Whenever the body is injured, inflammatory cells and other mechanisms typically cause a release of a water-based fluid (edema). When this water-based edema builds up in large amounts, the result is the condition commonly known as swelling. The injured area can swell in several different directions. Outward swelling is often observable to the public. Inward swelling may cause skin to enlarge to the point of pressing on internal structures, which often forces swelling outward or in another direction.
Nearly all liposuction procedures produce some degree of swelling in the areas on which the surgery is performed. There are several variables that affect swelling. Some of these factors are genetic (hereditary). Usually a combination of events will determine the degree of swelling each patient will have to deal with.
Location of the liposuction procedure is a key factor. Swelling is more likely to occur when the affected area is on the lower portion of the patient’s body. Individuals who have had previous liposuction surgeries are also more likely to develop swelling because repeated procedures, particularly on the same area, are more prone to additional swelling due to the buildup of scar tissues that resulted from previous procedures. Scar tissue is more prone to swelling because of its water-based fibrous tissue, which is unlike other fatty tissue that is almost entirely oil-based.
If the patient has cells in his or her body that are prone to reacting to even the smallest amount of trauma, special chemicals are usually released from those sensitive tissues, in addition to the chemicals in which they are floating. These chemicals initiate the release of swelling fluids from blood vessels and lymph nodes. However, keep in mind that such chemicals cause more immediate swelling. Assuming that there is no cause for long-standing swelling, it should subside gradually with time.
Another obvious cause of immediate swelling during and after the liposuction procedure is the tumescent method. With this method, tissues balloon immediately upon injection of surgical fluids. However, if the proper methods are applied, the body is usually able to handle these excess fluids safely and naturally. Unfortunately, many surgeons do not adhere to the correct methods and procedures, and that is where the problem often begins.
Swelling can also be a result of insufficient compression after the liposuction surgery. When a liposuction procedure is performed correctly, tunnels are left behind where the cannula was passed through the fat. These tunnels tend to flatten faster when there is a significant amount of external pressure applied to the affected area by wearing a compression garment. Having a compression garment that is comfortable and of high quality is essential for ensuring that the patient will wear it for the necessary length of time after the surgical procedure.
Usually, the more fibrous a patient’s fatty tissue, the more the patient will tend to swell. Common fibrous fatty areas include “love handles” in women and in men, the breasts of men, the lower back, and sometimes the hip regions.
African Americans and individuals of Mediterranean ancestry are shown to have a higher rate of swelling occurrence. For these patients, it is important for the surgeon to make extra efforts to be gentle while performing the liposuction procedure, possibly lessening the trauma that would normally be inflicted on fatty tissues. These patients might also be well advised to wear their compression garments for a bit longer than what is recommended for average patients.
What exactly is the cause of swelling in liposuction patients? In some instances, swelling is the result of the trauma that is inflicted on the remaining fat cells by cannulas with sharp tips or by cannula movements that were made too aggressively by the surgeon. Failure to allow enough time for the Klein tumescent solution to take full effect can increase blood loss, which as a result can increase potential risk for post-surgical swelling. Tearing of the fat cells in an overly aggressive manner with the cannula can result in excessive damage to the surrounding blood vessels, causing blood leakage. The proteins and other chemicals in blood will attract water into the surrounding tissues, creating an even larger swelling problem. For these reasons, it is of utmost importance that the liposuction procedure be performed in as gentle and delicate a manner as possible. This is especially true for patients who have had previous liposuction surgeries and for those patients who are at increased risk for swelling due to other individual factors.
After swelling has set in, treatments are, regrettably, rather limited and can become time consuming. Continued external compression, massage, and external ultrasound might reduce swelling and open channels to allow excess fluids to drain from the affected area. Getting rid of persistent swelling can be a major nuisance for both the surgeon and the patient. It is often very difficult to nail down and identify the exact cause of post-surgical swelling, which makes treatment a hit-and-miss kind of ordeal until the problem is solved.