Can Your Belly Swell Even 4 1/2 Weeks After Lipo?

I had surgery 4 1/2 weeks ago and I have not been able to go back based on distance. I had upper/lower stomach, flanks and back done. My belly seems to have gotten bigger/harder since I saw the initial results. Is this common? Could it be because my garment is too tight?

Doctor Answers 10

Liposuction swelling

Swelling after liposuction is common, and some hardness may develop as a part of the healing process. Usually this softens with time. Sometimes massage helps.  Overtime things usually soften.  It is definitely a good idea to seek follow-up with your doctor.


New York Plastic Surgeon
4.0 out of 5 stars 22 reviews

Swelling after lipo

First, distance not withstanding, your responsibility is to follow up, and comply with your post op instructions.  Following these instructions ensures that you have the best chance of a safe and favorable outcome.  See your doctor.

Belly Swelling With Garment

There can be many reasons, garment too tight, edema, residual fat swelling, constipation, all can make your tummy swell at this late stage. Ask your surgeon if you still need to wear one and if so for how many hours per day. Compression garments type and when applied varies from plastic surgeon to plastic surgeon and not dependent usually on the type of lipo performed. In my practice, A compression garment placed in surgery immediately after liposuction (steristrip protects the sutures) is recommended and beneficial after liposuction because:
  1. It restricts the amount of edema that forms and hastens its resolution by mechanical pressure.
  2. It decreases the amount of bruising.
  3. It assists the loose skin in retracting or shrinking.
If bulging ridges above or below, creases or bands are present then you probably need to change garments - see your plastic surgeon.
It is common to have weight gain due to edema, serum that collects in the area, and the tumescent fluid that was injected. This will resolve over time. The more you wear the garment initially, the quicker this fluid resolves.
Edema: a condition characterized by an excess of watery fluid collecting in the cavities or tissues of the body.
The length of time that the garment should be worn varies depending on the amount of fat removed, the elastic nature of your skin, how much loose skin remains, and other factors. Your surgeon would give you the best advice, however this is the general routine for my patients.
The first garment should be fitted for you in the office prior to surgery and applied in the operating room. Often it will become loose as the edema is mobilized, and then it will need to be replaced. Spanx is a reasonable compression garment if it gives enough support and is the right size. I have my patents bring them in so I can confirm that it fits well.
Most important advice is to listen to your surgeon, as he or she knows how much fat was removed, the elasticity that remains in your skin, and amount of skin redundancy.
I recommend that my patients wear their garments for a minimum of three weeks full time then for twelve hours at a time (day or night). If there is not a lot of redundant skin, this continues to a maximum of six weeks.
To be effective, the garment needs to fit snugly—but not too tight as that can make it difficult to sleep or cause pressure problems (inspect your skin when it is exposed if you are uncomfortable). As the edema resolves it is common for patients to switch to a smaller garment that fits. A Spanx-type garment would work fine, rather than ordering one or paying more at your doctor’s office.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 89 reviews

Followup with your surgeon or find a new one

Swelling can take a couple of months to resolve so it's not unusual that you're still swollen a month after surgery. However, if the swelling is recent then it may be a seroma. Please see your surgeon for a follow up, or find one that you can trust in your area.

Swelling, stiffness, and discomfort after liposuction

Hello DC,

Thank you for the question.  The most important thing is to make sure that you are healing well.  Without a photo or an examination this is not possible to do.  The symptoms that you have described are not all together uncommon after liposuction.  It will be important for you to make sure you have not gained weight during the recovery period as well.

All the best,

Dr. Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 132 reviews

Duration of Swelling AFTER Liposuction of stomach, flanks and back

Liposuction, like all operations, is an organized injury done in a sterile environment. The body always responds with a varying degree of swelling which is maximal the first few days after surgery and then gradually decreases with time.

Compression garments are used after liposuction to help diminish this swelling response but vary in their efficacy since they do not fit all people the same way and do not exert the same amounts of pressure.

By a month after surgery you should NOT have more swelling than you did just after the surgery. At this point you should be well down on the down slope of the post surgical swelling curve. You REALLY should see your surgeon and make sure everything is going well.

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 85 reviews

Abdominal swelling a month after surgery.

If the swelling and hardness is diffuse, then it is normal for many patients. It is not caused by the garment. If you have pain, localized swelling, etc. see your surgeon.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 27 reviews

Belly swell even 4 1/2 weeks after lipo

It is possible to have late occurring swelling. Go see a local PS to re evaluate. Or call the treating surgeon to discuss and send him photos.

From MIAMI DR. B

Persistent swelling after liposuction

There are many potential causes for this which cannot be diagnosed via email. While this could be due to your garments, it could also be due to a seroma and/or pseudocyst. You should seek evaluation by a surgeon and possibly consider an imaging study.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 64 reviews

Swelling after liposuction

Swelling can occur for more than four weeks after liposuction but if there is any pain or change in your bowl habits or fever you must be seen. This is always the concern when someone travels a distance for surgery but is not willing to travel for follow-up. You need to ask these same questions of your surgeon! Please call them.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
5.0 out of 5 stars 34 reviews

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.