6 Day Post Op -- Large Volume Lipo- Heavy Swelling/Bruising on Pannus + Pubic Normal?

This amount of liposuction (4.75L aspirate with 3.5L fat content) is a "standard" amount, though on the "upper limit" for one anatomic location such as the abdomen. You likely have seroma in the cavities created by this much fat removal, and gravity pulls it toward the most dependent area--your pubic tissues. This includes any bleeding/bruising, and occurs with most patients undergoing any type of abdominal liposuction. (When men have this procedure we frequently get worried calls about their genitalia turning purple or black; they wonder if it is going to "fall off." Answer--no.)

There is a reason your surgeon used a tight garment; getting a looser one only allowed more fluid to accumulate, and more fluid to drop with gravity to your pubic area. Sitting not needed (reclining or lounge chair position until fluid absorbs would have been better), but breathing is always a good idea. Still, this is something that should have been reviewed by your surgeon had you stayed close by until better. Surgical tourism is usually not a good idea unless you stay close by or make arrangements for proper follow-up (or are prepared to return to your surgeon); sometimes it is disastrous.

Dr. Blinski has this right. "Hot and painful" may be infection, but this description is very subjective and objective examination in person is necessary to check this out and determine if antibiotic therapy is needed. You need to see someone for two reasons--the seroma fluid should be aspirated (if pus is present, cultures should be taken, and if seroma, this may take more than once, particularly if delayed), and the possibility of infection should be evaluated. If you cannot return to your surgeon ASAP, seek a local ABPS-certified plastic surgeon for advice. Expect to pay for the service, since this is part of what you paid your surgeon for. Please attend to this promptly; this is not an online type of issue! Best wishes! Dr. Tholen

A few issues. You did not have large volume lipo! If only 3.5 liters removed you are just regular lipo. Large volume is over 4 liters and in my hands over 5 liters. Where you operated upon in USA?? Sounds like you were not. You may need drainage of seroma/hematoma fluids in the pubic area. And more in person follow up wit a boarded PSs in your city. Also if hot you need antibiotic therapy. 

SOme bruising is normal with liposuction and often more swelling and bruising occur in the dependent regions of the body.  Best to speak to your doctor or see him to make sure.