Yes, you had large volume liposuction. The more fat that is removed, the more pain can be expected as it took more strokes/back and forth with the cannula to remove the fat. It is also likely that a larger caliber cannula was used, which can contribute to pain. There is no set standard or law as to exactly how much fat can be removed in a setting, but there are recommendations. Recommendations are made to prioritize safety. Usually no more than 5 liters in a session is recommended. If more than that is taken in one session, it is recommended that the patient be observed overnight for fluid imbalances. In my practice, for patient safety and comfort purposes, I recommend staging the liposuction (having more than one liposuction procedure at minimum one week apart) if I anticipate more than 5 liters will be removed. Some patients don't like this, and prefer convenience to safety and will go to another plastic surgeon (and sometimes a NON-plastic surgeon) willing to accept the risks and consequences that come with large volume liposuction. High BMI/volume patients can be a double-edged sword for a plastic surgeon when it comes to liposuction and patient satisfaction. More fat has to be removed to make a difference in shape, and still some of those patients will complain that not enough fat was taken. On the contrary, when a large volume of fat is removed, there is the complaint of excessive or "unbearable" pain due to the greater number of strokes/back and forth and the larger caliber cannulas it took to remove the large volume of fat. Frequent urination is likely due to the high volume of fluid that was absorbed by your body during your procedure (fluids through your IV and the tumescent fluid). Your body is "diuresing" or letting go of the fluid through your kidneys. One liter (1050 cc in your case) per buttock cheek is more than adequate volume for a Brazilian Butt Lift, but the effect it will have in contour depends on the overall size of the person into which that fat is injected. A 1050 cc per cheek in a person with a BMI of 21 will look far, far different than in a person with a BMI of 33. If more than one liter is needed to make a difference in buttocks contour, the patient really should come back for secondary fat transfer to avoid complications of overfilling. Staying still to avoid pain I find only makes the pain worse as now your adding stiffness to the pain. Lack of movement also contributes to blood clots. If you're in that much pain, which it seems as if you are because you're calling it "unbearable," you should really relate this to your plastic surgeon. Hopefully he can prescribe you an adequate pain regimen so that you can get comfortable. You should really ask your plastic surgeon these questions. As plastic surgeons, our job is not simply to perform the surgery, but to answer your questions before and after surgery and to be with you through your postoperative recovery. Best of luck. Sometimes the pain associated with liposuction is underestimated because no large incisions are made. Healing takes time. You will get there!
