Plastic Surgery Post-Op Care Provider – Lymphatic Drainage

As a Certified Manual Lymphatic Drainage therapist with specialized training in post-surgical care for Liposuction, Abdominoplasty (Tummy Tuck), Brazilian Butt Lift (BBL)Facelift, and Breast Surgery, I’m here to support you in your journey to a smooth and successful recovery!

I understand that undergoing cosmetic surgery can be both exciting and challenging.  My goal is to ease your experience by providing personalized care that optimizes healing, minimizes discomfort, and maximizes your results.

My post-op protocols are tailored to your specific situation, addressing the unique challenges associated with each surgery type.  All of my protocols include Manual Lymphatic Drainage (MLD), with other techniques added as appropriate for each procedure. I always start sessions with an assessment and am on the lookout for any potential complications that may be developing so they can be addressed quickly. 

When to Start Pre & Post Op MLD

Studies show that receiving 1 or 2 MLD treatments pre-operatively to enhance lymphatic system efficiency prior to surgery, followed by multiple treatments post-operatively, can lead to faster healing and improved outcomes. 

Ideally, I would like to start seeing you about a week before your operation to clear out your lymphatic system in preparation. Pre-Op sessions also give us a chance to get to know each other and develop a therapeutic relationship, and have a care plan in place so we are ready to proceed with your recovery as soon as possible after your surgery.

Your surgeon will decide how soon you can begin receiving lymphatic drainage after your procedure. Many clients are able to start Lymphatic Drainage treatments anywhere from 4 days to 1 to 2 weeks after surgery, however, every surgeon will have their own preferences about the timing, and they will let you know when they want you to start.

What to Expect

Below is an overview of my specialized approach for different cosmetic surgeries. All treatments include MLD to reduce inflammation, swelling, pain, and bruising, and will be complemented by other techniques as indicated for each type of surgery.

Clients will often have a combination of these surgeries all at once, for example Lipo360 w/ BBL or a Mommy Makeover.  In those cases, I will combine different elements from the below descriptions, with the goal of giving a safe and effective treatment for your unique situation.

Important Note: The post-op MLD therapy I practice is never supposed to be painful. I am working with the lymphatic system, and the techniques are very gentle, yet very effective.  My myofascial work is also gentle and painless, yet deep and effective.  There are other styles of post-op work out there that can be very harsh and painful. Some claim to be doing MLD as they painfully drain fluids out of incisions (and are even opening incisions that have already healed to do this!), however, this method is not actually working with the lymphatic system. Please understand that this is NOT how I work. Read on to understand how I DO work.

Overview of My Approach to Different Types of Cosmetic Procedures

Abdominoplasty (Tummy Tuck) – In the early treatment phase for a tummy tuck, I will focus on using MLD to reduce inflammation, swelling, and pain, and also address secondary discomfort due to altered sleeping positions and reduced mobility. I often use myofascial massage and hot stones (as indicated) for the back and neck.  Our primary precaution in the early stage is to NOT introduce any shearing forces or to put any strain on the incision as it heals, so we will stick with these techniques for some weeks until you are healed enough for scar work, and contouring work.  We can start working with your scar around the 6-8 post-op timeframe, when your surgeon says it is okay.  Scar work helps remodel the scar tissue so it heals flat, remains pliable, and without any adhesions, fluid build up, or reduced mobility in the area.  Once your surgeon releases you for vigorous exercise, which may happen somewhere around 2-3 months post-op, we can begin to do contouring work in the abdominal area using massage and various myofascial techniques.   

Liposuction – For liposuction, I add myofascial massage to MLD in the very early stages of recovery.  One of the most common complications of liposuction is the potential for the development of fibrosis, which is a hardening of the tissues due inflammation and stagnant fluids accumulated in the lipo areas.  This can result in stiffness, limited range of motion, and hard, malformed lumps in the surgical areas – exactly the opposite of what is desired!  We will use MLD to effectively drain the fluids, and myofascial massage to keep the tissues soft and pliable, improve your range of motion, and for defining and contouring as you heal.

Fat Transfer (BBL, Hips, Breasts, Face) – Fat transfer is generally accompanied by liposuction to harvest fat for the transfer. Our most important precaution is to NOT apply pressure or shearing forces to the areas that received a fat graft until the fat has fully vascularized and developed a proper blood flow.  This can take a while, so we do not work directly on the fat transfer sites until later, but we do work work directly with the liposuction areas.  Lymphatic drainage is always part of the treatment to reduce overall inflammation, swelling, pain, and bruising in the body, which positively affects both the transfer sites and the lipo areas, along with myofascial work where liposuction was performed to prevent or treat fibrosis.  Meanwhile, we protect the transfer sites with proper bolstering and positioning on the table so they are not compressed or disturbed.

Face Lift – The normal lymphatic drainage pathways are impaired after a facelift, so there can be a lot of swelling in the face, neck, and  upper torso, as well as the usual pain, bruising, and inflammation. It is very important to manage the swelling to get the best outcomes and the aesthetics you are looking for by the end of your recovery period. I will mostly work to move the fluids through alternate lymphatic drainage pathways, as well as soothing massage in other areas to ease discomfort from altered sleep positions and stress. While swelling can take up to three months to fully subside, MLD can significantly expedite this process and enhance your comfort during recovery.

Breast Surgery – As usual, all sessions will be centered around MLD to help with your swelling, bruising, and pain, and working to prevent complications from developing, with other types of massage to help with discomfort in other areas of your body.  I will help you with your home self-care plan prescribed by your surgeon to make sure you know how to do it.  We’ll also work with your surgical scars starting 6-8 weeks post op (per your surgeon’s instruction) to ensure they heal optimally as well. Whether you’ve had implants placed or removed, a fat transfer, a reduction, or just a lift, I tailor each session to your individual healing process. 

Primary Benefits of Receiving Lymphatic Drainage after Your Surgery

Reduced Swelling and Bruising: By stimulating the lymphatic system, excess fluid and cellular waste products are removed from the surgical area more efficiently, leading to decreased swelling and bruising. This can help improve patient comfort and accelerate the healing process.  

Pain Management: Reduced swelling and inflammation can also alleviate pain and discomfort in the surgical area.  This is complemented by soothing massage for other sore areas, when appropriate.

Improved Scarring: Lymphatic drainage may help to minimize the appearance of scars by reducing inflammation and promoting the healthy regeneration of tissue.  I also work directly with your scar using myofascial techniques around weeks 6-8 post-op according to your surgeon’s permission.

Faster Recovery: By promoting efficient fluid removal and waste elimination, lymphatic drainage can help speed up the overall healing process, allowing patients to return to their daily activities sooner.  

Reduced Risk of Complications: By encouraging lymphatic flow, the risk of complications such as seromas (fluid build-up) and fibrosis (scar tissue formation) may be reduced.  

Enhanced Aesthetic Results: By minimizing swelling and promoting proper healing, lymphatic drainage can contribute to a more refined and natural-looking outcome.

Research

Excerpt from: The Utility of Lymphatic Massage in Cosmetic Procedures
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10045879/

In the case of cosmetic plastic surgery, the postoperative period is one of the most critical phases. General postoperative manual lymphatic massage recommendations consist of manual lymphatic massage 2 to 3 times per week during the initial 3 to 4 weeks of recovery to be performed by a certified lymphedema therapist or a licensed massage therapist who have undergone some degree of lymphedema training and are often certified to perform postoperative lymphatic drainage techniques. It is through postoperative care that the expected results are achieved. Rapidly reducing lymphostasis postoperatively may help improve early results and prevent late sequelae. In addition to fighting this accumulation of fluid, doing lymphatic drainage after plastic surgery may help in recovery, improving blood circulation, reducing pain, and facilitating healing. Fibrosis, an inflammatory process that causes hardening of the skin, is a common concern for those recovering from plastic surgery. Aesthetic procedures, especially liposuction, results in postoperative swelling that can take between 3 and 6 months for the body’s lymphatic system to resolve. Similar to skin pathophysiology of chronic lymphedema, fluid accumulation after liposuction can create hardened lumps and bumps of the skin. However, unlike lymphedema, these lumps and bumps can be fully resolved with MLD and compression garments; patients undergoing elective cosmetic procedures have healthy intact lymphatic systems, while lymphedema patients do not. Since the recovery process from plastic surgery can be a lengthy one, between 3 and 6 months, utilizing MLD therapy during the postoperative recovery phase, can be beneficial in supporting the lymphatic system in its role in reabsorption of fluid.