Causes of swelling after liposuction

What is liposuction?

Liposuction surgery is a cosmetic plastic surgery procedure in which fat is aspirated (sucked out) from under the skin through small tubes called cannulae. The skin is by necessity lifted off underlying muscle tissues to a certain extent, though it is still attached by connective tissue, blood vessels and nerves (unless laser liposuction is used, where such connections are destroyed). Nevertheless, there is an area under the skin that is “empty” and the body will fill any empty area with fluid, causing swelling after liposuction. The important questions are first how to minimize the post-lipo swelling and second how to remove it (the subject of another post).

Minimizing post-liposuction swelling

What is swelling?

Any time our bodies are “injured” in any way, be it by surgery or a mosquito bite, the area will swell.

Swelling is a combination of two different types of fluid accumulation in our tissues after any trauma and is a necessary part of wound healing.
Intra-cellular swelling
Intra-cellular swelling is swelling or enlargement of the individual cells that form our tissues. With any trauma, cell membranes will become more porous and fluid-bearing nutrients outside cells will go in to swell and plump it up. Fluid that enters cells comes from the fluid outside and in between cells, called interstitial fluid, which is initially derived from the blood.

Extracellular swelling

This is the type of swelling we are more used to seeing. You hit your head on a wall and get a bump almost immediately. That bump is initially due to blood vessels in the area becoming porous (not the cells yet) and allowing fluid from the blood to enter the area between cells, adding to interstitial fluid. Of course, if you hit your head hard enough, you may get some bleeding as well and get a bruise (blood and fluid mixed).
For example, think of it this way. You burn the back of your hand on an oven. Very soon, you get a blister and the area swells up. The blister is dead skin and blister fluid, and that clear/yellow liquid is your lymph or interstitial fluid, the fluid around and outside your cells. Burnt cells send a signal that opens channels in the blood vessels to allow the lymph part of the blood to get into the tissues. The red blood cells are kept out; that is why blister fluid is not red.
Fluid that comes in to bathe injured cells has proteins, antibodies, white blood cells and other factors needed in wound healing. With the continued effects of injury, interstitial fluid then goes into cells also, as described above. So “swelling” is a combination of intracellular and extracellular swelling. In the next post we’ll see what this means to for liposuction treatment and garment use. The suspense is thrilling…