Smartlipo, also known as laser liposuction, uses heat to breakdown fat. Through the joint concepts of direct fat destruction by contact with a 1mm probe which emits laser energy to raising the internal temperature of the zone of treatment to above 45 degrees C, fat cells are thermally disrupted. The heat either directly breaks open the cell walls and the internal lipids leak out or the intracellular fluids boil and explode open the cell walls. This is clearly visible during the procedure as yellowish-colored fluid drains from the skin entrance site where the laser probe is inserted.
By either heating mechanism, fatty oils are released. When the suctioning phase after laser heating is done, these oils become part of the mixture of particulate fat, blood, and tumescent solution which makes up the aspirate. While suctioning removes a lot of these fluids, some fatty oils are either left behind or will be created afterwards as additional fat cells die and leak additional oil.
This process creates a unique postoperative finding that is unique to laser liposuction procedures. That is the draining of fluids for several days after surgery out of the skin entrance sites. The amount and duration of the drainage is higher and more extensive than with any other liposuction procedure. The drainage is the combination of these residual fatty oils and other fluids and the compression garments applied and worn after surgery.
In my Indianapolis plastic surgery practice, our presurgical education and postoperative instructions point out this perfectly normal drainage. We supply absorbent pads to be used under your compression garments to help absorb much of this fluid. They should be worn as long as any of the skin holes are draining. If hips and thighs are done, for example, do not be alarmed that fluid comes running out of the holes the next day when you change your garments.
While this fluid drainage is temporarily annoying, it is very beneficial. It is far better that these fluids are out of the body, otherwise they will take days to weeks to be absorbed. This will result in greater swelling and bruising and a longer time to get to the final contoured shape.
Barry L. Eppley, M.D., D.M.D.
Indianapolis, Indiana