Is Genital Swelling
After Plastic Surgery Normal?

genital swelling after plastic surgery
So you get back from your plastic surgery and you head to the bathroom and look down.  Surprise!  Your nether regions are HUGE and black and blue.
Is this normal?!?!?!?  No one told you about it.  Did the plastic surgeon do something inappropriate while you were under anesthesia? 
You didn’t sign up for surgery ‘down there,’ so what in the world is going on?!?!?!?!

You Can Relax. 
It’s Normal.

Genital swelling is a normal occurrence after plastic surgery.  This can happen in both men and women.  It can be minimal, or quite extreme, and the swelling can be accompanied by some nasty-looking bruising.

Some people have said it looks like someone took a baseball bat to their ‘junk’ while they were out cold.

While, yes, it can look just like that, rest assured that the surgeon didn’t have to do anything wrong for this to happen, regardless of how it may look.

Dependent Edema

The phenomenon of genital swelling after plastic surgery is known as “Dependent Edema.”  The word “dependent” means in a downward position, and “edema” means swelling.

Dependent Edema occurs because of gravity.  It is no mystery to anyone that water rolls downhill.  If you spill a glass of water on a table that is uneven, it will roll to the lowest point.  This is exactly what happens after plastic surgery. 

Surgery in the abdomen, whether liposuction, a tummy tuck, or even a BBL causes swelling in areas above or near to the genitals.  Much of this swelling is “free floating” under the skin, and it simply goes to the lowest point which includes the genital areas (and may also affect the legs).

Our Genitals Swell Naturally

To make matters even worse, our genitals tend to swell when we are…um…”having a good time.”  It is a natural function of this area of our bodies, for men and women alike.

Since the area is accustomed to swelling, there is a lot of extra room, so to speak, in the area for fluid to be held.  The fluid migrates there because of gravity and finds a nice temporary home.  Not nice for you, of course, but convenient for the fluid.

Don’t Worry. 

It’s Temporary and Fixable.

As distressing as genital swelling can be (because it can look really awful), there is no need for initial concern.  The swelling can resolve on its own slowly, or more quickly with Manual Lymphatic Drainage (lymphatic massage).

 

woman confused about swollen FUPA - genital swelling after plastic surgery

The Mons Area
a.k.a “The FUPA”

It is common for plastic surgeons to remove the fat pads that exist on the mons area.  The mons is the area right on top of your pubic bone that is at the base of your abdomen.  In popular culture this is commonly called the FUPA, or Fat Upper Pubic (or other P word for a nearby region) Area.  (Technically, the FUPA can also include the pannus, or hanging skin on the lower abdomen – what is typically removed during a tummy tuck.)

These fat pads are removed in order to provide a more even contour of the body when there has been liposuction of the abdomen or a tummy tuck.  If the surgeon does not remove the fat in this area, there is a chance that once the healing is complete that it will remain forever poofy looking.  So, the result will be worth it, despite how it may appear right after surgery.

Once the fat pads have been removed from the mons area, there is a void, or empty space.  This space gets filled with that fluid heading south.

But, Is It Supposed to Be
Black and Hard?

Again, it looks and feels terrible, but both the dark discoloration that sometimes happens and the hardness are completely normal.  So what causes it?

The dark coloration is like a bruise.  When surgeons are doing liposuction, it is very difficult to completely stop all bleeding from happening.   It is easier to cauterize (burn) the blood vessels to stop bleeding during a tummy tuck because the surgeon can see exactly where they are.

Some liposuction is done using tumescent fluid (sterile saline solution, lidocaine, and epinepherine).  Tumescent fluid is injected into the area where a person will be getting liposuction.  The epinepherine causes the blood vessels that are damaged to close off quickly.  Other types of liposuction such as SmartLipo and Vaser Lipo use laser or ultrasound to help liquify fat before it is sucked out.  These types of liposuction also tend to cauterize, or seal off, the blood vessels so that there is less bleeding.

All of that being said, people still do bleed.  Usually it is not very much, but it looks terrible.  It takes a while for the body to break down the escaped blood, so it’s not unusual to still have that bruising for a week or two.  Post Op lymphatic massage speeds up this process.

As for the hardness, it’s just swelling.  Don’t freak out.  It’s actually not too hard to make it go away in most cases.  Lymphatic massage does just that.  You can see my video of how to do your own lymphatic massage for general instruction.

A Word About Men

man confused about genital swelling after plastic surgery

So, while genital swelling can happen to anyone after plastic surgery, for men it can be a bit more distressing than for women.  Not that it’s not distressing for women, it is.  It’s just that when men get genital swelling it can get a little out of control.  But, don’t freak out.  You guys just have a lot more real estate down there, and it’s especially good at swelling.  Lucky you!

If you find yourself walking like a cowboy with legs turned out because that’s the only way you can walk, you are going to be ok.  Things do get back to normal, and there should be no permanent damage.

Lymphatic Massage Can Help, But…

Your therapist can only do so much.  The rest it up to you at home.  First, be sure to watch the video of how to do your own lymphatic massage.  This video doesn’t demonstrate techniques for the genital area, but it does show how to clear the lymph nodes and other important steps that must be done first.  Just this much work will still help.

Massage therapists who are trained in lymphatic massage can get the major parts of the lymphatic system moving.  However, massage therapists are not licensed to work directly on the genitals.  Despite this restriction, getting a lymphatic massage of the rest of the body can help with genital swelling because when the lymphatic system is being helped by Manual Lymphatic Drainage, it causes a suction type of action for the rest of the body.

Another option, if you really need the help is to seek out a Certified Lymphedema Therapist who is licensed as a Physical Therapist or Occupational Therapist.  Call them, explain your issue and make sure they are comfortable doing the work.  Not every therapist is – even if their license permits it.

How To Perform Lymphatic Drainage of the Genital Area

 

The first thing you need to do is watch the video on general lymphatic massage. This will teach you how to do the technique, and it is important to do the neck sequence and the groin sequence before trying to clear the genital area.

Females

Begin by clearing the mons area (the skin on top of the pubic bone).  Using the midline of the body as the dividing line, hold your hand flat on top of one side of the pubic bone and pull the skin towards the lymph nodes located where the leg meets the body.

Repetition of these motions is key.  It takes time for the fluid to move.  Once you have done one side, compare it to the other side.  When you can feel the difference, switch to the other side.

To clear the swelling from the labia surrounding the vagina, you should apply pressure.  A great way to do this is to use a folded hand towel that you place over the swollen area.  Then sit on the corner of a chair or other piece of furniture and rock back and forth.  If you happen to have a large exercise ball or ball that is used as a chair, this is ideal.

If you have had a BBL and you cannot sit, then simply place a flat hand over your vulva, then press and hold for a few minutes.  Repeat until swelling begins to go down.

genital swelling after plastic surgery females

Males

Begin by clearing the mons area (the skin on top of the pubic bone).  Using the midline of the body as the dividing line, hold your hand flat on top of one side of the pubic bone and pull the skin towards the lymph nodes located where the leg meets the body.

Repetition of these motions is key.  It takes time for the fluid to move.  Once you have done one side, compare it to the other side.  When you can feel the difference, switch to the other side.

To move swelling from the penis and scrotum, hold the penis with one hand and gently tug the skin back towards the body.  Begin at the base of the penis and work your way towards the tip.

For the scrotum, pull the scrotum to one side and hold it against your leg with one hand.  With the other hand, take the palm and place it flat on the scrotal skin and tug the skin up towards the body.  Repeat on the other side of the scrotum.  When both sides are done, hold the scrotum up and tug the skin downward toward the body.

As you are moving fluid, you are directing it toward the lymph nodes in the groin region.  See the diagrams below for more specific direction.

Male Genital Lymphatic Drainage for after plastic surgery swelling
Male Genital Lymphatic Drainage for after plastic surgery swelling
Male Genital Lymphatic Drainage for after plastic surgery swelling

Again, Don’t Stress –
But Do Talk to Your Doctor About
Any Severe Pain

The swelling you are experiencing is more likely than not just par for the course in plastic surgery recovery.  If your swelling is accompanied by severe pain (more than the general ache of say a swollen ankle), be sure to touch base with your surgeon.  

To be sure, swelling is uncomfortable.  There are lots of special molecules called inflammatory markers that accompany swelling after an injury or surgery.  They raise pain levels (another reason why lymphatic massage is so great, because it helps remove them!).

The pain you feel in your nether regions should not be severe.  If you are having severe pain, this is definitely a reason to contact your doctor.

More Questions About
Plastic Surgery Recovery?

Check out the complete list of blog posts here:

Navigating Your Plastic Surgery Recovery

More Questions
About
Plastic Surgery Recovery?

Check out the complete
list of blog posts here: