Dear LipoCheckers,
Two weeks before the surgery, the excitement should still be manageable. This means you still have the nerves to properly prepare for the strenuous days ahead and take one last look at the journey of suffering: It will soon come to an end!
Your surgeon should have already informed you extensively about everything. Since they themselves do not suffer from lipedema, I will help you make the days before and around the surgery easier. With this personal companion booklet, based on my experience with Dr. Stefan Rapprich, you will have everything in view.
To Do
First and foremost: Make an appointment with your general practitioner for an ECG and blood test at least 14 days before. Please bring the results to the surgery; they are needed to rule out any possible risks and ensure a safe procedure.
Next, arrange for someone to pick you up from the clinic on the day of the surgery and take care of you afterward. It is very comforting to be looked after in the first two days, but that doesn’t mean you will be incapable of taking care of yourself afterward. You are even supposed to move around (the previously injected fluid can be expelled faster).
It also feels good to have someone nearby. Trust me on this: I speak from personal experience!
After the surgery, multiple lymphatic drainage sessions are highly recommended, so make appointments with a physiotherapist as early as possible. The first treatment, lasting about an hour for the entire body, can take place three to four days after the surgery, and then twice a week for about a month. Your general practitioner will provide the prescriptions for this. The surgeon can also provide this with a referral from your general practitioner.
NUX VOMICA or ARNICA globules are miracle remedies when it comes to reducing swelling and bruising. I used them during both of my surgeries and noticed a significant difference. Your general practitioner may not be able to prescribe them, but try them or buy them yourself at the pharmacy; they are not very expensive.
Those prescribed heparin injections as a precautionary measure against thrombosis (your treating physician will discuss this with you) should also get a prescription for them.
Prepare your home for your return: have plastic sheets and large bath towels ready for the area where you will be resting, as the injected fluid may leak out, and you don’t want to mess up your living space.
For the surgery day, pick out older, comfortable, and loose-fitting clothes. First, everything will be stained by the fluid injected under your skin before liposuction (though it is washable), and second, you won’t be able to tolerate tight, uncomfortable pants.
Your underwear shouldn’t be your best either. You can keep your bra on during the surgery; everything else will be provided by the hospital.
Shopping
After the surgery, your body will need plenty of fluids, and you will be very thirsty! Stock up on enough drinks:
You will need to walk a few steps during the surgery as you will feel the urge to go to the bathroom. For this, it’s best to get a pair of rubber shoes (like Crocs) or slippers. Cheap versions are available everywhere now and are affordable for everyone. Regular shoes would get soaked quickly, as the fluid injected before the surgery will leak from your legs.
Small bandages (approx. 7x5 cm) will be provided by the clinic. If you run out, it’s useful to have a small supply. Buy some or get a prescription from your general practitioner. These bandages are flexible and breathable. After showering, they must be changed.
You probably already have compression tights. From personal experience, I recommend getting a second pair. On the evening after the surgery, your tights and the “diapers” will be so wet that you won’t want to wear them anymore!
I personally had compression leggings with side zippers (e.g., Caromed Expression). Such garments are more expensive but are much easier to put on – although it’s still quite exhausting!
The “diapers” will be placed either under or over the compression garments, depending on the surgical area. Since I had compression leggings, I found it more comfortable to wear the “diapers” under the compression. This also had the advantage of holding the “diapers” securely in place.
Good old hand cream will become your best friend in the first few days. Due to frequent bathroom trips and constantly taking the compression on and off, your hands will dry out quickly, and applying cream will feel great. And you definitely don’t want pain in your hands as well! A week after surgery, you should gently apply lotion to the operated areas (avoid the incision areas). A regular body lotion is sufficient.
To-Do List
The night before the surgery, pack your small bag with everything you need for the procedure:
Now you should be well prepared for the surgery! I’m keeping my fingers crossed for you!
Is your companion really there to pick you up after the surgery? Without them, the surgery will not take place for safety reasons. You won’t be under general anesthesia, but after a while, you’ll feel drunk. We all know that state and understand that it means we are not fully capable of making decisions. So: Is your companion there?
Arrive 15-30 minutes before your scheduled surgery time in the waiting area. Ring the bell to check in. After a short wait, you will be called to the surgery area, where you will first be prepared for surgery. Don’t worry, no one will bite you. Everyone is very nice and friendly.
In the surgery room, take your signed paperwork and valuables with you. If you have reading material, place it within easy reach in the room where you got changed.
During Surgery
During the surgery, you can casually talk to the entire team. During my surgery, we even laughed a lot. So don’t worry, you are in good hands. The nurse will suggest whether to wear the “diapers” over or under the compression. Underneath has the advantage that you can easily take the tights down and up when going to the bathroom, and the “diapers” are held in place better. There is one exception: if the lower legs are being operated on, the “diapers” must be worn over the compression. The clinic will provide everything you need for changing the “diapers” at home.
The Journey Home
After the surgery, get dressed and be handed over to your companion. They can drive directly to the short-term parking lot in front of the surgery building after registering at the clinic reception. You can use the elevator that takes you directly to the parking lot, as climbing stairs can be torture!
If you have a car with a high entry, bring a small stool/step for getting in and out. You should make everything as comfortable as possible.
You will receive an absorbent pad to place on your car seat and the floor for the journey home. Don’t be alarmed if the pad becomes saturated with fluid – this is completely normal. Be sure to keep your legs elevated – the height doesn’t matter.
Go ahead and eat your packed food and drink. Your body will need it anyway.
Arrival Home
Everything that goes in must come out! Believe me, you’ve never had to use the bathroom so urgently as you will NOW (right after surgery)! This will be your first trip, and don’t hesitate to sit down. It may hurt at first, but once it flows, the pain will slowly subside.
Your companion should accompany you to the bathroom or at least stay nearby; anything can happen. Tell them that if you have circulatory problems, they should lay you on your back and elevate your legs – most people learned this in a first aid course.
Take Arnica or Nux Vomica globules (5 pellets) every 20 minutes for two hours (it’s best to start taking them a few days before the surgery). After that, take them every hour, and during the night whenever you wake up. This helps reduce swelling and inflammation. Of course, there are other good remedies as well.
Take the medication given to you by the clinic according to your doctor’s instructions.
You should walk a lot, but when you lie down, do it in a place where you are not alone. The sofa in your living room is ideal for this. Place a protective pad under yourself and cover up with an old clean towel. A lot of fluid can leak out from the puncture sites, and you can’t put your entire living room into the washing machine! To be extra safe, place a large plastic sheet and a towel underneath as well.
To relieve your joints, put a pillow under your knees. I always used a neck roll, which I’d been using for support before as well.
Changing Dressings
In the evening, a few hours after surgery, your “diapers” will need changing.
Prepare everything you need:
Unwrap yourself in the shower or bathtub; if there is little fluid leakage, it’s better to do it lying down, as fluid can be squeezed out while standing. If this happens: sit down or lie down as quickly as possible. The circulatory system can go quite haywire then. Clean yourself a bit with the washcloth, and then get repacked while lying down. Everything soaked should be replaced. So if the bandage strips come loose, replace them as well. Do everything while lying down! This process will be quite exhausting.
By the way: Take a quick look in the mirror, completely different, isn’t it? You’ll feel much better already!
Until the Next Morning
Now do whatever you feel like. Only you know what’s best for you. Whether watching movies, reading a book, or sleeping, the most important thing is to keep your legs elevated. You’ll be going to the bathroom constantly anyway. The clinic’s instructions say to walk immediately after surgery – do what feels right to you. Everyone experiences it differently. Just make sure to drink at least 2-3 liters a day.
You may feel restless due to the adrenaline in the injection fluid, making it hard to sleep. That’s okay, as you can catch up on sleep the next day. By the way, I found that good movies are also shown at night!
Tip: When your caregiver goes to bed, have them lay everything out for you beforehand!
Goal Setting
The day after surgery, have your dressings changed again around noon. After that, no more fluid should leak, but if it does, put “diapers” back on those spots. Set everything up as you did the previous day. You will feel much fresher and freer afterward.
You should wear the compression garment or tights around the clock for a week; you can only take them off for showering. After that, wear them only for 12 hours a day to allow the tissue and skin to regenerate, ideally during the day when you are active. It’s hard to imagine at first, but you will also want to wear compression at night. This feeling will pass after about the third night.
At first, wash and dry the compression garment every time you take it off so it’s ready for the next change. Special washing lotion for compression garments is available at your orthopedic store.
Caring for the Skin
You can shower one or two days after surgery. Afterward, replace the soaked white bandages and possibly the strips over the incisions. These need to stay on the wounds for a week.
Bathing or swimming should only be done after a few weeks, once bruising has subsided and the small incisions have fully healed. The more healed it is, the lower the risk of infection at the operated sites. Enjoy that first bath even more!
A week after surgery, massage your affected areas with body lotion. It may not feel like your body yet, but after a few weeks, this strange sensation will fade. Massage and moisturize daily, especially before bed. My skin hadn’t been this soft and beautiful in a long time, despite the bruises.
If you start exercising after one to two weeks, only do light exercise. Cycling or jogging is good, but don’t dive in too quickly; it will put too much strain on your body.
Better to reach the goal slowly than do nothing at all! Now exercise is much more fun; you’ll see for yourself! It all feels effortless now.
The sauna or tanning bed should be visited no sooner than four weeks post-surgery. It’s better to wait a bit longer to enjoy a pain-free, healthy body. After all, you’ve suffered from pain and discomfort long enough!
Always keep fresh fruit in front of you as a small snack or treat and enjoy it. It’s delicious and helps tremendously. I could have lived off of it all day and still like to have a plate of fruit several months after surgery.
Don’t hesitate to call the clinic for any complications or concerns. You will always reach someone responsible. Dr. Rapprich is always very concerned about your well-being, and I felt very comfortable with him. You are truly in good hands.
Side Effects
The various side effects that may occur disappear quickly:
All of these side effects happened to me as well, but they didn’t bother me too much.
Tracking Progress
To better assess the "before and after" effect, I created a weight and measurement table back then. I also took photos of myself before and after the surgery, always in the same spot and wearing the same underwear, to document the exact changes in my body visually.
Hopefully, I have provided you with thorough information, and I hope I have been able to alleviate any fears or uncertainties.
I wish you the best of luck and hope everything goes as well for you as it did for me so you can live a more relieved life. You certainly won’t miss the body contact with the stranger on the train!
GOOD LUCK!
P.S.: The most beautiful experience I had a few weeks after surgery was the looks from others, which no longer said: "OH MAN, SHE'S FAT," but "WOW, WHAT A WOMAN."
The surgery also gave me back my self-confidence. I no longer thought about the pain – I didn’t even feel it anymore. Now I don’t wonder whether I can "do it" (ride my bike up a hill, climb stairs, etc.) with my legs; I just do it!
From now on, I look forward!
Written by Katharina Hecht
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