Liposuction is one of the most commonly performed of all body contouring plastic surgery procedures. It is also uniquely effective being able to reduce large volumes of fat over broad body surface areas. To no surprise the most common body areas treated with liposuction is the abdomen and lateral waistline. (aka flanks, love handles) These areas are also the largest single continuous body surface area treated that is not a flat surface and wraps around two ‘corners’. (waistline)
While abdominal liposuction is a frequent request, what one can expect after the procedure in terms of recovery and results is not well understood or appreciated by most patients. As a starting premise, liposuction is much harder to go through and recover from than the way it is frequently advertised and marketed. There is no such thing as ‘lunchtime’ or rapid recovery liposuction. While the procedure may be able to performed in an hour or two and may even be done under some form of local or sedation anesthesia, do not confuse the surgery process with how the recovery will go or how long it may take to see the final result.
No matter what technique of liposuction and anesthetic technique that is used, it is a very traumatic process to the subcutaneous tissues. This results in more swelling and bruising that one may anticipate and a much longer period of time until all the details of the final contours are seen. This is best illustrated by going through the sequence of a typical abdominal liposuction case.
This is a 38 year-old female who was an athletic horse rider (5’ 9”, 165 lbs) but had developed some abdominal and waistline fat that she could just not get rid of. Her abdominal skin did not have any significant stretch marks and was not loose or redundant. In short, she was an ideal candidate for liposuction…the type of patient plastic surgeons wish all liposuction candidates looked like before surgery.
Under general anesthesia and in a one hour procedure, she had a total of 2,050ccs of liposuction aspirate removed of which the vast majority was fat based on how it layered out in the canisters. (after one hour of sitting or decanting) She had foam placed over all treated areas and a wrap around garment applied at the end of surgery. She removed the foam the following day to shower and wore the binder regularly thereafter.
When see at one week after surgery, she had the very typical bruising over the treated areas. What is most noteworthy, however, and incredibly common is that some of the bruising migrated downward into the pubic region and into the lower back and upper buttocks. This surprises all patients and is the result of gravity and the compression of the binder which forces bruising ‘south’. (in men it can even be more impressive)
When seen 6 weeks after surgery, all of the bruising had resolved as well as much of the swelling. The improvements in abdominal and waistline contours could be fully appreciated. There remained some slight irregularities around the belly button area and some of the abdominal and back skin remained numb although that was improving. She had returned to all normal activities including exercise and horseback riding.
This abdominal liposuction case is very typical and one can appreciate that near full recovery takes four to six weeks and the very fine details of the contour and skin smoothness will take up to three months after surgery to fully appreciate. Note that bruising may be more extensive that one would think and may drift into unexpected areas, taking weeks after surgery to fully clear. Numbness of the skin, some stiffness and an occasional twinge here and there with activity may take up to six months to return to normal.
Dr. Barry Eppley
Indianapolis, Indiana