Doctor recommends NO compression first week after surgery

Question

I am getting lipo and afat transfer to the breasts in 2 weeks. During my pre-op, my doctor said that I wouldn’t be receiving my compression garment until my post op appointment, one week after surgery. He said he doesn’t recommend compression during the first week as I will be sore. He also made remarks that compression doesn’t really do anything. This worries me as I have read otherwise. He is a trusted doctor of over 15 years with successful lipo patients but I am not sure what to think

Carlos Mata, MD, MBA, FACS · Answer

Each surgeon has their own protocols based on their experience and what they believe yields the best outcomes for their patients. While it's common for compression garments to be recommended immediately after liposuction and fat transfer procedures to reduce swelling and support healing, some surgeons may have different approaches. Your doctor's recommendation against immediate compression could be based on his specific post-operative care strategy, designed to maximize comfort and healing in the first week. If your doctor has a long history of success with such procedures, this advice likely reflects his tailored approach to post-operative care. It's important to have open communication with your surgeon about your concerns. However, trusting your surgeon's guidance, especially if you've chosen him based on his expertise and track record, is crucial for following through with the pre- and post-surgery instructions.

J. Timothy Katzen, MD, FACS · Answer

Hello, thank you for your question regarding the recommendation against compression in the first week after liposuction and fat transfer to the breast surgery. This is indeed an interesting question. Most experienced Board Certified plastic surgeons do recommend compression therapy following liposuction. The body's normal reaction to surgery is to swell, which is particularly true for liposuction. Most patients experience swelling for at least six weeks post-surgery. Therefore, most plastic surgeons recommend compression for at least 6 to 8 weeks after liposuction. Additionally, Lymphatic Massage is usually suggested in the first or second week. What your plastic surgeon may be advising is the avoidance of compression on your breasts where the fat grafting has been performed. Compression is typically not applied to newly transferred fat cells as it could harm or even destroy the delicate newly transferred fat cells. Therefore, in conclusion, most plastic surgeons do recommend compression therapy after liposuction for at least several weeks, typically advising at least 6 to 8 weeks of compression. Good luck. I hope I’ve answered your question regarding compression therapy after liposuction and fat transfer to the breast.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS
Plastic and Aesthetic Surgeon

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS
Plastic and Aesthetic Surgeon

Connie Hiers, MD, FACS · Answer

Every surgeon has his/her own preferences. I prefer to use compression garments for comfort, control and minimize swelling, and assist with skin tightening.  Plus, it is a reminder that you had surgery and to avoid excessive activities early on in your healing.

Camille Cash, MD · Answer

Each surgeon will have her/his own protocols for post operative care.  Compression is used to help control swelling as well as give support to tissues as they heal.  It can be problematic if worn too tightly.  I encourage you to speak to your surgeon about your concerns.  It is important that you feel comfortable and confident as you prepare for surgery.

Garrett Jones, DO · Answer

If a plastic surgeon recommends no compression during the first week after surgery, it's important to follow their advice diligently. Surgeons typically provide specific post-surgery instructions based on the type of surgery performed, the individual patient's condition, and other factors. Here are some reasons why a plastic surgeons might advise against compression during the initial post-surgery period:1. Swelling Management: Compression garments are often used to reduce swelling, but in some cases, the immediate post-surgery period may require allowing the body to naturally manage and regulate swelling without external compression.2. Blood Circulation: Compression garments can impact blood circulation, and in certain cases, the plastic surgeon may want to ensure optimal blood flow during the critical early stages of healing.3. Wound Healing: Depending on the type of surgery and the incision site, compression may interfere with the wound healing process. Plastic surgeons may prefer to let the incision heal naturally before introducing compression.4. Risk of Complications: Some patients may have underlying medical conditions or specific considerations that make compression risky or less suitable during the initial recovery period.Always communicate openly with your plastic surgeon and make sure to ask questions if you have any concerns or if you need clarification about their recommendations. Follow the post-surgery instructions carefully, and if you experience unexpected symptoms or have concerns during your recovery, contact your plastic surgeon promptly for guidance.

Scott C. Lindsay, DO · Answer

Thanks for your question! Every doctor has their own set of recommendations that work best for them and their practice. I might suggest asking why this is his recommendation. Good luck!

Mark Eberbach, MD · Answer

Compression after surgery such as liposuction, or tummy tuck may or may not be a good thing. Our thinking regarding postoperative compression is changing as recent studies of demonstrated more prolonged swelling, with the use of garments because it interferes with lymphatic drainage. This was demonstrated in abdominal plasty.

The jury is not completely out, but I have discontinued using compression after abdominal plasty now for a couple of years and feel the results are better.

The issue is one of uniform compression on the torso versus the leg, for example. It’s very difficult to avoid creasing and uneven distribution of pressure on the torso.

It seems your doctor is moving with the times. Good luck.

Mats Hagstrom, MD (license on probation) · Answer

There’s no clinical evidence that produced showing benefit of using compression garments.
They have no impact on final outcome, and in some ways are more of a hindrance than useful.
Some patients like the snug secure, feeling other people find them uncomfortable, excessively hot in the summertime and can’t stand them.
Even if they keep swelling down swelling as a normal response to the procedure and reducing swelling as by itself, no benefit.
The main reason most plastic surgeons use compression garments is to not look like an outlier, because everybody else uses them and this is simply a self propagated step in Liposuction that has no scientific or evidence based reason. We do use compression garments but only for the first two weeks.
I have no problem if a patient wants to skip wearing them.
I also don’t believe postoperative massage or any postoperative treatment as any impact on the outcome of the procedure.
There are two variables that determine the outcome for this procedure.
The first is the patient’s candidacy for the procedure in the first place and the second is the skill and experience of the provider.
These are the only variables that matter.
 Understanding your candidacy for both Liposuction, and is a key component to consistent quality high patient satisfaction.
Some individuals are simply not good candidates for Liposuction, and the same is true for breast fat.
These procedures are also more difficult to do well un consistent basis than most people realize.
The number of plastic surgeons have truly mastered. Both Liposuction and fat transfer are in a small minority.
 Final, the outcome of fat transfer is often misrepresented by providers and patients displaying early post operative results, which can look very impressive, but do not have any correlation with final long-term outcomes.
For that reason it’s critical, when reviewing before, and after pictures to have a clear understanding of the timeframe between the pictures.
 After pictures do not become representative until at least 3 to 6 months after the procedure.
Pictures can show two or 300% increase in breast volume but this is not in any way representative of long-term outcome which is more typically about 50% breast volume increase if done by someone with sufficient skill and experience on a patient who is a good candidate.
 There isn’t much patience can do regarding their own candidacy. What patients do have control over his provider selection.
Considering how much variation there is in skill and experience among plastic surgeons for this procedure I recommend patients be very careful and vet providers thoroughly before selecting the provider.
There’s no correct number of consultations needed to find the right provider.
The more consultations you scheduled the more likely were to find the better provider.
 For liposuction and fat transfer I recommend patients consider having at least five or six consultations before choosing a provider.
Poorly the Liposuction can leave people permanently disfigured.
Being board-certified in plastic surgery with years of experience does not mean somebody has mastered one single procedure, especially not liposuction and fat.
 Most plastic surgeons believe they are far better at Liposuction than they actually are.
The learning curve for this procedure is long and steep.
Best,
Mats Hagstrom, MD

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