Why do I have to wear a compression garment for so long after liposuction?
After liposuction my patients are instructed to wear a compression garment 24/7 for 3 weeks except to shower followed by another 3 weeks wearing it during the day but allowed to take it off at night. I encourage patients to wear it overnight for the second 3 week period as well if they can tolerate it. There are several important reasons why a compression garment is used, the main reasons being:
1.) The compression garment controls postoperative swelling: Swelling, or tissue edema, results from a complex balance of forces on the fluids in your body. Without getting into the specific details of all of these forces, an important one is the mechanical pressure on the fluids outside the vascular system (meaning within the tissue itself). The compression garment applies pressure on your tissues which shifts the balance of these forces towards pushing the fluid back into the veins and lymphatic vessels that then carry it back to your heart. This helps to minimize the swelling that develops in the first place and helps to speed the reabsorption of the edema fluid that does collect.
2.) It prevents collections of fluid: when fat is removed, a space is left behind. The same forces that cause swelling will tend to cause fluid to collect in this space leading to pockets of clear fluid known as seromas. These can be uncomfortable and require repeat drainage with a needle to eliminate them. By applying external compression with a garment the space is kept closed while the tissues heal, allowing the skin to adhere to the underlying structures and preventing these fluid collections.
3.) It helps to improve the contour and final appearance: The same space that allows fluid to collect allows the skin to slide back and forth over the underling deep tissues and this can lead to a wrinkled skin appearance. The compression garment helps to keep the tissues where we want them while things heal which helps to prevent this.
4.) Compression improves scarring: Through research on burns and other scarring conditions we have learned that pressure softens and improves the appearance of scars. While external scarring is rarely significant with liposuction, there can be internal scarring that can take time to soften. Compression helps to organize the collagen fibers as these scars form causing it to be softer, earlier. Although liposuction scars are very small, the procedure is often done in conjunction with other surgeries that come with larger scars. A tummy tuck scar for example is quite long and right on the front of the body, so even if I don’t use liposuction as part of a tummy tuck I will still put my patients in a compression garment since anything that can help make it flatter, softer, and less visible is to my patients’ advantage. On the other side of the coin, although liposuction incisions are small, I have never heard anyone complain of a scar being too invisible, so there are still external benefits to the compression garment even with these small incisions.