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Compression Garments After Liposuction: Do or Don't?
- Dr. Megan Dreveskracht
- May 23
- 4 min read
Compression after a liposuction procedure is one of the most talked about postoperative interventions my Seattle plastic surgery patients ask about. Unfortunately, it seems that just about every plastic surgeon has his/her own protocols and there are about a million different types of garments available to confuse you. In this blog post, I want to walk you through the history, methodology, and evidence behind post-liposuction compression, and lastly, leave you with my personal recommendations for patients in my own Plastic Surgery practice.
History of Compression in Plastic Surgery
It's kinda wild but compression therapy dates back to Hippocrates around 460–370 BC for treating venous issues. Their use in cosmetic surgery specifically began in the 1970s when Dr. Yves Gerard Illouz applied them after liposuction. He collaborated with a Texas-based compression garment company to improve their products, and, in 1989, they conducted a study on 189 lipectomy patients using varying garment pressures. Their study concluded that the optimal pressure for compression garments to reduce swelling and create the best skin results was 17–20 mm Hg. From here, the idea of compression protocols following liposuction was born. Unfortunately, his lack of scientific rigor and peer review limited the validity of his findings. On par with this sub-par study, the use of compression garments in cosmetic plastic surgery, mainly liposuction, has continued on a half-hazard, evidence-poor trajectory. Adding fuel to the fire, plastic surgery garments have become big business for companies, and social media and its “influencers” play a huge role in how patients find information about them.
How Do Compression Garments Work?
Liposuction causes a significant amount of trauma to the tissues. That trauma during surgery creates inflammation postoperatively, which leads to diffuse swelling of the surgical site. By adding hydrostatic pressure to the tissue, compression will cause less fluid to leak out of blood vessels and more fluid to get absorbed by them. The overall effect is to minimize swelling which, when it comes to liposuction, is what will keep us from seeing our final results.
More speculative reasons for using compression after liposuction include helping the skin to smooth out, decreasing the dead space, and minimizing the risk of developing a fluid collection. Unfortunately, there have been no randomized controlled trials or even comparative studies to take an evidence-based approach to the benefits of compression garments, let alone to help spell out the finer details such as how long to wear compression, the optimal materials, etc.
How Long Do You Need To Wear Compression After Liposuction?
Well, as I spelled out above, there is no right answer or consensus on this issue. In my Seattle Plastic Surgery practice, however, I generally push patients towards a minimum of three months following their procedure. After that, I leave it up to the patient to determine whether or not their body is telling them it is still beneficial– i.e. do they notice a difference in swelling when they wear it versus leave it off.
The first 1-3 weeks after surgery, my patients generally will remain in the garments they were placed in immediately after surgery. These garments are tight, tend to be thicker, and tend to be a little bit of a pain in the ass to get on and off. By the time 3 weeks rolls around, patients are beginning to become more active and mobile, necessitating a more realistic garment for everyday wear. This is generally when we transition to a garment that they have purchased online. When a patient moves on from this second stage garment will have everything to do with the quality and fit of the garment, where it has either stretched out over time and no longer properly fits or the patient’s swelling has continued to decrease necessitating a smaller garment.
Key Characteristics Of A Compression Garment
Despite our lack of evidence for the overall benefits of compression after plastic surgery procedures such as liposuction, the wrong compression garment can lead to complications such as contour irregularities. Below are the characteristics I think matter most in a compression garment:
No constriction points, distorting seams or tight spots. The goal is to provide EVEN compression to the entire area.
Covers the ENTIRE surgical area. If not, it will simply just push out fluid to the non-compressed areas and can lead to long-term contour irregularities.
It’s actually tight. I get it, no one wants to wear these garments. But if it’s too loose, you really are just wasting your time and money.
It’s actually something you are going to wear. Buy something that actually fits with your everyday needs. If it doesn't fit your life, you won’t wear it. And if you won't be compliant, what is the point?
Take Home Points
I would bet that most plastic surgeons, despite the lack of solid evidence, feel that compression post body contouring procedures is an important part of obtaining good results. And I, myself, agree. Even without a solid foundation of evidence to stand on, I still continue to recommend compression garments for a minimum of three months following liposuction and body-contouring procedures. For a list of my patient-reported favorites, see the links below.
Dr. Megan Dreveskracht is a Female Plastic Surgeon in Seattle, Washington who specializes in Aesthetic Surgeries of the Breast, Body & Face. To schedule your consultation, call 206.860.5582 or fill out a contact form here.
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