A Comprehensive Guide to Post-Lipedema Liposuction Surgery Recovery

Introduction

Congratulations on completing your lipedema surgery! Your journey towards improved health has just begun, and we’re here to provide you with essential instructions to ensure a smooth and successful recovery. Follow these guidelines to support your healing process effectively.

1. Prioritize Nutritional Wellness

Before the surgery, focus on your nutrition to prepare your body for the recovery process. Incorporate these steps into your diet:

• Ensure an adequate intake of proteins, which are essential for tissue repair. Consider adding protein sources like GNC shakes to your daily meals. Some of our patients like Lean Shakes with 20gm of protein.  They are nonchalky and easily digested.
• Take multivitamins such as Centrum, one pill twice a day, 
• Take Vitamin C, 1000 mg twice a day.
  These supplements will aid in your overall healing.

2. Arrange for Support

Having someone with you during the initial recovery period is highly recommended. They can provide valuable assistance and emotional support. If you’re traveling from a distance and lack a caregiver, let us know, and we can assist you in arranging a skilled nursing facility or rehab bed.

3. Management of Surgical Site

After the surgery, you will have incisions from which bloody drainage will occur. Follow these steps for proper care:

• You’ll be provided with a garment featuring slits corresponding to the incision locations, along with additional compression from an ace wrap, short stretch bandages or Velcro based wraps.
• Expect drainage to occur for 24 to 36 hours post-surgery. Hospital floor nurses will change the dressing regularly, approximately every 4-8 hours or as needed. During these dressing changes, ABD pads will be applied on the drainage sites underneath the compression dressings.  Please make sure that they are applied without tape. 
• After high volume liposuction one or more sites may drain up to a week. It is normal.
• In most patients we do not use drains after liposuction surgery.  However, if in your specific case the drains were placed, you will be taught by nursing staff how to take care of them or refer to our tummy tuck page for details.
• We do not routinely close incision sites with sutures and staples any longer to allow easier drainage and decrease postoperative discomfort. Despite intuition, we do not see any difference in scar tissue formation in the long term.
• You should monitor for signs of bleeding and infection.  
  • Bloody looking drainage is normal but thick bloody drainage coming out from wound is not. Let the doctor know immediately or call the nurse if you are still in the hospital.
  • Infection is extremely rare after liposuction surgery.  Signs of infection are fever, chills, increased pain, increased redness, purulent drainage.  Infection cannot happen the first 3 days after surgery.  If you have low grade fever after surgery, it is usually not infection but atelectasis – a lower lung collapse because you are not taking deep breath, see more below.
• Keep your surgical areas elevated.  If your legs are treated, elevate them gently for at least 1 week after low volume liposuction or 2 weeks for high volume liposuction (over 5L).  If your arms were treated, place them on the pillows beside you to elevate closer to the level of your heart.  Do not elevate them above your head level, it is not necessary, and it can jeopardize your circulation.  
• You will be allowed to shower after 1 week.  Gently take off the garment.  Make sure you are sitting when the water hits your body first.  Some patients may feel lightheaded or dizzy initially. There is no pain.  It is important to have someone available nearby if you suddenly feel lightheaded. Wash in warm but not hot water, gently dry yourself to avoid excessive rubbing on the skin and replace garments.  If needed, you can quickly wash your garment in a washing machine while you shower. 
• Numbness, itching, tingling, uneven swelling, lumpiness, bumpiness, hardness, crusting, minimal redness at incision sites are normal after surgery.

4. Garment Usage

It’s essential to wear the garment consistently, especially during the first week after lipedema surgery. This garment helps prevent shear injury to the skin. In case the garment becomes wet, gently use a hairdryer on a warm setting to dry the affected areas. After the initial week, you can safely remove the garment but do not discard it yet as you might be able to use it for your next Lipedema surgery.

You must wear proper compression for a minimum of 6 weeks after lipedema surgery especially if you had over 5 liters removed. Wearing garments also helps promote shrinking of the skin and reduce pain and swelling, reduce use of narcotic pain medications and facilitate post lipedema recovery.

If you feel that your garment is too tight, you may loosen it.  You can rewrap the external ace wraps or other compression wraps looser.  If you feel that you fingers or toes are cold and tingly, you must do it as soon as you can.  Do not wait. Most common areas of tightness are ankles, knees, and wrists.  If you loosen the wraps and garment it still too tight, make a longitudinal cut an the garment to loosen it. 

It is impossible to measure the exact pressure of compression garment after the surgery.  Just listen to your body. If it feels too tight loosen it.  If it is too loose, tighten it.

5. Gradual Physical Activity, MLD, Therapy and Breathing Exercises

Begin walking on the first day following surgery, aiming for three short walks daily. It’s normal to experience intermittent swelling, which will gradually improve over time. However, you can reintroduce manual lymphatic massage or the use of your lymphatic pump only one week post-surgery, following a follow-up appointment with the doctor. Start at lower settings and perform it to the point of mild discomfort but not through pain.

Deep breathing exercises offer significant benefits after surgery, particularly for individuals undergoing lipedema surgery. Atelectasis, the partial collapse of the lung’s air sacs, is a common post-operative complication. Deep breathing helps counteract this issue by improving lung expansion and oxygenation. By taking slow, deep breaths and exhaling fully, you can promote the clearance of mucus and prevent airway blockages, reducing the risk of atelectasis. This simple yet effective technique not only enhances respiratory function but also aids in pain management, facilitating a smoother and speedier recovery process for individuals recovering from lipedema surgery.

6. Medication Management

Adhere to the prescribed medication regimen after surgery. We aim to minimize the use of narcotic pain medication as the primary pain relief option.

You will be prescribed all or some of the medications listed below.

1. Keflex or cephalexin is an antibiotic. We usually recommend taking it for the first seven days. The usual dose is 500 mg 3 or 4 times a day for 7 days.  Please do not take it if you have allergies to cephalosporin. If you have allergy to penicillin, your cross reactivity to cephalosporin is 5%. if you have previously tolerated Keflex, you should not have any issues. However, if you have severe allergic reaction to either penicillin or cephalosporin, like severe swelling of the throat, difficulty breathing, do not take it, and let us know, and you will be giving an alternative. The alternative medication usually Bactrim, doxycycline or erythromycin. Please take over-the-counter probiotic also. You cannot drink alcohol while you are on antibiotics because it will interfere with their function.
If you were given refill, do not routinely continue to take it, call our office to confirm that you need it.

2. Gabapentin is a medication designed to reduce sensitivity of the nerves and pain associated with surgery. It is not a narcotic. However, it can make you a little dizzy. Recommend taking it for seven days. If you notice that you’re feeling better with gabapentin, please let us know, and we can provide you additional prescription.
   
   3. Mobic or Celebrex. You’ll be provided with a prescription for one of these two medications. These are long acting non-anti-inflammatories, like Tylenol, Motrin or Aleve, but last for up to 12 or 24 hours. Remember, you’re taking them for inflammation and for pain. They are supposed to provide the baseline and reduce your consumption of narcotics. They are on routine basis and not as needed.
   
   4. Percocet, Dilaudid, Morphine, Tylenol 3 narcotic pain medication. You will be prescribed one of them. Take him on a as needed basis. Most patients take them especially at night. They can make you a bit constipated, so please make sure you’re taking plenty of fiber, and if needed, we can provide your prescription for medication, such as Colace or Peri Colace. They may cause some nausea.
   
   5. Xarelto is a mild anticoagulant designed to decrease your chances of having blood clots. Usually, you take them twice a day for seven days. However, in some patients with higher risk of blood clots, you may be asked to take the medication for two weeks. If you have previously had a history of blood, clots, replacement valve, or atrial fibrillation, your cardiologist should have provided us with their recommendations. Please do not duplicate medications provided by us and anticoagulant medication ‘s provided by your cardiologist.
3. Valium in low dose helps to reduce muscle spasms and cramps and commonly is more effective in pain associated with those muscle cramps. This medication is taken as needed up to 3 times a day. It can also help you sleep and reduce stress associated with surgery.
4. Hydration and Diet

Stay well-hydrated by drinking plenty of water. Additionally, follow a low-sodium diet to support your recovery. Avoid diuretics after surgery. Avoid high sugar drinks.

8. Follow-up Appointment

During your follow-up appointment, you may replace the garment with a new one.

9. Reach Out for Support

If you have any questions or concerns throughout your recovery process, please don’t hesitate to contact us. We are here to support you at every step of your journey towards better health.

10. Smoking and Nicotine use

It is crucial for individuals undergoing lipedema surgery to strictly avoid smoking and nicotine use during their recovery period. Smoking and nicotine can have detrimental effects on the healing process and overall surgical outcomes. Nicotine constricts blood vessels, reducing blood flow to the surgical site, which can impair tissue healing and increase the risk of complications such as infection and delayed wound healing. Additionally, smoking and nicotine use can compromise lung function, increasing the chances of respiratory issues like atelectasis. To ensure a successful and uneventful recovery after lipedema surgery, patients must commit to abstaining from smoking and nicotine products, both before and after the procedure. This precaution not only enhances healing but also promotes better long-term health and well-being.