Lipedema · After your operation
Recovering After Lipedema Surgery
Dr. Steven Ovadia's post-operative instructions for lipedema reduction surgery: the first days at home, your compression garment, when you can shower, keeping your legs up, what you can lift, when exercise and lymphatic drainage come back, and how to care for your incisions week by week.
Overview
How to use this page
This page is a general guide to recovering from lipedema reduction surgery with Dr. Ovadia. It covers the instructions most patients ask about: the compression garment, showering, elevation, lifting, exercise, lymphatic drainage, and scar care.
The written instructions you receive from Dr. Ovadia and his team for your own surgery come first. If anything here differs from what you were told, follow your own instructions, and call us if you are unsure.
These are Dr. Ovadia's guidelines for his own patients. Other surgeons have different protocols, and that is normal. If you had surgery with another surgeon, follow their instructions, not this page.
Everyone heals differently. The timings on this page are a general guide, and Dr. Ovadia reviews your timeline with you during your recovery.
The first days
Home after surgery
The day of surgery
Lipedema reduction surgery is done under anesthesia. When planning your operation, Dr. Ovadia goes over where it is done, the anesthesia, and whether you go home the same day. You will need an adult to take you home.
Wear your compression garment
Swelling is normal and expected. In lipedema, and especially if you also have lymphedema, the compression garment matters even more than after other surgery: the compression helps prevent and minimize swelling and supports the tissue while it heals. For the first 4 weeks, wear it around the clock, taking it off only to shower. For the next 4 weeks, wear it during the day or at night, whichever you prefer. After 8 weeks, go back to wearing compression the way you did before surgery, or as Dr. Ovadia advises.
Fluid from the incisions
There are no drains. For the first day or two, fluid that was placed during surgery drains from the small incisions. It is often tinged with blood. This is expected, and absorbent pads take care of it. Change the pads as they become wet, and keep the garment on over them.
Showering
You may shower 24 to 48 hours after surgery, once the drainage from the incisions has slowed. Let the water run over the incisions rather than scrubbing them, pat the area dry, and put your compression garment back on. Do not soak in a bath, pool, or hot tub for 4 weeks.
Pain and medication
Soreness, tightness, and tenderness in the treated areas are expected in the first days. Take your pain medication as prescribed, and ask us before adding any medication or supplement that was not on your list. Many patients find they need less than they expected after the first few days.
Rest with your legs up, and short walks
Rest in the first week, but get up and walk several times a day, starting the day of surgery. Walking helps your circulation and lowers the risk of blood clots. When you are not walking, keep the treated arms or legs elevated. After surgery on the legs, avoid standing in one place for long periods.
Activity and lifting
What you can do, and when
Two things keep the swelling down while the tissue heals: lift nothing heavier than 10 to 15 pounds for 4 weeks, and keep the treated arms or legs elevated whenever you are not walking. Walking is encouraged from the start. Everything else comes back in stages.
No heavy lifting for 4 weeks
Do not lift anything heavier than 10 to 15 pounds for 4 weeks after surgery. That includes groceries, laundry baskets, pets, and small children. After 4 weeks, build back up to your normal lifting gradually rather than all at once.
Elevate, and avoid prolonged standing
When you are not up and walking, keep the treated arms or legs raised. After surgery on the legs, avoid standing in one place for long stretches in the first weeks: it lets fluid collect in the legs and adds to the swelling. Sit with your legs up instead.
Walking
Walking is encouraged from the day of surgery. Start with short walks and build up to longer walks outdoors as you feel able.
Getting back to exercise
When you add an activity back, start easy and stop if it causes pain or new swelling. Driving can resume once you are no longer taking prescription pain medication and can turn the wheel and look over your shoulder comfortably.
Incisions and scars
Caring for your incisions
How the incisions heal
Lipedema reduction surgery is done through small incisions. Some are closed with a stitch or two, and some are left open so the fluid can drain. They generally heal well and fade into small marks.
Small open areas along an incision
It is not uncommon for one of the small incisions to look raw or open up a little in the first weeks. This is usually minor. It is typically treated with a thin layer of bacitracin and a bandage, changed daily, and it closes on its own. Let us know if you notice one so we can check it at your next visit.
Spitting sutures
Where an incision is closed, the stitch is dissolvable. Occasionally the body pushes one toward the surface before it dissolves, and a small red bump or a thread end appears. This is called a spitting suture. It is common, it is not an infection, and it does not affect your result. Do not pull on it. Dr. Ovadia or his team can trim it in the office, and the spot settles within a week or two.
Silicone scar strips are optional
The incisions are small, and most patients do not need scar strips. If you would like to use them, start at 3 weeks after surgery, once the incisions have closed. Silicone helps scars stay flat and fade, and we will show you how to apply the strips.
How scars change over time
Scars are permanent, but they fade. They are usually pink or red for the first several months and keep lightening for a year or more. If the scars will be exposed to sunlight, use sunscreen on them for the first year: sun darkens a healing scar and makes it stand out longer.
Firmness, lumps, and changes in feeling
The treated areas feel firm and lumpy for a while as the tissue heals, and there may be patches of altered sensation. These settle over months. Massage helps the firm and lumpy areas soften, and manual lymphatic drainage helps the swelling settle. Permanent changes or loss of sensation are uncommon.
Timeline
Recovery at a glance
This is a general guide. Everyone heals differently. During your recovery, Dr. Ovadia will review your timeline with you.
When to call
Call us if you notice any of these
Swelling, bruising, soreness, and firm or lumpy areas are expected and improve over the first weeks and months. The signs below are different. They can point to bleeding or infection, and they are best taken care of early, so call the office rather than waiting for your next visit.
Reasons to call the office
- One leg or arm becomes much more swollen, firm, or painful than the other
- Spreading redness or warmth around an incision
- Pus or cloudy drainage from an incision, or an open area that is getting larger rather than closing
- A fever
- Bright red bleeding from an incision that does not stop with pressure
- Calf pain or swelling, or shortness of breath
For chest pain, trouble breathing, or heavy bleeding that does not stop with pressure, call 911 or go to the nearest emergency room.
Questions during your recovery? Call or email us and we will go over it with you.
Questions
Common questions about recovery
How long do I wear the compression garment after lipedema surgery?
Around the clock for the first 4 weeks, taking it off only to shower. For the next 4 weeks, wear it during the day or at night, whichever you prefer. After 8 weeks, go back to wearing compression the way you did before surgery, or as Dr. Ovadia advises. The compression matters more after lipedema surgery than after most operations, because it helps prevent and minimize swelling and supports the tissue while it heals.
When can I shower after lipedema surgery?
You may shower 24 to 48 hours after surgery, once the drainage from the incisions has slowed. Let the water run over the incisions rather than scrubbing them, pat dry, and put your compression garment back on. Baths, pools, and hot tubs wait 4 weeks.
Will I have drains?
No. For the first day or two, fluid that was placed during surgery drains from the small incisions on its own. It is often tinged with blood. This is expected, and absorbent pads take care of it.
How much can I lift after lipedema surgery?
Nothing heavier than 10 to 15 pounds for 4 weeks. After 4 weeks, build back up to your normal lifting gradually rather than all at once.
Why do I need to keep my legs up?
Swelling collects in the lowest part of the limb. Keeping the treated arms or legs elevated when you are not walking, and avoiding long stretches of standing in one place after surgery on the legs, helps the swelling go down and keeps you comfortable. Walking is different: it pumps fluid out of the legs and is encouraged from the day of surgery.
When can I exercise again?
At about 2 weeks you can generally walk on a treadmill or ride an exercise bike at an easy pace. Heavy lifting and strength training wait until 4 weeks, and then build back gradually. Running and a strenuous treadmill come back at 3 to 4 weeks after surgery on the arms, and at 6 weeks after surgery on the legs. Everyone heals differently, and Dr. Ovadia reviews your timeline with you during recovery.
When can I start manual lymphatic drainage?
At about 1 week after surgery you can start manual lymphatic drainage, or resume it if you were already having it. It helps the swelling settle, and massage helps the firm, lumpy areas soften.
The treated area feels hard and lumpy. Is that normal?
Yes. The treated areas feel firm and lumpy for a while as the tissue heals, and there may be patches of altered sensation. These settle over months. Massage and manual lymphatic drainage help.
Do I need silicone scar strips?
They are optional. The incisions are small, and most patients do not need them. If you would like to use them, start at 3 weeks after surgery, once the incisions have closed.
A small spot on one of my incisions looks open. Is that normal?
It is not uncommon for one of the small incisions to look raw or open up a little in the first weeks. It is usually minor and is typically treated with a thin layer of bacitracin and a bandage, changed daily, until it closes. Let us know so we can look at it at your next visit, and call sooner if there is spreading redness, pus, or a fever.
There is a small bump or a thread poking out of an incision. What is it?
Most likely a spitting suture: a dissolvable stitch that the body is pushing to the surface before it dissolves. It is common and not an infection. Do not pull on it. We can trim it in the office, and the spot settles within a week or two.
Do I need sunscreen on my scars?
If the scars will be exposed to sunlight, yes, for the first year. Sun darkens a healing scar and makes it stand out longer. Under clothing or a compression garment they are covered and need no sunscreen.
When can I go back to work?
Many patients are back to desk work in about 2 weeks, with the legs up when possible. Work that involves lifting, long periods of standing, or physical exertion waits longer, in line with the restrictions above. Dr. Ovadia goes over your return to work with you.
When can the next area be treated?
If another area is planned, the timing is usually discussed at about 3 months, once much of the swelling from the first operation has gone down.
About the surgery
Learning about lipedema?
The lipedema page covers the signs and stages, how it is diagnosed, treatment without surgery, how lipedema reduction surgery is done, and insurance coverage. Dr. Ovadia sees patients in New York City and in Jersey City and Millburn, New Jersey.
225 Broadway, Suite 3100, New York, NY
377 Jersey Ave, Suite 440, Jersey City, NJ
90 Millburn Ave, Suite 206, Millburn, NJ
Phone and video consultations available · info@ovadiaps.com