Tumescent Liposuction Recovery

I had Tumescent Liposuction performed on my outer hips yesterday. The procedure also involved some fat transfer from the front of the thighs to the indented areas on my left and right thighs. The doctor simply injected the anesthetic solution into my front thighs, broke down the fat with the cannulas, and consequently pushed it down toward the indentations with his hands. He stitched the incisions and wrapped me up with the solution and fat inside. He told me that the body will get rid of the solution and we will find out if the fat in the indentations survived in 2 months. The next morning, I unwrapped my legs; the swelling from the solution had came down a bit and shifted to the outer side of my legs. A few hours later, I started experiencing burning pain in the area.

This procedure did not seem very professional to me and I'm wondering, what are your opinions on this? Is the pain normal? What would the outcome most likely be?

Doctor Answers 17

Tumescent Liposuction Recovery is usually very easy!

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Tumescent liposuction is a very easy procedure to undergo with minimal pain and quick recovery. Most patients are back to work in only 2 days and up walking around right after the procedure. There is minimal bruising and dramatic results. It is so safe now that we have eliminated the need for general anesthesia. Another big advantage is that because we can stand the patients up and have them move into all sorts of positions, it allows us the get much better results by far as compared to gen. anesthesia liposuction since we can see what needs to be sculpted much better. Sincerely,

David Hansen,MD

Beverly Hills Dermatologic Surgeon
4.7 out of 5 stars 46 reviews

Tumescent Liposuction Recovery

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Fat transfer or fat grafting is the process of performing liposuction and harversting the fat for contouring use instead of discarding it.  The key component of grafting fat is making sure the recipient skin area is elastic enough or undermined a little so it can stretch out during the process of filling it with fat. 

Pain after 6 weeks is something to be concerned about however your pain seems seems to be during the first day after surgery.  I try to remind my patients that despite whatever advertisements you may have heard, liposuction, after the numbing medicine has worn off, is never painless- you have passed a metal instrument under your skin a number of times!  It will hurt at some point and I would not be alarmed. 

Fat manipulation in liposuction

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Most of what you describe is normal in a liposuction procedure. The manipulation of fat from one area to the other without removing it from the body is a bit different (but not wrong). It is possible that by not sucking the fat out, processing it, and reinjecting it, that the fat cells were less traumatize and therefore may have better survival. One day after surgery is much to early to judge - give it at least 2-3 months.

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Sounds normal but call if you experience more pain and/or fevers!

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The advantage to tumescent liposuction is that it can provide analgesia (pain relief) for up to 18 hours.

When you experienced pain it may simply have been the anesthetic wearing off. Occassionally when nerves "wake up" they are more painful. Think about what it feels like when you sit on your nerves in your leg and it falls asleep; it can be very painful when it wakes up.

Alternatively, it could be irriation of nerves which occurs more commonly with ultrasonic liposuction. Occasionally, when this persists beyond the first week and is disabling, I have prescribed medications such as lyrica which we use for painful nerves in diabetics.

I would continue to wear your compression garments as advised and take pain medication as recommended.

Fat grafting is like any other grafting or transplanting process. I like to give analogies, so here is one. If you want to grow a tomato plant, the instructions always tell you to put in 2-3 seeds per hole. Why? Because some die. Sometimes you get 3 plants, sometimes 2, sometimes 1 and sometimes none. Same goes for fat injection. We generally put in 2-3 time what we need, knowing that some of it will not grow. Rarely all or none of it survives but usually a portion. If you want to know how much wait and see. That's the best answer I can give.

Hopefully this helps!!

Liposuction Recovery Varies From Patient to Patient

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It’s not unusual for patients to experience pain, swelling and discomfort following tumescent liposuction.  The burning sensation that you describe is frequently seen when sensory nerves are bruised or stretched during the procedure.  This is usually a transient phenomena and resolves with time. 

It’s important to remember that tumescent liposuction recovery varies from patient to patient.  We generally recommend that patients take a week off from work following this procedure.  Occasionally, patients are able to return to work even sooner.  Patients usually resume all of their normal activities within six weeks following surgery without restrictions.

We feel that exercise facilitates recovery and because of this, we encourage physical activity.  Although swelling may still be present six weeks following surgery, the majority of patients have effectively returned to normal activity.

A variety of fat grafting techniques exist.  If you have concerns about the particular technique utilized by your surgeon a discussion is warranted.


Fat manipulation to fill indented areas

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I am not familiar with a technique that manipulates the fat and then pushes it to a new location.  In most cases of fat transfer the fat is removed and then replace using small cannulas. 

Recovery following tumescent liposuction

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Tumescent liposuction involves the use of large, dilute volumes of lidocaine and epinephrine into the treated areas.  I leave the adit sites (the openings in the skin from which cannulas remove the fat) open to drain excess fluid present in the tissues following the procedures.  It is also normal for a patient to experience an increase in urination in the day or so following the procedure and your kidneys help to filter the excess fluid.  Fat may be transfered from an areas of excess fat deposits to areas of indentation.  It is up to the surgeon whether fat is removed in a sterile manner, treated and reinjected into those areas versus using "liposhifting" to move fat with the use of the cannula.

Patients are typically swollen for 2--4 weeks following the procedure.  The skin undergoes some contraction around 1-2 months following liposuction, in which the skin may feel more "firm" to the touch.  I counsel patients that final results should not be expected until approximately 3 months following the procedure.

Melanie D. Palm, MD - Account Suspended
San Diego Dermatologic Surgeon

Fat transfer

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Most surgeons prefer to aspirate the fat after tumescent anaesthesia, process the fat and transfer to the required area.

Recovery from liposuciton

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One day after surgery if very early to start worrying about the results.  Also, without knowing all the specifics of your surgery and seeing your pre-op photographs, it really is impossible to give you specific advice.  Typically with liposuction you can expect a moderate about of bruising and swelling which resolves over a few weeks.  During the healing process you may feel slight tingling or itching which is due to the skin healing.  If you are concerned about your recovery, I suggest that you talk with your surgeon.  Hopefully you were treated by a board certified plastic surgeon.  If not, I would suggest that you see the care of a board certified plastic surgeon in the future.  Good luck.

Burning Sensation Post-Tumescent Liposuction

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A burning or tingling sensation after tumescent liposuction is not uncommon.  In fact, most patients experience some degree of altered sensation in the area that was liposuctioned for several days or weeks after the procedure.  Regarding the technique used for your liposuction and fat grafting, it is unclear if this was standard procedure or not.  While traditional liposuction and fat grafting (i.e. fat transfer) involves the actual removal of fat from the body with cannulas, collecting and processing the fat outside of the body, and reinjection into the areas of concern, there are limited instances when surgeons may perform "liposhifting" to push fat from an area where traditional liposuction was performed to an immediately adjacent area, and vice versa.  Regardless of procedure performed, you will not see the final results for several months.    

Most importanty, however, is to ensure that your surgery, and any future plastic surgery or revisions, is performed by a plastic surgeon that is certified by the American Board of Plastic Surgery and a member of the American Society of Plastic Surgeons.  You can go to each of these organizations' websites to find a list of legitimate members. 

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.