Bloating and swelling after liposuction is totally normal, but it can be alarming. You’ve gone in for a surgery with the specific intention of reducing fat and the size of your body overall, and then you leave this cosmetic contouring procedure and, in the immediate aftermath, you’re swollen. A quick note, traditional liposuction surgery doesn’t affect visceral fat.

What to do for a fast recovery

Swelling after liposuction procedure is caused by an accumulation of excess fluid in the treated tissue. You’ve had a suction tube called a canula, inserted inside you and rammed around for goodness’ sake, there is going to be a healing process. It’s easy to forget this because we know what we’re doing, but the body doesn’t and our cells react.

Read about what this is in our blog post.

Is my swelling getting worse?

This is a common question as many people feel that their swelling after lipo is getting worse every day in the week following their procedure. And this can be the case. Particularly if you don’t book in aftercare with a trained MLD therapist.

Dr Engler says that after liposuction, “maximum swelling and bruising — and therefore discomfort — may not occur until 1-3 days after the surgery. When bruising starts our relatively deep, (as after liposuction), it may take longer to peak, e.g. 5-10 days.”

Dixit and Wagh (2013) said in the Indian Journal of Plastic Surgery that “swelling will be apparent within 24-48 hours after the procedure and continues to mildly increase for the first 10-14 days”. This was after a study they did of over 600 plastic surgery procedures.

Some parts of my body are OK, but others are still swollen.

It’s usual during your liposuction recovery to have some areas that remain swollen longer than others. Flanks are a classic here and frustratingly really affect your clothing size. And it doesn’t matter how much exercise you put in, how improved your balanced anti-inflammatory diet is, these areas just take longer. You may also find that your skin is more lax in some areas than others.

In an article published in the Annals of Medicine & Surgery in 2017, Bellini et al found that oedema (swelling after liposuction) “in some venous areas such as your ankles and calves may persist for six months or even a year”. So if you have some water retention adding to your weight loss goals, don’t panic. We’ll get there. And of course, MLD and post surgery appointments with specialists such as us will always help, particularly immediately post surgery when you are desperate to get back to some kind of normal shape so your peers don’t ask questions about what has happened.

How can I get rid of swelling after surgery and vaser liposuction?

Firstly, as you can now see, your surgeon isn’t at fault when you’re swollen following your operation. It’s routine to go through this healing cycle before you achieve your desired outcome.

Lymphatic drainage massage (MLD) isn’t actually a massage. It’s more of a light pumping action which directs the lymph fluid to the correct drainage points (nodes). But it is excellent at assisting your body to remove efficiently excess swelling.

Let’s backtrack a little to understand why you keep fluid.

Once your surgical incisions have closed after persistent fatty tissue is removed, your body uses your lymphatic system to remove waste (swelling). Whilst this system probably wasn’t taught to us in our high school biology classes, it has plenty of work to do after we’ve had surgery.

The lymphatic system is our body’s recycling system. It comprises a network of vessels which move water, fat molecules, proteins and waste products from our interstitial fluid which surrounds our cells, and back to our hearts.

Foldi and Foldi noted in 2012, that “lymph vessels take part in the formation of lymph from the interstitial fluid and conduct lymph to the venous system”.

However, it’s also part of our immune system, as lymphatic fluid filters through our healthy lymph nodes. When tissue gets damaged and lymph vessels get cut, as they do during surgery such as micro lipo or vaser liposuction, we get swollen.

Ways to reduce swelling with a healthy lifestyle therefore are:
  • MLD (manual lymphatic drainage) as we offer at Essential Feeling
  • Exercises and joint movement, see our aftercare notes for advice on, e.g. start walking, gentle workout routine.
  • Diaphragmatic (belly) breathing, keep active but no strenuous activity for a while. It takes time to return to normal.
  • External compression garments, they’re not meant to be comfortable, they’re for medical purposes and to promote healing by reducing the buildup of lymphatic fluids, which would otherwise build up slowly and incrementally over time
  • Vibration as we offer at Essential Feeling with Deep Oscillation and Ultrasonic Cavitation
  • Cooling treatments which reduce your blood flow by constricting your veins.
  • It’s also important to manage realistic expectations as to the speed at what we can achieve and in what time frame period your healing process takes
  • Skin brushing is OK. The jury is out on how much it can help your body reduce swelling post lipo because you can’t go over your wounds. But it won’t do any harm if you avoid these areas, so why not?

MLD/ Manual lymphatic drainage

Lymphatic system

We’ve written a lot about this in our postoperative instructions, but there is a lot of confusion in social media. Many massage therapists, particularly abroad, push fluid out of open incisions. They are calling this manual lymphatic drainage, as they manually move fluid through vacant holes in your skin.

But, whilst they are manually moving excess fluid and it is draining, because it doesn’t enter into your interstitium, nor is it entering your lymphatic system, this is NOT manual lymphatic drainage. And this is frustrating to us because this procedure is often very painful to our liposuction patients as they place pressure on areas where you’re already experiencing soreness.

True, MLD is a beautiful relaxing session that is neither painful nor uncomfortable, and yet is hugely beneficial. It heals rather than causes additional inflammation.

Manual lymphatic drainage (MLD) is a gentle skin stretching technique that encourages the swelling in your body to move into the lymphatic system. It’s the stretch of your skin that makes it so effective. It is neither milking, rubbing or sliding.

According to “nonoperative Treatment of lymphoedema,” in the Semimars in Plastic Surgery, “manual lymphatic drainage is a technique that is used to increase the lymphatic fluid transport rate, develop new routes for lymphatic drainage from congested areas to adjacent non-edematous regions, increase the activity of macrophages to breakdown protein deposits, and mechanically break up fibrotic tissue. They showed it in patients with significant pitting edema of the extremity, trunk, or chest wall, with fibrotic or sclerotic tissue changes, and in those with significant symptoms including heaviness or tightness,” (Schaverien, Moeller & Cleveland 2018).

In a nutshell, if you’re feeling a little heavy or tight, then lymphatic drainage is your best friend.

Your lymphatic system will always work hard to remove stubborn swelling to its best ability. And after MLD it will continue to do this for some time. You’ll notice after a treatment that you’re going to the toilet more frequently. This is because swelling exits our bodies in urine.

How often should I have MLD to reduce swelling after lipo?

This is the most common question we’re asked. But, we prefer to work with your body and what it needs, so whilst a rough guide is twice a week whilst your swelling is uncomfortable, for some patients this can be too much or too little. We prefer to schedule your appointments around you healing needs. Each session is about an hour.

Some clients only want to have MLD for a few weeks after they’ve had their surgery. Others who are looking for optimal contour results continue to come and see us for a few months.

Top tips to aid swelling after liposuction
  • Wear your compression garment and put it back on again asap post MLD
  • Drink plenty of water stimulates the lymphatic system as it pushes your lymphatic fluid around your body. Not drinking enough decaffeinated fluid hinders; it doesn’t help fluid.
  • Don’t freak if your urine smells or looks a little different and comes more often
  • You’re likely to be less constipated as we do some abdominal work as part of your treatment
  • Don’t think that MLD is a quick fix. There is no silver bullet. Your swelling will take longer than one or two sessions to resolve. And indeed it should because your body needs fresh fluid to heal, not no fluid. Especially at first.

What research supports MLD to improve your surgery outcomes and reduce swelling?

Renato Saltx and Bianca Ohana were doctors who studied 183 endoscopic midface lift patients. in “Postoperative Instructions for Patients,” which they published in the “Aesthetic Surgery Journal,” they recommended elevating the head, using cold compress over eyes, and lymphatic drainage massage 72 hours postoperatively. And then once or twice during the first week. Then regular sessions 2-3 times a week after that.”

Lymphatic drainage also helps orthopedic surgery results as well. There was a study, “Randomised Trial Investigating the Efficacy of Manual Lymphatic Drainage to Improve Early Outcome After Total Knee arthroplasty.” Ebert et al. published this in the Archives of Physical Medicine and Rehabilitation.

It found that just a half hour of MLD on days 2, 3 and 4 after surgery “appears to improve knee flexion for up to 6 weeks post surgery.”

This is important because range of motion is one of the most frequency complications post operatively and one of the main reasons for patient dissatisfaction. We find the same with our clients who are dealing with swelling after traditional liposuction because who wants to be bigger or more restricted when you’ve had a procedure to reduce unwanted bulk?

Olesen & Olesen’s patients find MLD “not only relaxes them but also contributes significantly to their recovery.” Also, that “some surgeons recommend one session before surgery and after surgery,” while others, “encourage only post surgery appointments”. Personally, we recommend before as well as it aids the clarity of your surgeons’ cut resulting in less obtrusive marks/ scar.

History of MLD to reduce swelling after liposuction

We’ve been using MLD massage to heal from plastic surgery for over 20 years. At Essential Feeling, we’ve been offering this for over 10.

In their presentation, “Manual Lymphatic Drainage Therapy: An Integral Component of Postoperative Care in Plastic Surgery Patients, in 1999,” Doctor Casas and Doctor DePoli noted that when their patients are recovering from liposuction on their abdomen, buttocks, hips or thighs, abdominoplasty/ tummy tuck or facelift, if they were treated with Manual Lymphatic Drainage a few times a week for the first 3 to 6 weeks. And then with deep tissue massage to deal with any arising subcutaneous fibrosis that develops, then they recover faster.

See our post on lumps after liposuction

Loose skin after liposuction

Fibrosis is the otherwise permanent thickening or scarring of connective tissue resulting in hard spots and lumps, see our blog on fibrosis and scars.

We’ve talked about faster recovery, but what does this mean in reality?essential feeling romford essex mayfair post op care lipo specialists

Casas and DePoli (1999) stated that without any postoperative decongestive therapy, “We see a complete resolution of postoperative edema and fibrosis between 9 and 18 months.

However, the groups who had MLD and deep tissue, as we’ve discussed above, their postoperative swelling and fibrosis resolved within 6 weeks to 3 months. This is a significant shortening of recovery time.

What’s important about this isn’t just cosmetic. When we’re healthy, our bodies use movement and muscle contractions to move lymphatic fluid around our system. MLD massages from a certified therapist such as us at Essential Feeling can help this lymphatic fluid to move when you’re not supposed to engage in vigorous exercise.

Guenter Klose says, “postsurgical clients who can benefit from manual lymphatic drainage include those recovering from cosmetic surgeries such as facelifts, breast augmentation, and liposuction and orthopedic surgeries. Manual lymph drainage can effectively minimise and reduce swelling by activating your lymphatic system even before muscle movement and function can be restored.” 2014.