Pain/Hardness 6 Weeks After Tumescent Liposuction?

Question

I had Tumescent Lipo of the hips, abdomen, and flanks 6 weeks ago, my surgeon removed almost 5 liters of fat. I am extremely pleased with my results, and I wear my girdle and compression garment everyday. However, I still feel extremely sore, my skin is still numb/tingley, have sharp pains and burning around my healed incisions, and have hard spots around my vagina and the middle part of my chest below my breasts. I also do not have regular bowel movements or hardly any appetite. Is this normal?

Larry S. Nichter, MD, MS, FACS · Answer

The symptoms you are describing are common following liposuction. The discomfort, numbness and tingling are common. At this point I would stop all of your narcotic pain medicines as this is probably the cause of your loss of appetitie and constipation. If tolerated a nonsteroidal anti-inflammatory drug like ibuprofen and/or acetaminophen (Tylenol) is preferred. Use the usual treatment for constipation that works for you or your doctor recommends and increase your exercise routing.

	Regarding your complaint of Post Tumescent Liposuction  Hardness and  Lumps - here are some answers about its cause and treatment
	Massage can help manage firm lumps and bumps following liposuction to a varying degree. If the reason for this firm area is because of residual edema (called induration) then it will likely be gone by 6 months. Other causes may be from a localized seroma, liquefied fat pocket, or a fat deposit that did not survive.

	Therapeutic or "lymphatic massage" may be helpful following  a  Liposuction Procedure to minimize swelling and resolve some of these firm areas.. Make sure your surgeon feels that you have healed sufficiently  and it is safe before doing this.  Endermologie is also very helpful after liposculpture/liposuction but again, not critical.  Although deep tissue massage following liposuction can aid in smoothing out  contour irregularities that invariably accompany this procedure it has limited effect on the final outcome and  is NOT mandatory. Some plastic surgeons recommend it to all  patients as they feel the edema resolves faster.  Ask your surgeon to show you or a significant other how to do this if cost is an issue. Typically they will have you massage toward areas of maximum lymphatic drainage ( for example groin or armpits) A low sodium diet may also be helpful early on.

Richard J. Bruneteau, MD · Answer

It’s not unusual for patients to have areas of
firmness and pain following tumescent liposuction, especially when large
amounts of fat are removed.  It’s
also common to have tingling, burning and numbness of the skin following this
procedure.  This occurs because of
stretching and compression of sensory nerves during the liposuction
procedure.  These findings are
usually associated with significant swelling and usually resolve with the
passage of time.

In
most cases, symptoms improve in about 3 to 4 weeks, but in some cases it may
take as long as 3 to 4 months.

Loss
of appetite and constipation are not typical following tumescent liposuction
and in most cases are related to the use of narcotic pain medications.  This problem needs to be evaluated for
a variety of reasons.  Under these
circumstances switching to a non-narcotic pain medication would be
appropriate.  In addition massage
and compression garments are also helpful in reducing swelling.

It’s
important to discuss these issues with your plastic surgeon.  Your surgeon should be able to address
these problems and improve the quality of your recovery.

Jon F. Harrell, DO, FACS · Answer

Some degree of discomfort and firmness are typical at the 6 week mark after larger volume liposuction procedures. If the symptoms are more intense or difficult to deal with I will place some patients on medications such as Elavil or PreGabalin. I also am not a big fan of long term garment use, particularly - tight fitting garments as I think this can prolong the discomfort. Lymphatic Drainage therapy - as opposed to Massage, and often help these symptoms. Best of Luck Dr Harrell

Steven Wallach, MD · Answer

At 6 weeks after liposuction, your symptoms are not uncommon. You should of course review your concerns with your surgeon but they shoudl get better with time.

Peter Marzek, MD · Answer

It is not unusual to have some contined swelling and firm areas at the 6-week post-op mark after liposuction, especially an aggressive liposuction procedure where 5 liters of fat was removed. This is just caused by fluid retained in the area and this will usually go away with time. I put all my patients on an aggressive massage protocol after surgery. The massage will help the fluid dissipate more rapidly. Numbness and tingling is also not unusual in the skin, and should also improve with time.

Pain/Hardness 6 Weeks After Tumescent Liposuction?

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