After Smartlipo or liposuction, there will be swelling, bruising, and a generalized hardening of the skin. The extent of these changes will vary greatly from patient to patient, and site to site.
There are several important factors to keep this swelling and bruising to a minimum and encourage healing:
- Appropriate numbing techniques (numbing contains epinephrine which decreases bruising/bleeding)
- Following instructions not to take advil or aspirin before the procedure
- Compression therapy right after the procedure
- Massage after liposuction
Massage techniques after liposuction
In our practice, we like to see patients for follow up in the first two weeks after the procedure. Once they demonstrate that the healing is started, we often instruct patients to start massaging the area. There are two goals and two techniques for massaging after smartlipo that we recommend:
- For localized swelling, we recommend a pressing type massage. This often occurs in the lower abdomen and inner thighs. In those areas, blood, melted fat, and lymph fluid all mix to produce extra materials that takes the body some time to be able to reabsorb. This keeps the area from being as flat as it can be. I tell my patients to think of themselves as crushing a cube of sugar to make it melt in the water faster. Five minutes daily of massage in a gentle pressing motion morselizes this collected fluid and makes the body absorb it faster.
- For generalized skin hardening, where there is not necessarily a bulge to treat but just a “woody’ feeling to the skin, we recommend a pinching type massage and circular skin motion type massage. These massages are designed to promote the mobility of the skin above the underlying musculature, and prevent the unnatural adherence of skin to the underlying muscles. This type of massage is particularly useful in the neck area and in the flank area after smartlipo, but again, our patients are guided during the follow up to the appropriate type massage if needed.
The factors that affect your degree of swelling are:
- Factors during surgery such as proper and experienced tumescent technique, patient bleeding tendencies, and proper use of right sized cannulas during extraction.
- Compression therapy right after the procedure, applied immediately and with good padding. The compression should not be too tight, but snug enough. We supply the compression to make sure we are happy with the degree of snugness.
- Massage after liposuction, to be done daily around the two week mark
Lymphatic drainage massage and other professional massages
Lympahtic drainage massage is the sequential massage of fluid away from an area towards the lymphatic drainage system. It is useful in the treatment of lymphedema, but can also be used after liposuction. It is my opinion that lymphatic drainage massage can help after surgery, but that it is not superior to self administered massage techniques. It is my opinion that five to ten minutes of massage DAILY is superior to an extended massage session that is performed less frequently. Therefore I tell my patients that they may seek professional massages and lymphatic drainage massages if they wish, but not to neglect the basic daily self massage techniques.
Do I need lymphatic drainage massage after lipo?
First, what is lymphatic drainage massage? It’s a technique that originated in Europe for treatment of lymphedema, an abnormal accumulation of fluid that can occur after lymph nodes are removed during cancer operation surgery.
Characteristics of lymphatic drainage massage is that it is gentle (this is not a deep tissue sports massage targeting muscles, rather a soft massage), and seeks to push the fluid towards the lymph nodes.
The timeframe to getting back to soft skin and getting rid of the swelling after surgery is compression related, time related, and daily massage related. The key thing to remember is that your swelling is going to get better. On the internet, and in my own patient populations, those patients that got lymphatic drainage massage attribute this improvement to that, but they of course do not see the patients that did not get professional massages. In my experience, there is no difference, and daily massages self administered are certainly superior to weekly professional massages.
Finally, a note on swelling. The areas that are most prone to swelling are:
- The lower abdomen, especially if there is skin laxity.
- The inner thighs.