Manual Lymphatic Drainage Massage after Liposuction and Plastic Surgery

Updated: Jul 20

"MLD is a specific massage technique which can be fundamental in helping a patient in the healing journey."



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MLD stands for Manual Lymphatic Drainage and it is a group of specialized massage techniques. MLD is used in post-surgical recovery to promote wound healing, support the immune system and improve the reabsorption of swelling and waste products (bruising, proteins, cellular debris) from the spaces between the cells in the tissues.


Liposuction and surgeries such as tummy tucks are very invasive and cause tissue damage by removing fat cells. These cells live in a network of blood vessels and lymphatic vessels held together within a fascial network of connective tissue. Removing fat causes damage to blood and lymphatic vessels that bring nutrients to the living adipose (fat) cells.

Liposuction causes swelling and tissue damage that needs to be managed to limit the chance of complications. These complications can vary from patient to patient but overall can result from the swelling in the surgical area becoming stagnant thus prolonging the healing process. Scar tissue may also take form which can adhere to underlying structures and cause pain, tightness, and/or numbness.

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  • Liposuction causes swelling and tissue damage that needs to be managed for best results.

  • Common side effects of liposuction:

  • Scarring

  • Prolonged swelling or swelling pockets

  • Fibrosis

  • Numbness

  • Feeling of tightness and restriction

  • Pain



Manual Lymphatic Drainage (MLD)


MLD stimulates fluid reabsorption and lymphatic transport in order to promote healing using a skilled understanding of the anatomy and physiology of the lymphatic system. MLD therapists who have advanced training and experience use MLD as the main part of their tool box. They also provide many other recommendations and techniques to help speed recovery and healing.


Recommendations:

  • Compression Therapy and Garments: correctly fitted and comfortable, your certified lymphedema therapist (CLT) may recommend using foam or other inserts to help maintain even pressure of compression and use other types of fibrosis pads to break down hardened tissue. A nice layering system may be -- tank top, foam, ab or liposuction board and then compression garment (Faja)

  • Exercise (when appropriately cleared by surgeon or physician): even a 20 minute walk can be very beneficial after surgery, even just light range of motion exercises can help move swelling especially when performing with compression on

  • Nutrition: Getting plenty of protein for healing, vitamins and minerals

  • Hydration: Drinking about 1/2 your body weight in ounces of water to help thin out fluids so they are able to move easier within your body

Examples of different techniques for scarring and swelling:


-Lymphatic Kinesiology Taping can be applied to enhance lymphatic drainage. It can be applied after MLD to reduce swelling and bruising. It also helps with complications such as seromas, fluid pockets and hematomas.

-Deep Oscillation is an electro-static therapy, which uses vibration to help stimulate movement from the lymph fluid and assist in healing.

-Silicone cupping and lymphatic cupping work as a negative pressure force to lift skin over hardened or fibrotic tissue to allow space for fluid and protein thickened swelling to break up and begin to drain

-Myofascial Release works on the connective tissues and is used to promote smooth scar tissue formation and deal with keloid and hypertrophic scarring. It also reduces tightness and stiffness which often occurs along the hips and side body after abdominal liposuction surgery.

-Heat or Cryotherapy: Heat is used generally to soften tissue and promote relaxation, cold or cryotherapy can help speed up manual therapy time when working on fibrosis.


It is the job of the lymphatic system to fight infection, reduce inflammation and clear the damaged area of swelling, bruising and residual toxins and promote wound healing. With so many jobs to do, the lymphatic system can be easily overwhelmed, as it is also damaged from the surgery. MLD and associated therapies enhance and support the natural function of the lymphatic system. This means it can work much more efficiently and does not get overwhelmed, lessening the chance of stubborn bruising, hardening of the tissues and uneven, lumpy results-especially following fat transfers and liposuction.

In certain cases, seromas (a collection of serous fluid) or haematomas (deep bruising) occur. MLD (supported with Deep Oscillation and Lymphatic kinesiology taping) can quickly and effectively manage these complications.


There are many advantages for using specialist post-surgical therapies including MLD.

  • The lymphatic system is supported to make patients heal substantially faster

  • Anaesthetics are evacuated from the system more quickly

  • The inflammatory phase of recovery is sped up

  • Wound healing is accelerated

  • Scar tissue is laid down evenly

  • Complications can be rectified

  • Smooth, even results are achieved

  • Results are attained more quickly

  • Patients can return to their daily lives much sooner

  • Therapists also can give psychological support through recovery

Treatments can start less than 24 hours after surgery with surgeon approval. Usually patients can be seen 2-3 x week for first few weeks, then 1x week for about 8 weeks after surgery. Then depending on the patient, they can be seen for follow ups as needed. Usually by 3 months the patient and therapist can see what the end results will look like.


"There is a MLD treatment for each part of the body, but again, every person is different so there is no exact routine.
The body drains lymphatic fluid in specific routes and directions. MLD follows these drainage pathways. MLD moves fluid from areas which are not draining, to areas which are draining freely."





https://www.surgery.org/media/news-releases/the-aesthetic-society-stats-reveal-americans-spent-over-9-billion-aesthetic-plastic-surgery-2020

https://www.bloomberg.com/news/articles/2021-04-27/u-s-plastic-surgeons-expect-boom-in-procedures-below-zoom-line

https://torontophysiotherapy.ca/patient-guide-manual-lymphatic-drainage-after-liposuction/

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