How long you have to wear the compression garment, and why so long

The garment comes up twice. The first time is day three, when it is heavy and hot and feels as though it will not let you breathe: there the question is how much longer. The second time is week four, when the swelling has gone down, you look in the mirror and you look fine. Then the question changes: do I really have to keep wearing this?

Both have the same answer, and it is not a number.

What it does, and what it does not

Start with what it does not. The garment does not make you thinner. It does not burn fat, it does not take off centimetres by itself, and it does not sculpt a contour that was not created in theatre. If a garment could shape the body, there would be no need to operate.

What it does is three specific things, and none of them is decorative.

It controls swelling. After an area has been worked on, the tissue becomes inflamed and holds fluid. Even pressure from outside limits how much gathers and helps the lymphatic system move it along. That is why, if you take the garment off for a while, within minutes you feel more swollen than you did with it on.

It helps the skin stick down to its new plane. This is the important one and the one almost nobody explains. In liposculpture the fat that sat between the skin and the muscle is removed: where there was volume there is now a space, and the skin has to attach itself again to a surface that is no longer the same shape. Compression keeps those two surfaces in contact while that happens. Without it they stick down anyway, but with more freedom to do it unevenly.

It reduces the space where fluid collects. Less empty room under the skin means less chance of a pocket forming.

Why the timeline runs in weeks and not in days

Because the calendar is not set by the garment: it is set by the tissue.

Swelling does not rise and fall in an afternoon. It is at its worst in the first days, falls away over the first weeks, and the last of it — the part that makes a pair of trousers fit differently in the evening than in the morning — takes months to go. The skin attaching to the deeper plane runs in weeks. Its retraction, in months.

While all of that is going on, the operated area is still deciding where it settles. Compression is what accompanies that decision, and that is why it is measured in weeks: it is not how long the swelling takes to look smaller, it is how long the tissue takes to hold still.

How long, in practice

In liposculpture the usual range is four to eight weeks of continuous wear, day and night, and after that a period of daytime wear only. The exact figure depends on how much surface was treated and on how your skin is doing, and it is adjusted at your follow-ups.

That range shifts a good deal depending on what was done. In gynaecomastia surgery the garment matters most in the first days, because what it is preventing there is a haematoma. After submental liposuction the garment is a chin strap and the timing is different. After breast surgery it is not a girdle at all but a surgical bra, wireless and front-fastening, and sometimes a band on top of it. After an abdominoplasty or extensive body contouring, the wear is longer.

And above any range you may read is the sheet of instructions you were given. Yours may be longer, and when the two do not agree, the sheet wins.

One clarification that saves confusion: compression stockings, if you are given them, are not the garment. Those have to do with circulation in the legs and with preventing a thrombosis, not with contour. They come off when you are told, not when they stop being annoying.

Day three and week four

Almost nobody abandons the garment on the day it is hardest to wear. It gets abandoned later, and the reason is always much the same: the need is no longer visible.

That is entirely logical and exactly backwards. What you see in week four is a contour being held by the garment you have on. It is the result of the garment working, not proof that it is no longer needed.

Looking good with the garment on does not mean you no longer need it. It means it is doing its job.

How to tell it is too tight

Tighter is not more effective. A garment that compresses too hard impedes venous return, can leave grooves in the contour, and punishes skin that has just been operated on. And it has a worse practical effect: it becomes unbearable and gets dropped, and a garment in a drawer compresses nothing.

• It leaves a deep groove that does not fade within a few minutes of taking it off.
• You feel tingling or numbness in the area or further down.
• You have to hold your breath to fasten it.
• Pain increases while you are wearing it instead of easing.
• It rolls up into a cord at one of the edges: there the pressure stops being even and concentrates along a line.
• The seams sit on a scar.

None of this is solved by loosening it for a day and going back to the same thing: it is raised at the follow-up, because there is nearly always another size, another height or another garment. And if an area of skin changes colour and does not recover once it is released, if pain grows instead of settling, or if one leg alone swells, that does not wait for the follow-up.

What happens if you stop early

Nothing collapses all at once, and it is worth saying so plainly so that the rest is believed. Stopping early does not undo the surgery.

What it does is raise the odds of things that are hard work to put right afterwards: irregularities and dips in the contour, areas that stay firmer, swelling that comes back on busier days, fluid gathering where there was space. Stopping compression before the time is up is one of the avoidable causes of an uneven contour.

And a point of order: if you are going to stop, let it be a decision made at a follow-up and not out of tiredness on a Tuesday afternoon. The difference between the two is invisible at the time; it shows up at six months.

What depends on you

• The size, from measurements. Not from the clothing size you wear, and never one size down "so it presses harder": that is the mistake that throws the most garments in the bin.
• Ask whether you should have two. With only one, wash day becomes a day without a garment.
• Fasten it lying down and starting from the bottom. Put on standing up, it ends up badly distributed.
• Wash it by hand, in cold or lukewarm water, with no fabric softener and no bleach, and dry it flat in the shade. Compression lives in the elastic fibre and heat destroys it: no tumble dryer, no iron, no direct sun. A badly washed garment stops compressing within weeks even though it still looks new.
• Do not wring it out.
• If it becomes unbearable, say so. Putting up with it in silence ends in abandoning it.

The timeline is not set by the mirror. It is set by the tissue, it is counted in weeks, and yours are written on your sheet.