Terrible Itching After Smart Lipo

There can be several factors that attribute to itching after a procedure. I always tell patients that a "crawling" feeling, itching and numbness are normal for several weeks after surgery.
There is also the possibility that you are having a mild allergic reaction to one of the medications. Make sure you let your surgeon know and see what they recommend.

A deep itch is very common after a liposuction procedure and it due to the nerves healing and "waking up" under the skin. It generally lasts for a few weeks and then subsides. Sometimes, the itch is on the surface of the skin caused by irritation from the compression garment especially if the garment has become wet. Removing and washing the garment if it becomes wet is recommended if this is the case.

This is one of the most common side effects after any type of lipo.  We warn clients that it may be experienced, although it is usually mild and self-limited.
The first approach is a topical cream with Benadryl, or maybe even Hydrocortisone twice a day.  A cool compress often helps and most client find this to be enough.
Anything worse than that should prompt you to follow up with your surgeon as soon as possible to avoid the possibility of anything worse.