Will Stitching Incision Site After Tumescent Lipo Hinder Drainage and Prolong Swelling?

Open Incisions vs Closed for Liposuction is highly variable based on surgeon's preference and either way way in good hands you get a satisfactory result. I differ however in some of the recommendations below. Most Board Certified Plastic Surgeons close liposuction incisions regardless of the type of liposuction used (Smart Lipo, Ultrasonic liposuction, conventional or PAL - power assisted liposuction. In my more than 2 decades of practice and trying each of these devices, I have not found any prolonged recovery by closing incisions. On the contrary I feel that I have prevented the mess and hassle to the patient. The ultimate scar has a better chance of being smaller if sutured based on my more than a quarter of century of performing liposuction and having used both techniques.

                  In
the vast majority of patients we suture the liposuction entry sites.  This doesn’t appear to impact swelling
or seroma formation in the post-operative period.  In theory, closing these wounds should minimize scarring,
but scarring doesn’t seem to be an issue when wounds are left open.

                  The
major advantage of this approach is decreased drainage from the wound.  When wounds are left open, constant
drainage occurs with bloody fluid which constantly stains the patient’s
compression garments.  When wounds
are sutured this fluid is resorbed by the body.  In our experience, we’ve not seen problems when wounds are
closed following tumescent liposuction and it appears to simplify after care.

Slightly loose stitching of the access incisions is really the preferred way to go.  This technique provides the advantages of both worlds - drainage can still proceed but the wounds heal more reliably and more invisibly. 

I don't suture the small incisions after liposuction is finished, and here's why:


once the lipo is done the fluid has served its purpose--so let's get rid of it

the fluid will drain onto dressings and be removed from the body faster than absorption

trapping the fluid also traps blood and increases the appearance of bruising

there's less of a feeling of swelling if the fluid drains rather than slowly absorbing

any skin bacteria that may have been dragged into the tissue won't be trapped there

the incisions are very small and heal without the track marks suturing may cause


Dr. Jeffrey Klein, the dermatologist who invented tumescent anesthesia liposuction, proved the benefit of open incisions rather than sutured incisions. He did lipo on hips and thighs and sutured one side and left the other to drain without sutures and the evidence was clear that the open drainage side healed much faster and the patients were more comfortable. After performing more than 5500 tumescent liposuction procedures without sutures, I don't see the need for them.

Thank you for the question. There is really no hard rule as to close or not to close the liposuction incision. Most liposuction incision are too small to require suturing. When larger cannulas are used, I close the incision site. But,  ultimately its up to your surgeon to make that decision. The outcome of the surgery depends on how its done and not on the closure of the incision. You need to see before and after photos of your surgeon and base your decision in part on that. Many patients are concerned about the incisions before liposuction; after surgery, it is not a concern. I wish you all the best