Should I still have swelling 4 weeks after liposuction of the saddle bags?

It's not unusual to have swelling 4 weeks after liposuction.  It's a bell shaped curve for post liposuction swelling, as with everything else.  In my own practice, I once had an ex-special forces guy come in.  We did liposuction on him on 6 areas on Monday.  By Friday, he had no swelling at all.  I was truly amazed.   I once had a female come in and we did 4 areas of liposuction on her.  In 3 months, using every trick I knew, she still had swelling.  The swelling finally went away after 6 months.  As you can see, liposuction recovery demonstrates a bell shape curve, at least in my practice.  With reference to closing the liposuction incisions rather than leaving them open to drain, it's been my experience that the final results at 6 months are exactly the same, but it is a lot messier, more uncomfortable, and increases the risk of infection to leave the incisions open and draining.  I am sure your plastic surgeon has his or her own tricks for making swelling go down faster, and I suggest you query your plastic surgeon as to whether there are other modalities besides wearing a girdle that might decrease the swelling.That being said, in my practice, we use DMSO which is the world's best anti-inflammatory for taking down bruising and swelling, and also ultrasound (the kind physical therapists use for sore muscles).  Please don't worry.  I have been doing liposuction since 1983 and I know of no cases, mine or other plastic surgeon's , in which the swelling did not go down eventually.

You should still be swollen, but I am not sure it's appropriate for you to be so swollen that you can't fit into clothing you wore prior to surgery. I would recommend you see your surgeon to review your recovery and see if massage and/or new compression garment might be helpful.Good luck!

Swelling can take 3-6 months to fully resolve.  My patients get massage and velashape or venus treatments starting 3-4 weeks after surgery.  Exercise, compression, diuretics, and low dose amphetamines help swelling resolve faster.  I suggest speaking to your physician.  Best, Dr. Emer.