Question 1

Why do I need Lymph Drainage Therapy after my liposuction, Smart-lipo, Cool Sculpting or other cosmetic surgery procedure?

Accepted Answer

You many notice a hardness or lumpiness to the areas treated with liposuction Smart-lipo, or Cool Sculpting especially in the abdominal area and even more so if combined with other body contouring procedures (such as fat injections for what is popularly known as the Brazilian Butt Lift) This is normal right after your procedure. This post-surgical lymphedema is caused by inflammation and trauma from the cannula (instrument that sucks out the fat) moving under the skin. Channels are formed by the cannula that can fill up with fluid and the tissue also becomes swollen. Manual Lymph Massage helps to move the fluid by gently pumping it back into the lymph vessels. Reducing the swelling can reduce discomfort. Without Lymph Massage (LDT or MLD) the inflammation can evolve into fibrosis (a permanent hardening of the tissue) or a seroma ( pocket of serum) can form. Many doctors prescribe Lymph Drainage Therapy after liposuction or other plastic surgery procedures to make sure their patients get the best possible results from their procedure.

Question 2

Is Lymph Drainage Therapy a deep massage?

Accepted Answer

No, although it may seem that deep massage would assist in decreasing the hardness following liposuction, it would actually increase the circulation to the treated areas making it harder to evacuate the lymph fluid. Even though MLD is extremely light work, it is the most efficient way to reduce swelling and bruising. It is based on scientific knowledge of the anatomy and physiology of the Lymphatic System. It is a myth that deep massage and heat are beneficial in healing after liposuction. The Vodder Method and the Chikly Technique are widely accepted forms of Lymph Drainage Therapy performed in hospitals and clinics all over the world. So, even though it may seem to you that a deep massage or other forms of therapeutic or Swedish massage would be helpful, it is not.

Question 3

Does MLD help get rid of bruising?

Accepted Answer

Yes. That is one of the best applications of MLD. Bruises are an accumulation of cellular debris and old red blood cells in the tissue. Lymph Drainage Therapy greatly reduces healing time for bruises by cleansing the extracellular spaces where these substances are trapped.

Question 4

Is Lymph Drainage Massage Painful?

Accepted Answer

Performed properly it is not painful. The Vodder Technique is the most respected method of Manual Lymph Drainage (MLD) over the world. It is NOT traditional massage. It is a specialized, advanced bodywork modality that uses a gentle, rotating, pumping motion that moves the lymph fluid without increasing the blood circulation. Increasing the blood circulation with deep massage and heat can actually inhibit the movement of lymph fluid by changing the permeability of the lymph and blood vessels. Do NOT receive a general therapeutic, deep tissue or Swedish Massage in lieu of MLD.

Question 5

How many treatments will I need?

Accepted Answer

It is ideal to receive at least one or two MLD treatments prior to a procedure. There are many different things that can influence healing. Some patients get 1-6 treatments post-operatively and that is enough, especially if the only area of liposuction was the legs, knees, or flanks. People getting liposuction to the abdomen often find they require up to 12 sessions. Occasionally a client will need more than 12, especially if they had “Smart-lipo”. Also, patients who get multiple procedures at the same time (lipo and a tummy tuck, or lipo and a buttock enhancement; Brazilian Butt Lift) may need more sessions than someone who only gets one procedure. Sessions may be paid for individually, or in discounted packages of 5.

Question 6

What is an MLD treatment like?

Accepted Answer

After an initial consultation, you will undress, lie down on a massage table in the face-up position, covered modestly with a sheet. The atmosphere is the same as a massage treatment room with dim lighting and soft music. Although you are in a massage setting, it is important to understand that MLD is a specific form of bodywork designed to efficiently move lymph fluid in your body. MLD is completely different from a deep tissue, Swedish or relaxation massage that you may be expecting or have had in the past. Stimulation of the Lymphatic System activates the para-sympathetic nervous system producing an automatic physiological relaxation response. Many clients fall asleep. Only the area being worked on is undraped at any time. Gentle, rotating, pumping motions with the therapist’s hands and fingertips begin at the collarbone area, then focus on areas where there is a concentration of lymph nodes…the underarms, abdomen, groin and back of the knees. Usually the entire session is performed with you lying in the face-up position because all of the areas of lymph nodes that need to be decongested are located on the front of the body, although some surgeries do require the patient to turn side to side or face down for a short time if tolerated. Starting on the back (even for fat injections to the buttocks) would not be indicated because it is necessary to open up the major lymphatic areas on the front of your body before the backside of the body can drain. It is very important to decongest the areas of drainage in the groin, abdomen, underarms and collarbone areas before sending extra lymph fluid to them. Directing lymph fluid to nodal areas without opening the lymph nodes up first increases the discomfort and overwhelms the nodes, leading to increased recovery time. Each session is one hour, although those who have several procedures at the same time might prefer a 90 minute session.

Question 7

How often is MLD applied?

Accepted Answer

The first week it is suggested that sessions be daily or every other day, if possible. The second week, every other day, reducing in frequency after that. It is not possible to get too much MLD and the sessions can be scheduled at your convenience.

Question 8

How soon after my procedure can MLD begin?

Accepted Answer

It is possible to begin within 24 hours. Most people wait until they can comfortably drive themselves to appointments.

Question 9

It has been over a month since I had my procedure. Is it too late to begin MLD?

Accepted Answer

No. The healing process after these types of procedure is several months. If it has been over a month since your procedure you can still get the smoothing benefits of MLD. If it has been over 6 months since your procedure and you are still feeling lumps and hardness you should contact your doctor to make sure you have not developed fibrosis or a seroma.

Question 10

Do I need a prescription for MLD?

Accepted Answer

No. Although many doctors recommend MLD, it is also perfectly fine to self-refer.

Question 11

Is massage after surgery safe?

Accepted Answer

In many cases, the answer is, yes.  But it’s always a good idea to check with the surgeon or primary care doctor, because there may be certain areas you’ll want to avoid, or the specific conditions when it might be best to wait.

Question 12

How long after a surgery can a massage be given?

Accepted Answer

The answer involves much more than the surgery – remember, massage therapy addresses the needs of an individual, not a procedure.  Generally, as soon as the client is comfortable with having a massage, you’re good to go.  Remember, surgery carries with it emotional components, so one of the best approaches is to provide a relaxing, soothing and caring touch to help heal the soul.  And then there are the pain-relieving components as well – some people have post-op pain, and massage is a terrific natural alternative to those prescription drugs patients get sent home with.

Question 13

What about massaging the surgical wound site?

Accepted Answer

That would depend on the condition of the surgical site.  If it’s still healing up – especially if it hasn’t closed up yet, is red or draining, or is swollen, you should avoid working on the area with any friction or pulling strokes that might stress the wound.  However, feather-light stroking in the surrounding area can be soothing.

Question 14

Can I work on scar tissue?

Accepted Answer

The old-school answer was, not for two years.  But what is becoming more common practice is to begin massaging scar tissue after as little as three weeks, as it can boost healing. In fact, some patients are even being taught self-massage of scar tissue before even leaving the hospital.

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