Christopher Chung, M.D.
American Board of Plastic Surgery
Chief Medical Officer
Sono Bello
While there has always been a fairly predictable framework for liposuction recovery, we have had substantial enhancement of the process over the last few decades, following scientific understanding and clinical correlation.
– Establishment of superiority of Tumescent Technique. The use of a dilute solution of lidocaine and epinephrine for control of surgical bleeding and local anesthesia has become the standard technique for liposuction. This technique has demonstrated clear advantage in safety and cost-benefit over general anesthesia.
– Management of acute wound milieu. Changes in clinical practice regarding the encouragement of open drainage from wound sites and the titration of the amount and timing of phased compression garments have resulted in the sophisticated management of the inflammatory exudate following the surgical injury of liposuction.
Being prepared for the post-operative period after a liposuction procedure and knowing what to expect are important. Your surgeon and the nurse should give you prescriptions for postoperative use and instructions for how they want you to use them. Most liposuction procedures utilize tumescent fluid – this is an IV solution to which lidocaine for anesthesia and epinephrine, a vasoconstrictor, to minimize blood loss, has been added. This tumescent fluid is injected into the area to be suctioned at the start of the case.
At the end of the case, some surgeons suture the small skin openings closed, but many leave the openings open to allow any excess tumescent fluid to run out. The fluid that comes out will contain a small amount of blood in the excess IV fluid, so this drainage fluid has the appearance of red or maroon water. Your surgeon and nurse should recommend dressings to absorb this fluid and protective barriers to be placed on any upholstery or bedding. The drainage can last one to two days.
Patients are placed in a compressive garment or binder immediately following the surgery and instructions will be given when to take the first shower, usually one to two days after, and how to progress their activity. Patients are generally instructed to rest the first 24 hours and then start moving around more on the second or third day. Walking is a good physical activity and patients should advance to this as soon as they are able. However, they should avoid bending, twisting, heavy lifting, and other strenuous activities for 4-6 weeks or until cleared by their surgeon or nurse.
Most people will swell 2-3 days after their liposuction procedure and then it gradually goes down over time. The area suctioned may be bruised as well. The area can remain firm or even lumpy as the swelling recedes. You will be told when to start massaging the suctioned areas.
Individual healing varies, but most end up using their compression devices at least 3-6 weeks. Most will start to see results in the first days to weeks with a final result seen by 6 months postoperatively.
A useful conversation of liposuction recovery time should begin with a discussion of typical milestones.
– Days 1-2. During this time, the effects of the local anesthetic will wear off. The magnitude of the acute surgical discomfort may well require narcotic analgesic pain relief. The volume of serous drainage will be greatest during this time. The dressings will need to be frequently replaced. While the drainage will certainly be blood tinged, it should be emphasized that the actual amount of blood that is lost is very minimal. During this first 48 hours, the maximum impact of the original compression garment is realized.
– Days 3-14. Drainage will have completely stopped by day 4. The need for the early acute high compression garment Is now waning, and by day 7, the more comfortable second stage garment may be applied. The early garment is applied to help express the acute inflammatory exudate from surgery, and the second stage garment is intended to assist in comfort. This strategy in switching from an initially high compression garment to a lower compression garment is known as bimodal compression therapy. Typically, a clinical encounter will be arranged around days 7 to 10 to evaluate the progress of wound healing and to assess for any acute concern such as infection or retention of fluid. Many patients that are employed in sedentary positions find its possible return to work at this point. Those who are laborers and are more active may need an extended period of time to resume full work responsibilities.
– Days 15-28. The surgical incisions will have all completely healed. This period of time will be marked by substantial decrease in post-operative swelling that had been recognized in prior weeks. The general constitution will have improved to the point that light to moderate exercise can be introduced into the daily routine.
– Days 29+. This period is marked by the conversion of the acute inflammatory edema phase to a phlegmonous subacute wound healing phase. There is also substantial progress in exercise tolerance and ability to resume fitness routines. The period between the third and the sixth month is marked by ongoing resolution of the inflammatory phlegmon and the progressive reveal of the final contours.
While it is suspected that some individual variation will occur with the above, it is helpful to have consistent guidelines and establish expectations preoperatively.
Here are some helpful secondary nuances in liposuction recovery:
– As in most health-related paradigms, diet has a substantial impact. Specifically, it is helpful to the patient to maintain hydration through an adequate fluid intake, but inadvisable to have foods or fluids that are rich in electrolytes and salts which promote edema.
– Activity is to be encouraged, as this helps avoid the pooling of blood in the lower extremities and pelvis and contributes to risk reduction of thromboembolic events.
– Massage has advantages that can be realized through encouraging lymphatic drainage reorganization of a scar, stretching, and stress mitigation.
– Of particular importance regarding the choice of clothing is to avoid wearing tight waistbands and other focally constrictive garments, as substantial contour irregularities can be created by poorly fitting clothing.
The focus on the biomechanical details and improvements in the technique of surgical delivery and recovery is the hallmark of the collected experience of over 100 board certified plastic surgeons performing over 140,000 surgeries during the last ten years by the Sono Bello clinical team.
Dr. Christopher Chung, Chief Medical Officer of Sono Bello explains the key components of the recovery process after Sono Bello’s TriSculpt laser liposuction and how our procedure is customized to reduce soreness and recovery time.
Video Transcript
Mike Garrison, President, Sono Bello: Dr. Chung can you talk a little bit about the recovery process from liposuction?
Dr. Chris Chung, Chief Medical Officer, Sono Bello:
Yes. The recovery process mostly involves swelling. Because of the liposuction your body will swell. I would say that in about six week, 60% of your swelling is gone and people start to see dramatic changes. And during that period most people take about several days of pain medication, some may be a little bit more, some a little bit less, but very rarely does anyone take over five days. So once the swelling is gone, then the second part of the recovery comes into play and that is the skin tightening part. And obviously with further reduction and swelling with the skin tightening, the final outcome can be achieved, anywhere between three to six months. I personally encourage my patients to resume normal activities right away and that’s how you minimize complications. And even light exercise as about two weeks.
Asking Dr. Chung: What Downtime and Soreness Can be Expected During the Liposuction Recovery Process?
Dr. Chung explains the typical expectations around downtime and soreness for patients who undergo the Sono Bello Trisculpt procedure.
Video Transcript
Mike Garrison, President, Sono Bello: Dr. Chung can you talk a little bit about what the downtime is with a liposuction procedure? what patients might expect in terms of soreness?
Dr. Chris Chung, Chief Medical Officer, Sono Bello:
Yes. So in terms of downtime I actually encourage my patients to resume normal activities right away. I know that there is some soreness, most patients take some form of pain medication for two or three days but really not much beyond that. You know most of that soreness is from the swelling that occurs naturally and most of that swelling will be gone by about six weeks.
Mike Garrison, President, Sono Bello: And what do you advise patients to do to achieve their absolute best results after a liposuction procedure?
Dr. Chris Chung, Chief Medical Officer, Sono Bello:
So, in order to achieve the best possible outcome, we ask all patients to comply with our very specific post-operative instructions. Which are really there to help navigate the patient through this process after the surgery, to promote safety, to minimize complications. And ultimately for the long-term outcome, obviously, it’s a strict maintenance to a better lifestyle is key, absolutely key, to achieving the most optimal outcome.
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