Is swelling after tumescent lipo normal?

Question

I had Tumescent Liposuction on my upper and lower abdomen 5 days ago, is the pulling pain in my lower ab normal when i stand the first few minutes?   I also feel that my lower belly still looks the same. My upper abs look way flatter, could it be swelling? It looked perfect immediately after the procedure and it swelled for 2 days and on day 3 it looked flat, but now I am concern because it is poofy and jiggly.

Richard J. Bruneteau, MD · Answer

Patients
undergoing tumescent liposuction will inevitably develop swelling and pain
following this procedure.  During
the procedure, the liposuction cannula is passed through the subcutaneous
tissue.  This causes disruption of
the lymphatic channels and cellular injury.

Significant improvement in swelling
can be seen in the first three weeks following surgery, with the majority gone
in about three months.  Small
amounts of swelling may persist up to a year following surgery.

We
generally recommend the use of compression support garments for about three
weeks following surgery.  We also
recommend a low salt diet before and after liposuction.  Exercise is usually started early in
the post-operative period, and we want patients to ambulate as soon as possible
following surgery.

Massage is also helpful, it
decreases swelling by mobilizing retained fluid following liposuction.  All of these steps help to minimize the
duration of swelling following surgery. 
In your case, pain and swelling are normal and should resolve with
time.  Compression massage
ambulation and low salt intake will hopefully help you get there sooner.

Jerome Edelstein, MD · Answer

I sounds like you are recovering normally, although you should see your surgeon if you are very concerned about the pain. The final result can usually be assessed at 3-4 months, so please wait until then. In the meantime, follow your surgeon's post-surgery care instructions closely.

Vivek Bansal, MD · Answer

Swelling goes to the direction of gravity and swelling goes from north to south and the swelling will be in the low abdomen last. This will resolve, but avoid sitting too much and causing a crease there. Standing and a good compression garment is good as well.

Joseph Mele, MD · Answer

There are two reasons for swelling after tumescent liposcution. First, in the operating room fluid is injected into the fat to help with the fat removal and speed your recovery. Second, any surgery is a form of injury, and injury leads to swelling as part of the healing process.

	The tumescent fluid goes away in about a day, and the swelling from the injury of surgery peaks at two to three days. After a few days the swelling will begin to subside. In most areas it goes away from the top down due to gravity pulling the fluid downwards. Less swelling at the top of the abdomen is normal. The other side of this coin is that there will be more prolonged swelling at the bottom of the abdomen.

	It takes about three weeks for a significant amount of the swelling to resolve, but even at three weeks there is still swelling. You will usually notice the swelling continuing to decrease for about three months. If you look critically at photographs of liposuction, I can usually notice changes out to a year, but the amount of change becomes more subtle with time.

	Properly fitted compression garments can be helpful to decrease swelling and discomfort after surgery. Medications, such as diuretics, are not usually helpful or recommended, but some herbal medications can be helpful with proper guidance.

Steven L. Ringler, MD, FACS · Answer

Swelling after liposuction of any type is a normal process. The tumescent technique for liposuction uses injection of large volumes of fluid containing local anesthetic and epinephrine to constrict the blood vessels and reduce bleeding. Much of the tumescent fluid is removed during the procedure, however, many times there is additional fluid that is left behind that can cause swelling in adjacent areas for several days. Typically, surgical swelling reaches it peak at three days, and then dissipates gradually over the next several days to weeks. With liposuction swelling can be prolonged due to damaged fat cells that were not removed during the procedure, loose skin which allows fluid to accumulate, or collections of blood or serum in the treatment area. If your swelling continues to increase rather than resolve, you should see your surgeon for follow-up to make sure this is not an abnormal collection of fluid (seroma) which could require further treatment. In most cases, the immediate result following liposuction is the best indicator of the end result. Good luck to you.

James F. Boynton, MD, FACS · Answer

Almost all liposuction is "tumescent" which means that close to a similar volume of saline (salt water solution with some adrenaline and xylocaine) is pumped into the tissues or areas to be liposuctioned as are removed, which in the abdomen can be several liters of fluid. This is done mostly for safety reasons in order to minimize blood loss and improve the purity of the fat removed. There are a lot of fluid shifts in the body in the first several days in the body after liposuction and it is normal to be swollen and puffy 5 days after surgery.  And it is perfectly normal to see swelling really peak several days after the surgery.
Some doctors (like myself) prefer to leave the small puncture liposuction incisions open after surgery so that the excess fluid can drain and typically the swelling resolves a bit quicker. Otherwise, the body had to reabsorb it on its own which can take several weeks. Either way, it was done technically, it is very normal to be swollen at 5 days after liposuction. If there is a "jiggly" area, it could be a fluid collection called a seroma. Also, most plastic surgeons advocate wearing a compression garment and/or an abdominal binder afterwards. Finally, a low salt diet is important in helping expedite a more rapid resolution of swelling after liposuction.
I tell my patients that it is important to be patient after liposuction and that most patients will see significant changes in their appearance as early as 3 weeks.  Final results can take up to 6 months to appreciate.
I would go back to your plastic surgeon this week and make sure that you don't have a seroma (fluid collection)
Hope this helps.

Francesco Campanile, MD · Answer

Given
that you are only a few days after surgery, I’d be more surprised if you didn’t
notice some swelling and discomfort in the treatment area. Swelling is part of
the body’s normal healing response after trauma, including liposuction surgery.
Also, any remaining tumescent solution can also contribute to some of this
effect. Give it a little more time and keep wearing your compression garments,
and you should see noticeable improvements in your contours before too much
longer. If the swelling seems to be getting more pronounced, definitely call
your surgeon and schedule a follow-up.

Andrew Jimerson, MD · Answer

I am not too concerned about the pain you are describing. Your surgery was quite recent. The swelling should probably be evaluated by your surgeon. If you are standing frequently, it may be that gravity has caused the swelling (edema) after surgery to accumulate in your lower abdomen. If this is the case, wear your garment religiously according to your surgeon's instructions, rest as much as possible and talk to your surgeon about lymphatic drainage massage. The reason I suggest a follow up visit is the possibility of a seroma. A seroma is a collection of fluid that sometimes needs to be drained in the office.

Tom J. Pousti, MD · Answer

Thank you for your question.

	At 5 days post op  It is much too early to evaluate the results of your surgery.

	Swelling is part of the healing process.  I ask my liposuction patients to wear a compression garment for 4 weeks post op surgery to help with the swelling.  The swelling can take months to subside and even longer for skin to &ldquo;redrape".  At that point you will see the final results. 

	Best Wishes.

Karol A. Gutowski, MD, FACS · Answer

What you are describing sounds normal. The swelling and retained fluid tend to follow gravity and make your lower abdomen seem fuller. If you looked good at the time of surgery, you will most likely get that result within 2 to 3 months.

Is swelling after tumescent lipo normal?

Answers (14)

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