kinks, and your new shape is gradually unfolding. Trust the process and try not to judge your results too soon. “Some patients get anxious and waste valuable energy worrying about results way too early,” Dr. Shafer says. “It’s very important to allow time for the final results to show—6 to 12 months—before considering additional surgery or revisions.”
