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Liposuction induces significant trauma to the treated tissues, disrupting cellular contents as well as severing  blood vessels and lymphatic channels. No matter how liposuction is performed, this results in significant swelling and some bruising.

To help control the amount of swelling and encourage its elimination, the use of compression garments is the current standard of postoperative care. Compression garments work by the application of continuous low-grade pressure which helps in reducing lymphatic outflow from severed channels and provides an external molding pressure for the skin to adapt to its modified understructure.

One other very helpful postoperative therapy for liposuction is massage. In my Indianapolis plastic surgery practice, I have found that lymphatic massage after liposuction can assist significantly in recovery of the traumatized tissues. Lymphatic massage offers a variety of tissue benefits of which the most significant is lymphatic flow and circulation improvement. By improving lymphatic flow through connective tissues, the elimination of dead and necrotic debris and released toxins are carried away from the treated site. Such outflow also helps to remove microorganisms and bacteria which reduces the risk of infection.  As lymphatic massage increases the flow of the lymphatic system, swelling from liposuction is also reduced. Massage also improves circulation which enhances delivery of oxygen to damaged tissues. Increased oxygen concentrations allows increased rates of capillary ingrowth and delivery of tissue building cells which make collagen.

Lymphatic massage also helps break up areas of fluid and early scar formation. Manually lysing areas of tissue adhesions can help smooth out areas of irregularities and help create an earlier more confluent result.

Given that liposuction rarely removes fat evenly and swelling and bruising also occur irregularly, manual external molding and massage early after liposuction is useful. I have my patients begin massage therapy two weeks after surgery if they can tolerate the light to moderate pressure. Massage sessions continue every week for four weeks for a month of total therapy. Thereafter, massage therapy sessions are optional. One can also have hydrotherapy (wet room) treatments in lieu of ‘dry’ massage if so desired.

Given that the final results of liposuction are affected by unpredictable forces of healing, it is prudent to consider helping shape this process. Massage therapy is an inexpensive investment that has numerous beneficial healing effects which offers improvement over compression garments alone.

 Dr. Barry Eppley

Indianapolis, Indiana

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