This information explains what to expect before, during, and after your liposuction (LY-poh-SUK-shun) surgery for advanced-stage lymphedema (LIM-fuh-DEE-muh). It also explains how to care for yourself after your surgery.
About your liposuction surgery
Liposuction is surgery that uses a vacuum device to gently suction (suck) out fat and tissue.
You’re having a type of liposuction surgery called a suction-assisted protein lipectomy (lih-PEK-toh-mee), or SAPL. SAPL is a type of liposuction that treats Stage 2 or Stage 3 lymphedema, also called advanced-stage lymphedema.
In advanced-stage lymphedema, the swelling in your affected limb (arm or leg with lymphedema) is no longer just lymphatic fluid. Over time, it has turned into mostly a solid buildup of fat and scar tissue. Liposuction surgery is the main treatment used to take out this solid buildup.
Your liposuction surgery can help make your affected limb smaller and ease your lymphedema symptoms. It does not cure advanced-stage lymphedema.
Before your liposuction surgery
Your care team will give you the resource Getting Ready for Surgery. It has information about how to get ready for your liposuction surgery. Follow those instructions, along with the instructions in this section.
See a lymphedema therapist
A lymphedema therapist is a physical therapist who has special training in treating lymphedema.
You should already be seeing a certified lymphedema therapist for regular lymphedema therapy appointments. If you’re not seeing a therapist now, go back to working with one as soon as you can. Talk with your plastic surgeon if you need a referral for a lymphedema therapist.
Regular therapy appointments in the months before surgery are important to help manage the swelling in your affected limb. Plan to see your lymphedema therapist for 3 to 6 months before your surgery. They’ll recommend a therapy plan based on your lymphedema symptoms.
Have your compression garment or wrap ready
Make sure you have your compression garment (sleeve or stocking) or wrap ready at home before your surgery. You’ll start wearing it 48 hours (2 days) after your surgery.
If you’re not sure which compression garment or wrap to use, ask your lymphedema therapist before your surgery.
Schedule follow-up appointments
You must have follow-up appointments with your plastic surgeon and lymphedema therapist after your surgery. It’s best to schedule these appointments ahead of time, before you have surgery.
Plan to see your plastic surgeon and lymphedema therapist about 1 to 2 weeks after your surgery. These follow-up appointments can be on different days.
To learn more, read the section “During the first 2 weeks after your liposuction surgery.”
During your liposuction surgery
Your liposuction surgery will be done in an operating room. During your surgery, you’ll get general anesthesia (A-nes-THEE-zhuh). General anesthesia is when you get medicine that puts you to sleep for surgery. You will not feel pain or remember the surgery.
During your surgery, your plastic surgeon will make small incisions (surgical cuts) in your affected limb. They’ll use a surgical tool called a cannula to gently suck out the buildup of fat and scar tissue. A cannula is a thin tube connected to a vacuum device.
When your surgeon is done, they’ll take the cannula out. They’ll close your incisions with Steri-Strips™ (thin surgical tape), dissolvable sutures (stitches), or both. Steri-Strips will loosen and fall off by themselves over time. Dissolvable sutures will naturally break down in your body over time. Your healthcare provider will not need to take them out.
Your surgeon will wrap an elastic bandage, often known as an ACE™ bandage or ACE wrap, around your affected limb. This compression bandage applies steady, gentle pressure to your affected limb. It will help keep the swelling down after your surgery.
Your surgery will take about 1 to 2 hours.
After your liposuction surgery
You’ll be in the Post-Anesthesia Care Unit (PACU) or a recovery room when you wake up after surgery. A nurse will keep track of your temperature, pulse, blood pressure, and oxygen levels. You’ll stay in the PACU or recovery room until you’re fully awake.
Your affected limb will be elevated (raised) on a few pillows. This helps keep the swelling down. Tell your nurse if the ACE bandage feels too tight, uncomfortable, or causes numbness or tingling in your affected limb.
Your plastic surgeon will prescribe an antibiotic (medicine to treat or prevent infections). Your care team will tell you and your caregiver how often to take it and how many days to take it. Follow their instructions. You’ll take the first dose before you leave the hospital.
Most people go home the same day as their surgery. Some people must stay in the hospital overnight so their care team can monitor them (watch them closely). This depends on how much buildup of fat and scar tissue they suctioned out. Your care team will tell you what to expect.
Caring for yourself at home
Follow the instructions and guidelines in this section to care for yourself at home after your liposuction surgery.
During the first 2 weeks after your liposuction surgery
Wearing the ACE bandage
Keep the ACE bandage on at all times for 48 hours after your surgery. Keep it clean and dry. Call your plastic surgeon’s office if:
- You see lymphatic fluid or blood leaking through the ACE bandage.
- The ACE bandage feels too tight or uncomfortable.
- You feel numbness, tingling, or both in your affected limb.
After 48 hours, take off the ACE bandage and switch to your own compression garment or wrap. We suggest taking your first shower after surgery at this time. Read the section “Showering” for instructions.
If your affected limb is too swollen to fit into your garment or wrap, put the ACE bandage back on. You may need to wear it for a few more days, or even weeks, until the swelling goes down. If you have any questions about putting the bandage back on, call your plastic surgeon’s office.
If you still cannot fit into your garment or wrap after a few days, talk with your lymphedema therapist. For many people, the swelling starts to go down once they go back to lymphedema therapy after surgery.
Wearing your compression garment or wrap
Wear your compression garment or wrap at all times to help keep the swelling down. If you have separate daytime and nighttime garments or wraps, wear them whenever you’re awake and asleep.
Only take off your compression garment or wrap to shower. Put it back on right after you dry off.
Plan to wear your compression garment or wrap this way for at least 4 weeks (1 month). You may need to wear it for longer. Follow your plastic surgeon’s instructions.
Using a pneumatic pressure pump (lymphedema pump)
If you have a pneumatic (noo-MA-tik) pressure pump, do not use it yet. Your plastic surgeon will tell you when you can start using it again.
Showering
Shower 48 hours after your surgery. Taking a warm shower is relaxing and can help with discomfort.
Take off the ACE bandage before you’re ready to shower. While showering, wash yourself with warm water and mild soap. Let the soap and water run over your incisions. Do not scrub over your incisions.
After your shower, gently pat the area around your incisions dry with a clean towel. After you dry off, put on your compression garment or wrap right away. If it does not yet fit, put the ACE bandage back on.
Do not take tub baths, swim, or use hot tubs or saunas until your plastic surgeon says it’s OK. You can ask them about this at your first follow-up appointment.
Managing your pain
If you have pain or discomfort after your surgery, taking an over-the-counter pain medicine can help. Examples of over-the-counter pain medicines are:
- Acetaminophen (Tylenol®). You can start taking acetaminophen a few hours after your surgery. Follow the instructions on the medicine’s label or from your plastic surgeon.
- Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil® and Motrin®) and naproxen (Aleve®). You can start taking an NSAID 48 hours after your surgery. Do not take it any sooner, because it can raise your risk for bleeding. Once you start taking the medicine, follow the instructions on the medicine’s label or from your plastic surgeon.
Tell your plastic surgeon if taking an over-the-counter pain medicine does not help your pain. They may give you a prescription for stronger pain medicine.
Putting pressure on your incisions
Do not put direct pressure on your incisions until your plastic surgeon says it’s OK.
Direct pressure means massaging, rubbing, or pressing on your incisions with your fingertips. It’s not the same as compression, which puts steady, gentle pressure around your whole affected limb.
Activity restrictions
Do not push, pull, lift, or carry anything heavier than 15 pounds (6.8 kilograms). This includes pets and children. You may need help with things like doing laundry and carrying groceries.
Do not do any strenuous exercise, such as running, lifting weights, or aerobics. A strenuous exercise is something that takes lots of energy or effort.
Do not play any contact sports, such as football, soccer, or basketball.
You can do light exercise, such as walking or stretching.
First follow-up appointment with your plastic surgeon
Your plastic surgeon will check how you’re healing from surgery. They’ll also check the size of your affected limb and how much swelling you have.
Your plastic surgeon will tell you how often you’ll need to see them after this first appointment.
First follow-up appointment with your lymphedema therapist
Your lymphedema therapist will start decongestive (DEE-kun-JEH-stiv) therapy. This is a treatment plan that helps reduce swelling in your affected limb after surgery. Your decongestive therapy may include:
- Manual lymphatic drainage (MLD), also called lymphatic massage. This gentle massage helps move lymphatic fluid out of your affected limb so your body can reabsorb it.
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Compression bandaging. This is when your lymphedema therapist wraps special bandages around your affected limb to help move lymphatic fluid out. These special bandages are firmer and less stretchy than the ACE bandage you wear after surgery.
Some people wear these special bandages only during their therapy appointments. Other people may need to leave the bandages on for a few hours after their appointments. Follow your lymphedema therapist’s instructions. - Exercises to help reduce swelling in your affected limb.
- Skin care tips to help prevent infection in your affected limb.
Your lymphedema therapist will tell you how often you’ll need to see them after this first appointment. If they have questions about which therapies are safe for you to do, have them contact your plastic surgeon.
Starting 2 weeks after your liposuction surgery
Manual lymphatic drainage
You or your caregiver can start doing MLD on your affected limb. Stay away from the areas with your incisions. Do not massage over or near your incisions.
Follow your lymphedema therapist’s instructions when doing MLD. Talk with your therapist if you or your caregiver has any questions about MLD.
Do not put direct pressure on your incisions until your plastic surgeon says it’s OK.
Lymphedema therapy appointments
Go to lymphedema therapy appointments as often as your therapist recommends.
Compression garments, wraps, and pumps
Keep wearing your compression garment or wrap at all times. This includes daytime and nighttime garments or wraps.
If your compression garment or wrap still does not fit because of swelling, keep wearing the ACE bandage.
If you have a pneumatic pressure pump, do not use it yet.
Activity restrictions
Keep following the same activity restrictions.
Do not push, pull, lift, or carry anything heavier than 15 pounds (6.8 kilograms).
Do not do any strenuous exercise or play any contact sports.
You can keep doing light exercise.
Starting 4 weeks after your liposuction surgery
Compression garments, wraps, and pumps
If you have a pneumatic pressure pump, you can start using it again. Follow your lymphedema therapist’s instructions.
Keep wearing your compression garment or wrap at all times. This includes daytime and nighttime garments or wraps.
If your compression garment or wrap still does not fit because of swelling, keep wearing the ACE bandage.
Putting pressure on your incisions
You can put direct pressure on your incisions when your plastic surgeon says they’re healed. This means you can massage, rub, or press on them with your fingertips. You also can do MLD over them.
Activity restrictions
You can go back to doing all your usual activities. There are no restrictions on pushing, pulling, lifting, carrying, or exercising.
Lymphedema therapy appointments
Keep going to lymphedema therapy appointments as often as your therapist recommends.
Traveling
If you plan to travel after your surgery, ask your lymphedema therapist first to make sure it’s safe.
Avoid flying on an airplane for at least 4 weeks after surgery. If you need to fly sooner, ask your lymphedema therapist if it’s OK.
When to call your healthcare provider
Call your plastic surgeon’s office if:
- You have a fever of 100.4 °F (38 °C) or higher.
- You see lymphatic fluid or blood leaking through the ACE bandage.
- The ACE bandage feels too tight or uncomfortable.
- You feel numbness, tingling, or both in your affected limb.
- You have pain in your affected limb that’s getting worse.
- The skin around your incisions is very red or getting more red.
- The skin around your incisions is warmer than usual.
- The area around your incisions is getting more swollen.
- You see drainage from your incisions that looks like pus (thick and milky).
- You have any questions or concerns.
Resources
American Cancer Society (ACS)
www.cancer.org
800-227-2345
The ACS offers information and resources about the diagnosis and treatment of lymphedema.
Lymphatic Education & Research Network (LE&RN)
www.lymphaticnetwork.org
855-378-8163
LE&RN offers videos, newsletters, and other resources and educational materials about lymphedema. It also has a list of lymphedema specialty centers.
National Cancer Institute (NCI)
www.cancer.gov
800-4-CANCER (800-422-6237)
The NCI offers information and resources about the diagnosis and treatment of lymphedema.
National Lymphedema Network (NLN)
www.lymphnet.org
800-541-3259
The NLN offers education, resources, and advocacy for people with lymphedema. It also has a directory that can refer you to qualified lymphedema therapists and doctors in your area.
New York State Department of Health’s Understanding Lymphedema
This educational material has information and resources about the diagnosis and treatment of lymphedema. It also has information about how to reduce your risk of getting lymphedema. Visit www.health.ny.gov/publications/0399 to learn more.
Step Up, Speak Out (SU-SO)
www.stepup-speakout.org
SU-SO offers resources, support, and advocacy for people who have lymphedema that’s related to breast cancer.
Learn about our Health Information Policy.