Role of compression after liposuction

Liposuction, which is a very effective treatment modality to reduce lymphedema, can be performed as soon as the pitting component had been corrected by a phase of initial compression (Figure 1). Just like after conservative treatment, the use of compression garments after liposuction is very important to maintain the outcome.Garments should be prescribed in such numbers so that the edema does not recur. A common mistake is that the patient receive one, or if lucky two, garments, after treatment. When the arm or leg is swollen again the patient comes back to the therapist and treatment starts again, and so on. Instead the patient must be followed up at his needs in order to prevent recurrence. This means that treatment must be individualized. An elderly woman may need two garments every 6 months, while a young active patient with a heavy work may need two garments every month. One can draw a parallel to the dosage of insulin to a patient with diabetes that in the same way must be individualized. Nobody prescribes two vials of insulin for 6 months, when the patient needs that same amount for one month.The purpose of compression therapy is to increase the interstitial pressure so that the capillary filtration is decreased. When treated with standard compression garments a study showed a reduction of the excess volume (1680 mL; range 670-3320) after two weeks with 20% (range 5-37) corresponding to 338 ml (range 95-1225).1 Studies of treatment for 6 months have shown a reduction of excess volume of 17% (range 16-52), corresponding to a volume of 139 mL (range 150-345).2Compression garments can be used at the onset of symptoms to possibly prevent the development of lymphedema. Garments that are used throughout the day (15 years’ follow-up)3 as well as only daytime (6 months follow-up)2 prevent the edema to recur.Compression garments must be ordered by a qualified and experienced lymphedema team, consisting of a lymph therapist with a basic education in physiotherapy or occupational therapy and a physician. The team should have vast knowledge regarding various compression trademarks and how to take measurements for ordering of garments. In order to increase compliance and feedback, the team should never let the patient have the measurements for ordering of garments taken by a retailer outside of the team. (Less)