Seroma after liposuction needs to be treated promptly.
Hard to tell without seeing you, but you may have seromas (fluid collections). This is one of the reasons we don't use ultrasonic liposuction.
Swelling 3-4 weeks after surgery is totally normal. This is the time when the body is healing from the procedure. You need to give yourself a few months for the swelling to go away completely.
Swelling after multiple procedure
You had extensive surgery in the lower part of your body. abdomen, buttock lift, lipo to back. There is some disruption to the lymphatic system, which causes the prolonged swelling.
Once you can tolerate it start massage, including a deep tissue massage or lymphatic drainage massage.
My patients also use their bath tub with the water jets on those areas it will feel good and act as a massage.
You had a lot of surgery - it will take time for the swelling to resolve
You had a lot of surgery -- it will take time (several months) for the swelling to resolve. Hopefully your surgeon is following you closely and can examine you for other possible issues such as seroma. However, I am not surprised that you are still swollen after so much surgery. Just be patient and follow your surgeon's instructions and you will see positive changes over weeks, not minutes. Good luck with your recovery.
Perioperative Massage Therapy
Congratulations on your successful lifestyle changes and weight loss. Did you really lose 221 pounds in 1 year? That is impressive, and is even beyond what is often seen after bariatric weight loss surgical procedures.
Undergoing body contouring surgery after successful lifestyle changes and weight loss is often an optimal situation. I do encourage patients that are significantly overweight or are at their maximum weight to demonstrate progress toward weight loss before plastic surgery.
Back to your question--swelling in the areas you mentioned, lower back and lower abdomen, often does take longer to resolve after multiple procedures such as in your case.
I can't recommend post-operative soft-tissue massage therapy enough in your circumstances. Our experience with such therapy has been very rewarding, so much so that we've brought an experienced therapist into our office and include pre and postoperative massage for all of our patients.
In situations such as yours, we commonly have patients mobilize so much fluid in a single session of therapy that they need to stop to go to the bathroom.
Bottom line: Congratulations on your weight loss and surgery. You will likely be quite happy in reaching toward your goals as you heal. I'd suggest postoperative massage--ask your surgeon for a referral to a qualified therapist--it is well worth it.
Hope this helps.
Early phase of healing, but rule out seroma
You had multiple procedures and you are still in the early phases of healing. I would recommend that you check with your surgeon. If you do not have a rapidly enlarging swelling, you are okay.
The minimal time for acute healing is 6-8 weeks. You had a significant amount of work done. The garment must be worn for at least 6 weeks. But depending on your preoperative appearance it may be needed for longer.
For most surgeries it may take up to 6 months for the swelling to subside and the tissues to settle.
Be patient. Think how great you will look this summer in your two piece!
Prolonged swelling after multiple body contouring procedures
You should of course discuss this with your surgeon to ensure that this is not a problem which requires intervention such as a seroma (treated with aspiration) or infection (necessitating antibiotic therapy or drainage). Having said that, given the magnititude of your procedures, this sounds normal and compatible with the extent of your operation.
It is not unusual to have swelling persist for several months and patients often do not experience decrease in clothing size until a minimum of 2 months after the surgery. Keep in close contact with your surgeon.
Swelling is normal at this point...
Given the nature of the procedure you underwent, swelling in the areas of suction 3 1/2 weeks after surgery is entirely to be expected.
Even with modern ultrasonic assisted liposuction, swelling in the tissues may take 2-3 months to completely resolve. I would continue to wear your garment snugly, and at all times, and be conscientious about following your surgeon's advice and keeping all appointments.
Hang in there and be as patient as you can.