Developing heat rash from compression garment after 4 weeks. What should I do? I was told to wear it for six weeks.

 Compression garments type and when applied and for how long varies from plastic surgeon to plastic surgeon and not dependent usually on the type of lipo performed. After 4 weeks most of the benefit has already been accomplished so check with your surgeon. If still recommended wear cotton clothing beneath and take a break for several hours as a possible solution. In my practice, A compression garment placed in surgery immediately after liposuction (steristrip protects the sutures) is recommended and beneficial after liposuction because:It restricts the amount of edema that forms and hastens its resolution by mechanical pressure.It decreases the amount of bruising.It assists the loose skin in retracting or shrinking.If bulging ridges, creases or bands are present above, within or below your garment, then you probably need to change garments - see your plastic surgeon.It is common to have weight gain due to edema, serum that collects in the area, and the tumescent fluid that was injected. This will resolve over time. The more you wear the garment initially, the quicker this fluid resolves.Edema: a condition characterized by an excess of watery fluid collecting in the cavities or tissues of the body.The length of time that the garment should be worn varies depending on the amount of fat removed, the elastic nature of your skin, how much loose skin remains, and other factors. Your surgeon would give you the best advice, however this is the general routine for my patients.The first garment should be fitted for you in the office prior to surgery and applied in the operating room. Often it will become loose as the edema is mobilized, and then it will need to be replaced. Spanx is a reasonable compression garment if it gives enough support and is the right size. I have my patents bring them in so I can confirm that it fits well.Most important advice is to listen to your surgeon, as he or she knows how much fat was removed, the elasticity that remains in your skin, and amount of skin redundancy.I recommend that my patients wear their garments for a minimum of three weeks full time then for twelve hours at a time (day or night). If there is not a lot of redundant skin, this continues to a maximum of six weeks.To be effective, the garment needs to fit snugly—but not too tight as that can make it difficult to sleep or cause pressure problems (inspect your skin when it is exposed if you are uncomfortable). As the edema resolves it is common for patients to switch to a smaller garment that fits. A Spanx-type garment would work fine, rather than ordering one or paying more at your doctor’s office.

Please see your surgeon about this, as skin irritations can compromise your recovery.I generally advise patients wear their garment 24 hours a day for three weeks, removing it only when bathing or washing it. From 3 to 6 weeks, wear your garment in the day only. It helps with easing swelling and reducing the risk of seroma. The garment should fit snugly but not to the point that you can't breathe or are feeling sore.  

I personally would give you a break from the compressive garment until the skin condition has resolved. Nevertheless, this is a question you should ask your own plastic surgeon.