You may not give much thought to your lymphatic system but it’s our body’s second circulatory system and it plays an important role in supporting our immune system and treating inflammation. Our lymphatic system drains and cleans up all the tissues in our body and is especially important after physical trauma or surgery.
Lymph moves slowly through the body and can easily become congested by our modern lifestyle (heavy metals, environmental toxins, immune challenges, poor nutrition, food intolerances, leaky gut, lack of exercise, and dehydration are a few of the culprits).
Scars, surgeries, tight clothing, prolonged sitting or bedrest, and structural imbalances are also physical barriers restricting lymphatic drainage.
A congested lymphatic system can slow down or even complicate wound healing. A free flowing lymphatic system before, during, and after surgery helps reduce inflammation, swelling, lumpiness, seromas, and fibrosis and facilitates optimal healing.
When it comes to surgery recovery, Manual Lymphatic Drainage reduces pain, swelling, bruising and even fibrosis.
What is Manual Lymphatic Drainage?
Manual Lymphatic Drainage (MLD) is a gentle and incredibly soothing massage technique.
Used pre and post surgically, Manual Lymphatic Drainage can accelerate the healing process by helping swelling, debris, toxins, and waste to move into your lymphatic system where they can be effectively eliminated.
What Manual Lymphatic Drainage is NOT
MLD is not machines or gadgets and it is NOT opening your incisions to push lymph out. With MLD, I simply assist your lymphatic system in healing your body.
When is Manual Lymphatic Drainage used?
In my practice, I use MLD pre and post surgery, to address tissue inflammation and bruising, which in turn help reduce pain and fibrosis and can reduce healing time by weeks to months depending on the surgery. I also use MLD to facilitate healing after deep tissue work, to help with neurological conditions, to relieve fibromyalgia pain, to reduce the frequency of sinus issues and colds, to relieve arthritis inflammation and pain, and to help balance an overactive nervous system (it works amazing to calm anxiety of all types, including the post surgical emotional rollercoaster).
It’s ideal to begin treatment one to two weeks before surgery to ensure that your lymphatic system is as healthy and prepared for surgery as possible.
After surgery, your lymphatic system transports white blood cells to injured tissue and removes swelling and inflammation (including waste, toxins, necrotic tissue, debris, and other harmful substances).
Surgical procedures can disrupt and overwhelm the lymphatic system which can cause lymph fluid to accumulate. Excess lymph in or around surgical sites increases inflammation and swelling while actually inhibiting the healing process.
Manual Lymphatic Drainage helps transport immune cells to the surgical site and moves swelling to it’s proper lymphatic drainage areas, helping to ensure that waste from the surgical site is effectively removed.
Waste from the surgical site is then processed in the lymphatic system and ultimately eliminated through your colon and kidneys.
Post surgery treatment plans depend on the type of surgery you’re having, your overall health going into surgery, and your surgeon’s recommendation.
Manual Lymphatic Drainage can be helpful with all surgeries including but not limited to:
- Body contouring
- Liposuction / Lipo 360
- Brazilian Butt Lift – BBL
- Rhinoplasty and Blepharoplasty
- Mommy Makeover and Tummy Tuck
- Breast reconstruction, lift, and augmentation
- Orthopedic Surgeries
- Abdominal Surgeries and C-Sections
- Skin Surgeries
What should I expect with Manual Lymphatic Drainage?
The words massage and drainage don’t actually fit this treatment very well. The superficial lymphatic system lies just under the skin. To directly affect lymphatic fluid movement we use gentle skin stretching and rhythmic pumping in the direction of the appropriate nodes with pressure as light as the weight of a nickle. Anything stronger goes right through the lymphatic system and into the muscles.
The “drainage” is happening within the lymphatic system as we coax inflammation and debris into the appropriate nodes. I do NOT open your incisions and no additional external drainage happens during an MLD treatment once your drain ports are removed. Your body takes care of processing all the fluid that we direct to the lymph nodes.
Pre-surgical treatment involves preparing the lymphatic system for optimal healing through a full body lymphatic massage with focus on the surgical region. Post surgical treatment is tailored to your individual needs and focuses on the surgical region as well as supporting the regional nodes.
You can expect a completely relaxing and gentle yet profound treatment. Many people fall asleep. You’ll receive home care instruction to be able to support your healing in between visits.
Most surgeons recommend that post-op Manual Lymphatic Drainage begins 24 hours after surgery – others ask you to wait a week or two. This is a good question to ask at your pre-op appointment so we can schedule accordingly.
My office is located in a quiet building with very little foot traffic so you are unlikely to encounter anyone on the way to your appointments.
When should I schedule?
Please contact me to purchase and schedule your preliminary package as soon as you have your surgery date. I hate to turn anyone away but I am a busy therapist and can only guarantee you space on my calendar if you pre-book.
Most plastic surgeons recommend MLD after surgery but it makes a significant difference before the surgery as well. MLD help to filter waste and toxins, excess of fluid, viruses and bacteria which helps prepare the body for surgery.
How many sessions will I need?
The answer to that depends on the type of plastic surgery you received and how extensive it was. Most surgeons will recommend a series of 2-3 sessions per week for the first 1-4 weeks.
For liposuction, where the damage to the lymphatic system from the cannula is more extensive, it may be necessary to follow a professional and home treatment plan for several weeks to a few months post-surgery to fully re-establish healthy lymphatic flow.
In reality, you should plan for 2 pre-op sessions prior to surgery, 2 sessions a week during weeks 1-4, and then one session a week ongoing based on your surgery and your individual healing response.
I’m more than a few weeks past surgery and have some concerns about lumps and bumps and scarring.
One of the primary goals of early MLD treatment is to assist the body in healing which helps prevent seromas and fibrosis and reduces scarring.
Both seromas and fibrosis need to be treated as soon as you notice them, the longer you wait the more difficult (but not impossible) they are to treat. First and foremost, please check with your Doctor about any concerns you have.
Manual lymphatic drainage is the most recommended treatment by surgeons to prevent and drain seromas without a medical intervention. The fluid inside the seroma will be “drained” manually and taken care of by your lymphatic system.
Some seromas can encapsulate and/or become infected and require medical intervention. Again, please check with your surgeon if you have any concerns.
Fibrosis usually feels like hard lumps, usually in the area lipo was performed. Fibrosis is common but abnormal healing involving the overproduction of connective tissue. Fibrosis results in scarring in bands and can be painful and limit movement.
To avoid fibrosis development it’s very important to start your post-op Manual Lymphatic Drainage Therapy as soon as possible, to wear your compression garment around the clock, and to have the right compression to prevent the accumulation of fluid.
If you didn’t receive MLD immediately after surgery, don’t despair. Our bodies have an amazing ability to heal with the right assistance.
In addition to being an Advanced Lymphatic Drainage Practitioner, I’m also Certified in the Arvigo Techniques of Maya Abdominal Therapy. I was trained directly by Dr. Rosita Arvigo in the US and Belize. I’ve successfully helped many clients with abdominal adhesions, fibrosis, and range of motion limiting scarring over the years.
What’s my investment?
To ensure your place on my schedule, post surgical MLD treatment is available in an initial package of 6 treatments for $547. Additional treatments can be added on individually or as discounted packages based on your personalized treatment plan.
You’ve come this far, you’ve done your research on surgery and your due diligence in choosing your surgeon, I encourage you to put the same level of preparation and care into your recovery and healing.
I look forward to partnering with you on your healing journey.
References and further reading about MLD and surgical recovery:
- Bruising reduction. Cells transported by the lymph system are moved away 10 times faster with MLD. Bruises heal in a fraction of the time, allowing clients the ability to resume activities of daily living, without having to wear sunglasses for months to hide bruises.
- Edema reduction. MLD reroutes lymph fluid to collateral and viable pathways untouched by surgery to allow for accelerated drainage, as opposed to the slow trickle of tissue fluids in the operative site.
- Pain management. As pressure of lymph fluid decreases around nerves, pain and discomfort are relieved and require less pain medication.
- Scar-tissue prevention and fibrosis reduction. Lymph fluid left to build up below incisions or sitting in interstitial space can solidify, causing the formation of scar tissue and fibrotic tissue. These tissues are often felt as ball-like substances below the skin surface. MLD prevents lymph fluid build up and solidification, for a seamless scar.
- Infection prevention. Postsurgical MLD is important when considering that stagnating lymph fluid can become infectious material and warrant artificial drain insertion—which is painful, costly and time consuming.
2. “Patients who do not undergo postoperative decongestive therapy have a predictable and
consistent postoperative course. Patients experience postoperative edema which peaks 2-4 days
following surgery and is followed by soft tissue fibrosis of the operated area by day 14-42. The
extent of the edema and fibrosis depend on the following variables: 1) the operated location
(dependent areas swell more), 2) the patients activity level 3) fluid retention 4) previous surgery
on the same area. We see complete resolution of postoperative edema and fibrosis in this group
between 9 months to 18 months following surgery. In the ten groups listed above who underwent
MLC and Deep Tissue Massage, postoperative swelling and fibrosis resolved within 6 weeks to
3 months, thereby shortening recovery significantly.” https://www.michellerankin.com/wp-content/uploads/2022/10/Research-Manual-Lymphatic-Drainage-An-integral-Component-of-Postoperative-Care.pdf
3. “A significant group effect was observed for active knee flexion, with post hoc tests demonstrating a significantly greater active knee flexion in the MLD group when compared with the control (no MLD) group at the final measure prior to hospital discharge (day 4 postsurgery) and at 6 weeks postsurgery.” https://pubmed.ncbi.nlm.nih.gov/23810354/
4. “Eighteen women aged between 18 and 60 years participated in this study, in the late PO period following lipoabdominoplasty or liposuction in the abdomen, flanks and lower trunk, which showed tissue fibrosis of the flanks and abdomen regions. They were divided into two groups: Liposuction group and lipoabdominoplasty group. A total of twelve sessions of therapeutic ultrasound followed by the Manual Lymphatic Drainage were performed. The patients were assessed with regard to pain, oedema and tissue fibrosis in different moments: Initial assessment, during assessment and final assessment through the application of the protocol of evaluation of cysts fibrosis levels. There was a statistically significant reduction of pain, swelling and tissue fibrosis in both groups [With MLD and Ultrasound].” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4075221/
9. Comparison of Manual Lymph Drainage Therapy and Connective Tissue Massage inWomen With Fibromyalgia: A Randomized Controlled Trial https://www.sciencedirect.com/science/article/abs/pii/S0161475408003527
10. Facelift and Patterns of Lymphatic Drainage: https://academic.oup.com/asj/article/32/1/39/210354
11. Compilation of resources: https://www.sciencedirect.com/topics/medicine-and-dentistry/manual-lymphatic-drainage