Compression garments after liposuction: benefits and limits in the research

Why are compression garments worn?

Swelling and bruising can develop in the treated area after liposuction. Compression garments are widely used with the aim of improving results by reducing swelling, bruising, pain, and seroma after surgery ^[1].

Tumescent anesthesia, which is commonly used for liposuction, is a method of injecting a very dilute local anesthetic solution until the tissue becomes firm and taut ^[3]. The literature notes that this method reduces bleeding through the narrowing of blood vessels together with the pressure the injected solution places on the tissue ^[3]. However, this explanation concerns the pressure of the fluid injected during surgery, and it is not evidence of the effect of compression garments after surgery.

However, the evidence on how well compression garments actually achieve these goals after surgery differs from one type of surgery to another.A 2023 review summarized that although compression garments are widely used, the amount and quality of the evidence and the consistency of study results varied greatly depending on the surgery and the outcome measured ^[1].

What research has confirmed, and what is lacking

A 2023 review examined studies on compression garments after cosmetic surgeries such as rhinoplasty, facelift, neck lift, breast surgery, abdominoplasty, and arm and leg contouring ^[1]. The best-supported uses were reducing swelling and bruising after rhinoplasty and reducing pain after breast and abdominal surgery ^[1].

On the other hand, an effect on reducing the occurrence of seroma was not confirmed ^[1]. For many procedures, such as arm lifts, high-quality evidence is lacking, and the authors stressed that the use of compression garments should be critically reexamined and that research should continue ^[1].

The research summaries used for this article contained no studies directly comparing people who wore compression garments after cosmetic liposuction with people who did not. It is therefore difficult to put a figure on the effect of compression garments after liposuction.

Findings from abdominoplasty research

A systematic review looked at the effect of abdominal binders or compression garments after abdominoplasty, which works on an area close to those treated with liposuction ^[2]. It is commonly believed that compression garments help drain fluid, keep fluid from collecting at the surgical site, and reduce the risk of seroma, but this analysis included only 5 trials with 130 patients ^[2].

The analysis found that compression garments tended to reduce seroma and swelling under the skin, but this was not statistically significant; they also tended to reduce breathing function, but this too was not significant ^[2]. Although the evidence is limited, findings were also presented showing that compression garments raise the pressure inside the abdomen (intra-abdominal pressure) ^[2].

The authors concluded that the evidence supporting the benefits of abdominal binders after abdominoplasty is weak and that consistent outcome reporting and rigorous randomized clinical trials are needed ^[2]. It is also important to remember that results from abdominoplasty cannot be applied directly to liposuction.

Discomfort and side effects of compression garments

The literature explains that the benefits of compression garments must be weighed against their cost and the problems that compression can cause ^[1]. Reported problems include patient discomfort, increased pooling of blood in the veins (venous stasis), and skin damage ^[1].

In abdominoplasty research, there was also a finding that compression garments can raise the pressure inside the abdomen ^[2]. If your compression garment feels much too tight or makes breathing uncomfortable, or if your legs become swollen or painful, it is better to tell your medical team than to decide on your own to put up with it or take it off.

Compression in lymphedema and lipedema

Lymphedema is a condition in which tissue swells chronically because the lymphatic system is not working well enough; treatment includes patient education and compression, and surgery is performed only rarely ^[4]. Conservative treatment of lymphedema consists of compression therapy, and surgical options include procedures that connect lymphatic vessels to veins and suction-assisted lipectomy to reduce enlarged tissue ^[4].

A review of liposuction for long-standing lymphedema explains that after the excess fat tissue is removed by liposuction, a compression garment is worn continuously, 24 hours a day, after surgery to maintain the reduced volume over the long term ^[5]. For lymphedema related to cancer treatment as well, complex decongestive therapy, which includes compression garments, and intermittent pneumatic compression are used as treatments ^[6].

In a systematic review of lipedema, compression therapy, along with diet and aquatic exercise, was also associated with reduced pain and swelling ^[7]. However, these results come from conditions involving abnormalities of lymphatic function or fat tissue. They are not evidence that the same methods and duration should be applied to recovery after cosmetic liposuction.

What to know when wearing a compression garment

The research summaries used for this article do not specify, for cosmetic liposuction, how long or for how many hours a day a compression garment should be worn. The areas treated, the amount of fat removed, and the course of recovery differ from person to person, so it is best to follow the instructions of the medical team that performed your surgery on how long and how to wear it. Consider checking the following in advance.

• Whether the garment's size and level of compression suit your body
• How long to wear it, how many hours a day, and when you can take it off
• What to do if your skin chafes or blisters
• How to get in touch if you have symptoms such as difficulty breathing or swelling and pain in your legs