Ask any plastic surgeon what the most reliable surgery is to remove unwanted fat while contouring the body, and you’ll receive a resounding, “Liposuction!” Different from noninvasive techniques that use heat or cold to destroy about 20 percent of the fat, “Liposuction is a one-time procedure, and you can remove as much or as little fat as you like through a two to four-millimeter incision,” says Newton Centre, MA plastic surgeon Joseph Russo, MD.
A sculpting procedure that should not be used for weight loss, Richmond, VA plastic surgeon Ruth Hillelson, MD, explains that patients ultimately will lose inches from liposuction, but weight loss should not be a reason to undergo the procedure. “The goal should be sculpting.”
The contouring effects of the treatment are unparalleled, but the amount of time it takes for a pre-lipo body to be bikini ready may be longer than expected. We spoke with four plastic surgeons for the lowdown on why it takes upwards of six months for the results to fully set in.
Why the Results Aren’t Immediate
Liposuction isn’t as invasive as other cosmetic procedures, but it is surgery, and all surgeries require a recovery period. “Part of the challenge with liposuction is that it seems like a simple procedure, but it is a lot more complex because there are so many different technologies and types of equipment that are used, which can affect downtime, swelling, healing and the final results,” says San Diego, CA plastic surgeon Joseph Grzeskiewicz, MD. “Surgeons all have different approaches and skill levels and that also affects downtime.”
Take, for example, SAFELipo. “The E in SAFELipo stands for equalization, which is an extra step performed with a special cannula to break up rough areas in the fat to prevent lumps and bumps. However, this technique can prolong recovery.” Superficial liposuction (including high-definition liposuction) performed under the skin improves skin contraction, but Dr. Grzeskiewicz says it is a bit risker and also increases bruising—it typically lasts 10 days to two weeks and is more intense with high-volume liposuction—and swelling. “Coupling liposuction with energy- or laser-based devices such as radiofrequency, BodyTite, laser lipo or VASER leads to more intense swelling short term, but more contraction in the end,” he says. “You’re looking at four to six months for the result.”
Palo Alto, CA plastic surgeon David Boudreault, MD, says, “Recovery from liposuction depends on the amount of fat removed, treated areas and skin laxity. Full recovery, meaning that all swelling has resolved and no further change in appearance or scaring is expected, can take six to even nine months.”
It’s also normal for patients to go thru a worse-before-better period due to swelling and settling of the tissues. As Dr. Russo explains, because of trauma from the procedure, there is an immediate inflammatory response and swelling, which can take months to completely resolve. “The lower you go on the body, the longer the swelling lasts because it’s hard to get swelling out of the legs compared to the arms, face, or chest.”
After a few weeks, the body’s new shape will begin to take form, but there is a second phase of recovery that starts to set in. “There is more thickness of the tissue, which is exactly what it sounds like—firm, hard and maybe tender tissue. It stays like this for a few weeks or longer,” says Dr. Grzeskiewicz.
It isn’t until about six months post-procedure that the result is attainable. There’s also the factor of skin elasticity—it can take time for the skin to snap back into shape. “Wearing a compression garment is important to contain the swelling and help it resorb,” says Dr. Hillelson. “Compression can be recommended for between three and six weeks depending on the extent and location of the procedure.”
Around the four-month mark, the treated areas should be trimmer, tighter and less bulky. “Again, it depends on the areas being done, how much fat is being removed and the patient’s inherent skin tone,” says Dr. Russo. “Younger patients with good skin elasticity always do better.”
“I always tell my patients that it is ambitious to be bikini ready in just a few weeks. It’s more like four to six months, which is why it’s best to have liposuction during the winter,” says Dr. Grzeskiewicz. “It isn’t impossible, but I always level with my patients and tell them what is realistic.”