What is it like to have leg liposuction?
Everything you need to know about the surgery: what are the costs, insurance coverage, recovery, methods, and more
Last January, I went through a leg liposuction procedure to treat lipedema, a fat disorder that causes an enlargement of the fat cells primarily on legs and arms. Because these are diseased fat cells, they don’t respond to diet or exercise, and only get bigger with time, creating fibrosis, causing pain, and even disability. The only way to remove this fat and ensure these cells don’t get any bigger is through liposuction.
In this article, I’ll detail my experience with the surgery, starting with the day before surgery. You might want to take a look at the list of supplies I recommend you get before surgery.
The day before
Since my surgery was scheduled for 11 am, and you have to fast for at least 12 hours before having surgery, I stopped eating and drinking water around 9 pm the night before. I also removed all my earrings and jewelry, as well as the nail polish on both my hands and feet. These are mandatory.
I packed a bag with everything I took to the surgery center with me–my compression garment, the maxi dress I was going to wear after the procedure, the slippers that would fit my feet in case they got swollen, and a stress ball–this may sound silly but was extremely helpful to keep me sane while I was in the waiting room.
I also put everything I was going to need for after the surgery in the backseat of my car. Those included: an elevation pillow to elevate my legs on the way back home (it’s very important to keep your legs elevated 24 hours a day or as much as you can for 2 weeks after surgery), besides puppy pads, maxi pads, and tape to stick the puppy pads on the car seat and prevent any leaks.
I also left the doctor’s notes and the medication I needed to take on the counter, with instructions for my husband.
Surgery day went by extremely fast. I was scheduled for 11am, so I was asked to arrive at the surgery center around 10 am to fill out paperwork. I woke up, did some yoga (this was important to help me relax), took a shower with Hibiclens soap (antibacterial), got dressed, and had my husband drive me. You’ll need to have someone with you to take you home.
I got there and signed some paperwork, changed into surgical garments, and did a pregnancy urine test (this is standard procedure). After that, I waited for the doctor to come and chat with me and mark my legs. I was only there for about an hour before my surgery started, but the wait felt longer, especially because there was another patient recovering in the room next door and I could hear that she was in pain.
This was hard for me, but I took a stress ball and I just kept squishing it, as the doctor and his assistant assured me that everyone was different, but most people feel no pain at all after–and they were right.
As for the type of liposuction I had, I had surgery with Dr. Michael Schwartz in Pasadena, California. He uses a combination of TAL (tumescent-assisted liposuction), PAL (power-assisted liposuction), and Vaser.
What that all means is that he first makes the incisions, then injects a solution of epinephrine and lidocaine to numb the area and constrict the blood vessels to avoid any damage, then he uses Vaser, which is a tool that uses ultrasound waves to disrupt the bonds between the fat cells (when seen up close, this makes it look like the fat is “melting”), and then he removes the fat with a power-assisted cannula, which vibrates and breaks the fat into smaller pieces.
I’m personally a huge fan of this method, as the results are usually great.
As far as anesthesia, I had GA (general anesthesia). I know that a lot of people are scared of it, but to me, it was a breeze. I didn’t feel any side effects (well, there was a minor one — more on that below*), and I regained consciousness 30 minutes after they brought me into the recovery room. I don’t remember anything about the procedure, and I didn’t feel any pain during.
*The minor side effect I had from GA was from the breathing tube. Somehow, it must have pressed a nerve on my tongue, so a small spot on my tongue was numb for about a month after surgery. It was no big deal and it healed quickly.
Did I feel any pain after?
Truth is, I didn’t. In fact, I kept raising my legs out of happiness when I woke up because I was so happy that they felt much lighter. I felt really good up to 24 hours after the procedure and could still feel the drugs they gave me during GA. When they started weaning off, I started feeling some discomfort around my knees — it feels like your skin is sticking to your bones. In the grand scheme of things, this feeling was no big deal.
I kept raising my legs out of happiness when I woke up because I was so happy that they felt much lighter
As soon as I woke up, I was able to move my legs and I even walked to my car. When I got home, I put my legs up and laid on the couch, getting up every hour or so to walk for 10–15 minutes, as recommended by my doctor — this helps prevent blood clots. What I also learned is that walking will speed up your recovery. Once I started moving around and walking more, that feeling of tightness started getting better and better. I also stretched as much as possible, and I even loved to put some music on and dance to it.
Here are some exercises to do after surgery:
Keep in mind that the pain level will vary depending on the type of procedure you have, your age, how much is removed, and your actual resistance to pain. I personally did not feel any pain. But everyone is different.
What you will have for sure are a lot of bruises. Everyone does. But they’re not necessarily painful. They lasted for about 1 month for me, and they went from purple to green to light green until they completely disappeared. I also used some arnica oil which helped with the bruising.
GRAPHIC IMAGE AHEAD. PLEASE PROCEED WITH CAUTION.
How bad was my swelling?
Overall, my swelling wasn’t that bad. I had pretty consistent MLD (manual lymphatic drainage massage) 2–3 times a week, which I highly recommend. MLD helps with swelling and fibrosis, trying to form after liposuction. Having MLD not only will help you feel better, but it will also make your results look better.
Some days, I had extra swelling in some areas and had to wear extra compression: for thighs, I wore thigh braces. For knees, I wore elastic compression wraps. And for my ankle, I wore knee-high compression on top of my compression garments.
One month later, my legs barely had any swelling and bruises anymore. I actually attended a 3-day conference out in the Palm Springs desert only 4 weeks after my surgery and I was completely fine walking around all day.
Did I take any medication?
After the procedure, I took antibiotics for 1 week, and for the pain I mostly took Tylenol. They also prescribed me Vicodin in case the pain got worse, but it never did, so I only took 2 or 3 Vicodin and it was, in all honesty, just out of curiosity to see what they would do to me, since I had never had opioids before. I actually hated them, because they made me feel sleepy and really out of it. #controlfreak 😂
Bathroom: The elephant in the room
I feel like this a bit of a taboo topic for people who have this kind of surgery, so I’ll be honest. Going to the bathroom is probably the hardest thing you have to go through after surgery. Whether that’s for #1, #2, or even showering.
During the first week, the doctors recommend that you have someone with you at all times because you might feel faint and pass out. I was skeptical of this until it happened to me.
Around day 4 or 5, I took off my compression to take a shower and felt lightheaded. At first, it felt like normal lightheadedness — and since I usually feel like this all the time anyway because my blood pressure is low, I didn’t make a big deal out of it. My mom was in the bathroom with me, so I told her: “Oh, I feel a little lightheaded, let me just lean on the counter for a bit.” The next thing I remember is hearing a voice in the distance calling my name, and waking up to my mom slapping my face. I thought I was waking up from a dream. It was my first time passing out ever.
This happens because when you take off the garments your body has fluid shifts. For that reason, it’s best to take off your compression garment while sitting down in bed and wait a few minutes before getting up, so that your blood flow can normalize before you stand up.
The doctors also recommend that you wear your compression garment 24 hours a day for a few months (this varies by the doctor), only taking it off to shower and to have MLD (manual lymphatic drainage massage). That’s the reason most compression pantyhose/leggings have a hole in the groin area. It allows you to pee without taking the garment off.
That’s where the GoGirl/SheWee comes in. If you’ve never seen these, they’re basically a silicon funnel that allows you to pee standing up. You hold it against your vulva and pee into it, directing the stream into the toilet. It definitely has a learning curve, and I would be lying if I said I didn’t pee myself a few times.
Actually, around week 2, I was so tired of accidentally peeing myself, that I burst into tears and said to my mom: “This is so humiliating.” But overall, the GoGirl works, and it’s a better alternative than taking off your compression garment every time you want to pee, especially the first week.
Around week 2, I was so tired of accidentally peeing myself, that I burst into tears and said to my mom: “This is so humiliating.”
I had no problem going #2, but some people have to take stool softeners. It’s a good idea to buy it to have it handy in case you need them. For that, you do have to take off the compression garment.
With time, I got so used to the compression garment that I put it on and took it off in seconds. In total, I wore it for three months straight, and I still wear it sometimes when I feel like I’m swollen. I like them. Marena is actually pretty comfortable compared to other compression garments.
Going back to work
I went back to work 1 week later, but if you can afford to take two weeks off, that might be more comfortable for you. I’m lucky I have a desk job, and so I was able to keep my feet up most of the time I was in the office, even during meetings in most cases. Of course, that might’ve made me look a little weird, but people forget things quickly.
Going back to exercising
I was able to start exercising again only 4 weeks after my surgery. Since high impact exercises are discouraged for lipedema patients, we should mostly stick to light exercise anyway, like yoga, pilates, and functional exercises.
I do p.volve, which I highly recommend. You’ve probably seen this mentioned by fitness and lifestyle influencers on Instagram, that’s how I first heard about it too, and because of that, I was completely skeptical about it. But they were offering a free month and I thought: why not? So I gave it a shot.
P.volve is described as “a mix of physical therapy, functional science, and hip-opening movements,” and it was created by Stephen Pasterino, an NYC trainer who’s best known for working with Victoria’s Secret models.
They have online classes, studios in LA and NYC, and they even have their own line of fitness equipment. They also have a group on Facebook only for p.volve members, which, at first, made this whole thing seem a bit like a cult to me, but after seeing muscle definition as early as 3 weeks in, doing the workout 4–5 times a week for anywhere between 30–45 minutes — the best results I’ve ever seen with any type of exercise — I was sold. Hell, I even bought all the equipment.
One thing that I think is worth mentioning is that the aftercare post-surgery isn’t just something you’ll do for 2 or 3 months. It’s for life. Besides maintaining healthy habits (eating well, exercising, etc.), you will have to take really good care of your legs, which includes massaging and putting on lotion/oils, etc. Here are some supplies that I recommend for this:
Tiger Tail massage stick–this is incredible. If I could only recommend one item, this would be it. It’s essentially a foam roller stick.
Ginger essential oil — Helps with swelling
Arnica massage oil–anti-inflammatory and helps with bruises
Scar sheets–these will help heal the incision scars more quickly. Speaking of scars, mine are barely noticeable now at the 6-month mark. I imagine they’ll fade even more with the years and become barely noticeable.
Handheld massager — after surgery, fibrosis will want to form. Ideally, you should continue to have MLD at least 2 times a week, but you can also learn how to do self-MLD and use a massager like this one to give yourself a deep tissue massage, which helps break fibrosis.
Overall, my post-op was really easy, and I think I’m much more prepared and know what to expect now for when I have the second surgery–likely, and hopefully, at the end of 2020.
I think that’s all I had to say. I still want to write an article just to talk about depression post-surgery, which I’ve learned is a pretty common feeling. Body dysmorphia is also common, but again, this deserves a whole new article, which will come soon, I promise.
Overall, do I think having surgery was worth it? Absolutely. My legs feel much lighter, my ankles don’t hurt anymore, my skin looks healthier, and my legs look nice too, which is a big plus.
I hope this article will help women in their lipedema journey.
As always, if you’ve stumbled on this and know someone who might have it, please share it with them. They’ll thank you.
*Please keep in mind that everyone is different, and my experience may be very different from yours. Nothing in this article is meant as medical advice and may differ from what your doctor wants you to do. As always, follow your doctor’s orders.