Can lipo swelling increase at 4 weeks post op?

Anna.  It is not uncommon for swelling to fluctuate during the first three months after liposuction. Especially after exercising, which increases blood flow to the region and modest temporary swelling as well. Try to stay patient and it is OK to continue exercising lightly, as long as you understand that swelling will fluctuate, but eventually go away. Best of luck.

Liposuction interrupts lymphatics, that is, the channels that are responsible for collecting fluid that normally accumulates in soft tissue and returning it back into the circulatory system.  Initially, the lymphatics are so compromised that a patient is swollen all the time.  As the channels heal, swelling slowly improves.  It is not uncommon, however, for patients to begin to increase their activity a few weeks after surgery.  With activity comes increased heart rate, blood pressure, and blood flow.  More fluid can accumulate in the soft tissue, and this can overwhelm the healing lymphatics.  Activity leads to too much fluid for the compromised "plumbing."  It is very likely your swelling is attributable to your time on the treadmill.  Treat it symptomatically with compression and leg elevation, and know that as your lymphatics heal over time, you will have less exercise-induced swelling.  Hope your recovery continues to progress well!