Question:
SWELLING AFTER THIGH REDUCTION & LIPO

Hi, I had a lower body lift and my inner thighs done 9 days ago. My lower body lift looks great! However I'm a little worried about my legs. I have an incision that goes from my knee all the way up my inner thigh and up around to my butt cheeks. He also did a little lipo on the upper part of my inner and outer thighs. My concern is that the top of my inner thighs are very big, in fact one side is bigger than the other. He said that is from the lipo. But why is one side swelling more than the other? Is something wrong with my lymphatic system (Ikeep reading about and don't understand what it is) or is this mormal? THANKS FOR YOUR TIME!!!    — Kelly* P. (posted on March 6, 2005)

March 6, 2005
Several things can account for the difference in swelling. Maybe more lipo was done on one side ( more tissue damage means more swelling), do you sleep on your sides ( maybe you stay on one side longer)do you lean to one side when sitting? Just some thoughts.If the skin becomes tight or shiny you need to call your surgeon immediately.
   — dianne E.

March 6, 2005
First of all your only 9 days out after surgery. Don't worry about it. You are going have swelling for months. Are you wearing a pressure garment? My PS required me to wear a pressure garment for at least 6 to 8 weeks after surgery. This helps with the swelling. Something to keep in mind... your PS can only do so much... during the first surgery.. there are times once the surgery is done and the swelling go down he or she will have to make some adjustments. Also something to remember... your not going to have legs like a 16 year old after PS. They are talking the excess skin off so you don't develop bad knees or hips because of the extra weight. Give yourself time. I'm going to assume you had the heavy legs for some time and it's going to take time to heal (at least 6 months).
   — Linda R.

March 6, 2005
from www.lipoinfo.com also be sure to talk to your doctor LIPOSUCTION SWELLING (EDEMA) Whenever the body is injured, inflammatory cells and other mechanisms usually cause a release of water-based fluid (edema). When this water-based edema fluid builds-up in a significant amount, it causes what we outwardly see as swelling. The inured area can swell in many directions. If it swells outward it may be noticeable by the public. If it swells inward, it may swell to the point of pressing on structure that ends up resisting the swelling, then the swelling may move in other directions including outward. Swelling occurs after almost all liposuction. There are many factors that can cause swelling some are genetic (hereditary, found in relatives). Usually a combination of events determines how much swelling a patient will have after liposuction. The location of the liposuction is important. The lower on the body that the liposuction performed the greater the chance of having some swelling in that area. Number of earlier liposuctions is important. If a patient has had liposuction in the same area of treatment once or twice before, there is hidden scar tissue laid down within the body. Scar tissue is much more prone to swell because it is a water-based fibrous tissue, as oppose to the fatty tissues which are more oil-based with only a small amount of water-base fibrous tissue coursing through the fat. Other things that influence swelling include genetic background and fatty-tissue type. If the patient has cells within his or her body that are fragile or prone to reacting at the slightest bit of trauma special chemicals are usually released from those fragile tissues as well as chemicals that are floating in the blood. These chemicals may cause the release of swelling fluid from blood and lymph vessels. Some of these chemicals are related to histamine, others may be related to prostaglandins. However these type of chemicals usually cause more immediate (right away) swelling. They may or may not be involved in long-standing swelling. If there is no cause for long-standing swelling, then usually the immediate swelling goes away with time as the name suggests. Therefore, the website author still does not believe it is reasonable to give antihistamine in order to reduce swelling in liposuction. In fact at this time the author has never even heard the subject of giving antihistamine discussed by doctors in relation to liposuction. Another obvious cause of immediate swelling during and following liposuction is the tumescent method. Pumping fluid into the tissues balloons them right away. But the body naturally can usually handle the fluid in a very safe manner when the Klein formula is followed (hopefully strictly by your surgeon). Unfortunately, too many surgeons try to change the formula and that is where problems have happened. Another cause of swelling would be not having enough compression following a liposuction. When liposuction is done as we have said before, tunnels are left behind in the fat where sucking tube or cannula has passed. These tunnels would tend to collapse flatter if a lot of outside pressure is provided usually by a garment. Liposuction garments vary in color, size, shape, texture and breath ability. Having a good and comfortable liposuction garment is important to help make sure the patient wears the garment for the right amount of time. Recently in the tumescent liposuction community, there has been a trend to decrease the amount of time that constrictive liposuction garments are worn. The website author now suggests wearing liposuction garment a hundred percent (100%) of the day and nighttime for the first week following liposuction, decreasing to 50% of the day or nighttime in the second week following liposuction. This second week period usually works out to wearing the liposuction garment all night long. The third week following the liposuction, the website author recommends that the garment be worn at least 25% of 24 hours which usually works out best to wearing the garment from 6:00p.m (when one returns home from work) until midnight. These recommendations may vary from patient to patient, site to site and situation to situation. Also, usually the more fibrous the patient's fat the more the patient will tend to swell. Common fibrous fatty areas include love handles in men and women, the breasts in men and the lower back and sometimes in the hip regions. African Americans and persons of Mediterranean ancestry tend to have a higher chance of swelling. For these patients, the website author is especially concerned about being very gentle during the liposuction so as not to cause much trauma to the fibrous part of the fat (the likely source of swelling fluid). The website author believes that these patients should probably wear their compression garments a bit longer than we just said. How can swelling arise in some liposuction patients? In some but not all liposuction patients trauma from cannulas that have sharp tips or are pushed too fast through the tissue by the surgeon or have too much vacuum (suction) applied. Not allowing enough time for the Klein tumescent solution to take effect can also cause more bleeding, bleeding can increase the chance of swelling. When the cannula hole(s) passes by the fat if the cannula is stroked too fast, the rubbing can tear at the little blood vessels that are naturally attached to all fat cell clusters. Blood and oxygen are even necessary to keep fat cells alive. Tearing too much of these blood vessels instead of delicately teasing the fat from the body can cause blood leakage. Blood contains proteins and other chemicals, which can draw water out of the tiny capillaries into surrounding tissues (remaining fat) making the swelling problems even worse. Once these chemicals and proteins are out of the blood space and located in the fat, a vicious cycle may be created drawing more and more fluid out of the vessels and with it more fluid sucking protein into the already swollen fat. So, it is very important that the liposuction surgeon be very delicate in the removal of the fat. This is especially true if you have had previous liposuction(s), or if you are in the groups just mentioned to be more prone to swelling following trauma. When swelling fluids has set in, the treatments for it are relatively limited and take a bit of time to work and may only work a bit. Continued compression, massage and EXternal ultrasound may possibly reduce the swelling and open up some channels to allow swelling fluid out of the area. Unfortunately, getting rid of persistent swelling can be a very difficult problem for both the surgeon and the patient. It is many times very, very difficult to prove the cause of the problem or the source of the swelling. Things vary from patient to patient, surgeon to surgeon, and month to month.
   — **willow**

March 7, 2005
I gained 18lbs of fluid after my LBL. I had every test under the sun to determine why. I never got an answer but it eventually went away for the most part. I will say though that the LBL changed my body. My thighs are larger than they were before my surgery. I guess having 11lbs of skin removed changed the way my body holds fat. Just keep in mind that you may not get the perfect body you dreamed of......my Dr. gave me a flat stomach and JLo's thighs....but I suppose I will live.....good luck Wendi LBL 9/04
   — lovemonterey