Confused About Liposuction After Care

I had Smart lipo and traditional lipo 4 1/2 weeks ago. I had a lot of bruising, which has almost completely disappeared but have soooo many questions with regard to my healing!! I have done HBOxygen and Dermawave treatments as well as lymphatic drainage massages. I am now thinking of doing Triactive to help with swelling and tightness in my abodomen and waist.

I have a hard stomach, which I am told is due to swelling. But, I've also been told that excess protein will lead to scar tissue!! I have been wearing my compression garments non-stop and wonder if that is actually slowing my recovery down (constriction of lymph nodes, etc.) My fear is this tight stomach (due to fluid) will somehow solidify into scar tissue!!

I am doing self-massage and trying everything I can to have the best possible outcome from this surgery. I do not want areas of hardness (scar tissue) to remain. Am I doing the right things? The doctor says to wear the compression garments for 6-8 weeks now. Beforehand, he had said 6 weeks, and maybe less if I did the extra treatments (HBO, Dermawave, etc.) Today, he said I'd wear them until the firmness (fluid) went away. That could take MONTHS!! Ugh.

I am just so confused by all of this. Now, he said to start exercising unrestricted, but wear the compression garments (Spanx)...but make sure nothing leaves a mark on my waist that might remain. When do I have to stop worrying about marks? Frankly, everything leaves marks. Even the corset leaves marks. They go away, but... I am just confused by all this. I want to do everything right. Am I doing the right stuff here?

Doctor Answers 10

Sounds like you need some answers.

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Most plastic surgeons are going to tell you to wear a compression garment for several weeks after the procedure. All of this other stuff may help to some degree but it also seems excessive. What type of Hyperbaric Oxygen are you doing? Are you really going in an oxygen chamber under physican observation and being pressurized? There are many "pseudo" hyperbaric oxygen therapies sold by doctors who either don't know or don't care about the science of hyperbaric oxygen. Simply going in an oxygen tent for 15-30 minutes is not going to improve your outcome. True hyperbaric oxygen therapy requires a physician to be sitting there while you are treated for 2 hours, 5 days a week. Dermawave non-needle mesotherapy has little peer recognized scientific proof that plastic surgeons believe needs to be done after liposuction. I have a feeling that some non-plastic surgeon is making extra money selling you treatments for which there is little scientific evidence or proof that it works. Your doctor should be answering all of these questions and if he/she is not you need to find a doctor who can examine you and answer your questions/concerns.

You are overdoing it.

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Post liposuction care other than a good diet, sun avoidance and a good compression garment is money poorly spent at least in my opinion. I am not sure if your doctor sold you on all that stuff, but it is probably not important. Skin tightness is not frequently achieved with liposuction. Either your skin is elastic enough with a good blood supply or it isn't. Massage can help swelling come down more quickly, but there is no good evidence that this changes the outcome of the operation. Hyperbaric oxygen is probably even less helpful.

If your doctor is not recommending this post-surgery care, get in with him or her and discuss what he or she advises. This advice is part of what you paid for with your surgery.

John P. Di Saia, MD
Orange Plastic Surgeon


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Alot of questions. In general, I tell my patients that they should wear a compression garment for 4-6 weeks.  If there are areas of firmness, then I tell them that they can do gentle massage over the area for lymphatic drainage.  Otherwise they have no restrictions.

Post liposuction care

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It sounds like you are doing all of the right things in the post-operative period. As for Smartlipo, I usually tell my patients to wear their garments for at least 2 weeks and longer if possible. For traditional liposuction, the healing time is longer, and the garnments typically need to be worn longer. You will continue to heal and see improved results for up to a year so don't get discouraged.

Those supplemental treatments can help, and I have seen some good results with some of them, but they are optional. If you have specific concerns, it is always best to consult your own physician, however it sounds like you are on the right track. And remember, it has only been a month, and the results will continue to improve with time. If a touch up is needed, I usually tell my patients to wait at least 6 months, and we can reevaluate the situation then.

Jennifer S. Landy MD
Tampa Ophthalmologist

Liposuction after care

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Whoa! This is a lot of anxiety and expensive extra treatment for a liposuction.

This is what I tell my patients:

Wear the garment for 6 weeks or longer if your body feels better wearing it. 

At 4 weeks, rolling the tissues with a massage roller, gentle lymphatic massage and swimming in a warm (and clean) pool may help.. 

Be patient. Around 6 weeks swelling starts to go down. It keeps going down for about 6 months. If your doctor has you so confused, consider a second opinion with a Board Certified Plastic Surgeon. Expect to pay but it might allay your fears, answer specific questions.  Good luck!

Proper recovery after liposuction.

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Your recovery is somewhat slower than average.  I think the telling sign is what you describe as a lot of bruising.   This most likely (in absence of any medical conditions that you might have) represents excess trauma during your surgery and/or sub-optimal application of post-operative garment.

Fast recovery after a liposuction surgery  required proper pre-operative planning by your surgeon, proper execution during your surgery, proper garment application and instructions, and to a lesser degree postoperative massage, hyperbaric, etc.  As  your case clearly illustrates that the use of lase/smart, etc. devices do not guarantee good outcome.  Make sure your surgeon not only has the latest equipment, but the knowledge, talent and experience to achieve the desired result.

It should be a lot simpler

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Assuming your Smartlipo and traditional lipo was uncomplicated, it sounds like you are doing more than we would recommend in our practice. Most of our traditional and Smartlipo patients wear a garment for 3-4 weeks after surgery and that is pretty much it.

HBO, Dermawave, lymphatic drainage and any adjunctive treatments would be extremely rare in our practice. From time to time (5-10% of patients) we may recommend something like Endermologie or VelaShape to supplement or enhance a result, but most of the time, normal healing takes place without any adjuncts.

Sometimes rushing into adjunct treatments can increase swelling and delay healing, so make sure you have a conversation with your doctor about this possibility. If you are paying for all these treatments it also is adding a lot of cost to what should be a benign postop course.

Liposuction Aftercare

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Just like in hand surgery, Liposuction aftercare is critical to a great result!
Although my patients often use a number of different noninvasive techniques after liposuction, nothing is more important than the garment! You are correct to pay close attention to avoid marks, zippers etc.
Sometimes a cotton T-shirt under the garment can help with this. 
Concerning hardness, yes, much of that is water. Stick to a low sodium diet and be patient, as the swelling comes down by 3 months so will the hardness.
Sounds like you are headed to a very nice result.

Optimizing liposuction recovery - Los Angeles

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The goals of liposuction aftercare are to minimize trauma to the treated area, optimize blood perfusion, and limit swelling and bruising. The compression and massage treatments are definitely a must during your recovery. Raffy Karamanoukian Los Angeles

Minimal post-operative care after liposuction.

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As my colleagues say, it should be a great deal simpler. We don't even use compression garments for most liposuction patients.  Lymphatic drainage massage does help.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

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.