What Causes Hardness After Tumescent Liposuction?

I had Tumescent Liposuction on my back, stomach, arms and legs two weeks ago. I am VERY pleased with my legs, there is very little swelling and no pain. My back looks great also but is still a little numb. My lower abdomen however is really hard right in the middle (not all over, just in the middle) - it feels like a deck of cards inside. It isn’t really sore anymore, but is big. I have synergy treatments twice a week which hopefully will help. Any idea what these “cards” are? Thank you!

Doctor Answers 7

It is the healing process and will continue to get better

This is very common an will eventually resolve. The underlying fat has been beat up and the body heals the area by sending in extra blood vessels which in turn increase the amount of fluid called edama. This mixture of traumatized tissues, extra blood vessels and fluid will lead to the hard areas.

The lower abdomen is a very common area for this to happen because it is dependent, i.e it is low down and accumulate the fluid and very commonly there are pants and underwear and belts that compress the part above the lower abdomen, thus making that area worse.

Harrisburg Plastic Surgeon
4.5 out of 5 stars 34 reviews

Disruption Of Lymphatic Channels and Cellular Injury

Patients undergoing tumescent liposuction of the abdomen will often develop swelling, firmness, hardness 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 which results in these characteristic physical changes.
These findings can persist for several months following surgery.In most cases improvement is seen within 3 to 4 weeks following surgery.In other cases, improvement may continue for up to 3 to 4 months following this procedure.Small amounts of firmness may persist for up to a year following surgery.
We generally recommend the use of compression garments for about 3 to 4 weeks following surgery.We also recommend low salt diets before and after surgery.Exercise is usually started early and we want patients to ambulate as soon as possible following surgery.
Massage is also helpful, it decreases firmness, hardness and swelling by mobilizing retained fluid following liposuction.All of these steps minimize firmness and swelling and improve the patient’s aesthetic result.

Richard J. Bruneteau, MD
Omaha Plastic Surgeon
4.9 out of 5 stars 194 reviews

It's internal scar tissue which need to be treated aggressively.

To Charley,

Hi. This is not a rare problem which we ONLY see in the abdomen. What seems to happen is that small fluid collections solidify into internal scar tissue with the resultant lumps (or deck of cards). Most of these lumps go away if treated with early, frequent lymphatic drainage massage and ultrasound.

Your surgeon may have a different routine that works also. Since you have a great result in your legs and back, you obviously have a very good surgeon.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
4.8 out of 5 stars 9 reviews

What you are describing is not unusual


I am glad that you are happy with your liposuction results. What you are describing is not unusual. For just two weeks out from surgery, it sounds like you are making a tremendous recovery. As for the "deck of cards," you may just have localized swelling or possibly a small fluid collection. Your surgeon will be best to evaluate this. If it is just swelling, it will resolve on its own. If it is a fluid collection, then you make need it drained, which can be easily performed right in your office. Either way, you should be fine.

I hope you find this helpful.

David Shafer, MD
New York Plastic Surgeon
4.9 out of 5 stars 77 reviews

Recovery and swelling after liposuction

There is a period of recovery after liposuction that involves pain, bruising, and swelling.  This is normal and should resolve with compression.

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 94 reviews

Hardness after tumescent liposuction

Liposuction is a safe, popular, and effective way to contour the body. Patients should be aware of the recovery process after liposuction. Immediately after the surgery, they will experience a moderate amount of pain, swelling, and bruising.

As the patient is healing, it is common for them to have firm areas, lumps, or uneven areas at the beginning of the healing process. In our practice, we provide every patient with a special compression garment that helps decrease the swelling and provide support for the patient to increase their comfort.

Pat Pazmino, MD, FACS
Miami Plastic Surgeon
4.7 out of 5 stars 108 reviews

Two weeks after liposuction

Being out only 2 weeks after liposuction surgery, it is not uncommon to feel numbness and somd areas of firmness. The numbness usually gets better over a few weeks, and the firmness will soften, but you can also massage it.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.