In order to understand why the swelling happens, it is important to understand how the procedure is done.
First, before any SmartLipo is performed, the area of the body that needs to be treated is injected with a fluid that contains electrolytes, lidocaine, and epinephrine or adrenaline. Epinephrine or adrenaline are designed to tighten up the tone of the blood vessels and decrease bruising and swelling, as well as prolong the effect of lidocaine and decrease its absorption into the system. It also provides an additional safety guard for rapid lidocaine absorption. Lidocaine is used to decrease the pain and increase comfort during the procedure and immediately after.
There are several techniques of liposuction, regardless of whether the laser is used or not and it depends on the amount of fluid that is injected. Depending on the amount of fluid that is placed under the level of the skin and the liposuction could be considered wet, super wet or tumescent.
The word tumescent means that the fluid is injected to the extent to allow for appropriate tissue tension or turgor. Then, the fluid is left in the body for 10 to 20 minutes to get the full effect of vasoconstriction and analgesia.
Then, the liposuction cannula or SmartLipo cannula is inserted and the liquefaction or laser lipolysis or liposuction is done. Whenever the fat tissue is destroyed by liposuction or laser lipolysis with SmartLipo, additional residue of the dead fat cells is intermixed with the tumescent solution, so after the procedure, the area under the skin contains not only residues with fat cells but also residual fluid and before we see the results, both the inflammation and swelling from surgery as well as resorption of the fluid that has been injected prior to the procedure has to happen.
Usually, the swelling continues to increase for the next three to four days. Some physicians use Medrol packs for the patient. Medrol packs are short-term steroid tablets that are designed to decrease the swelling and inflammation. Some physicians do not use them. Regardless, it will decrease the amount of swelling but it does not necessarily eliminate it.
The majority of the swelling will go away within two to three weeks. The most dramatic results will be seen after day 3 or 4 when the peak of swelling has been reached; however, it is not the final outcome. The swelling will continue to go away for the next two to three months and then slowly decrease for another six months or so. That is why revisions after liposuction, Liposculpture, or SmartLipo are done not earlier than six to nine months out. At that point, the physician and the patient really know what the final outcome is. So before the swelling goes away, all the fluid in the subcutaneous area has to absorbed.
Some areas have a tendency of holding on to the swelling or to the fluid longer than the others. For example, the chest, or the male chest, has the tendency of keeping the swelling for up to about nine months. That is why if SmartLipo is performed for gynecomastia, the garment is usually worn for at least six months, at least in our practice. Some areas have a tendency of getting rid of swelling earlier.
If the patient has the liposuction or SmartLipo done in the abdominal area, flanks, or inner thighs, it is quite common that the groin area becomes very swollen. It is very difficult to provide adequate support for the groin area. If you have liposuction yourself or you know someone who had liposuction, you would probably know that most surgeons will recommend wearing a postoperative garment for a while, and the protocol for the garment theory varies quite a bit; however, regardless how comfortable the garment is, it is very difficult to create the equal amount of tissue compression on the groin area and that is why the groin usually becomes swollen and stays swollen for a bit longer than the other body parts in the vicinity. The patient who is having the surgery or procedure performed in the vicinity of the groin be that inner thighs, pubic area or abdomen, it is important to realize that this was one of the side effects, not complications, but side effects of having swelling in this area.