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Cosmetic post Surgery Massage to improve drainage and swelling
Most surgeons advise patients have a course of manual lymphatic drainage (MLD) after surgery, the number of treatments will depend on the person and on the type of surgery they have.
Most surgeries will cause some degree of swelling and bruising. Cosmetic surgery such as liposuction is noted for post surgical swelling which can take many weeks to return to normal. The reason for this is that typically the procedure often uses moving micro-cannulas inserted into the subcutaneous layer of the skin that dislodge fat cells which are then vacuumed out of the body. During the procedure there is damage to small blood capillaries, lymph collectors and nerves.
The problem here is that the surgery causes more fluid to be produced but the mechanism of removal is now impaired leading to a prolonged swelling of the surgical area.
The good news is that the lymph collectors do grow back but this does take time, in the meantime the area will be compromised as fluid drainage from the area slows.
A short time after the procedure massage can carried out, especially if there are open drains. Here a relatively firm massage stroke is used to push lymph fluid and blood tinged aesthetic out of the drains. Compression garment(s) are used to apply some positive pressure to the area to help control the swelling and contour the area, these are often worn for up up 6 weeks post surgery.
Will massage during the recovery phase help reduce swelling?
It depends on the type of massage; sports massage and deep tissue massage will likely cause pain and its action will almost certainly cause more lymph fluids to be formed and therefore increase both swelling and recovery time.
MLD (manual lymphatic drainage) on the other hand is a very gentle light touch massage that is designed to work specifically to encourage lymph fluid to flow through a fairly complex network of specific pathways, if done incorrectly it can hinder rather than help. Again in the early days after liposuction or areas of other surgeries, drainage from the site is slow as lymph collectors are still re-growing but the gentle specific strokes still encourage lymph absorption especially in areas peripheral to the site. As more collectors establish MLD becomes even more effective and there is good evidence that it accelerates the speed of recovery.
It is common to experience a hardness in the tissues forming a few days or weeks after surgery either as discrete lumps or a large area that has hardened up. This is usually termed as fibrosis. Fibrosis develops for a number of reasons such as damage caused during the procedure, left over fat cells binding together as well as collagen fibres which also bind together. One advantage to starting MLD early it that it can help to slow down or prevent fibrosis as the massage strokes help to remove some of the fluid from the area.
Is there other effective alternatives to MLD?
MLD is said to be the gold star treatment, however MLD can be combined with DOT (Deep Oscillation Therapy). DOT sets up electrostatic attraction at different frequencies within the body of the client and can be adjusted to treat a number of different symptomologies. The client often feels gentle vibrations under the skin as the micro-tissues oscillate back and forth. These oscillations can reach to a depth of 8cm within the body and stimulate the smooth muscle fibres that surround the lymph vessels thereby making them pump lymph fluid faster towards the lymph nodes .
Why combine MLD with DOT?
1. The lymphatic system can be split into two areas; the superficial lymphatics that are just below the surface of the skin and the deep lymphatics much further down where the lymph from the skin regions eventually goes. Some modified MLD strokes are very effective at stimulating some of the deep lymph vessels and nodes, however for these strokes to affect the deep vessels much more pressure needs to be used. For someone recovering from abdominal liposuction it is very advantageous to stimulate the deeper lymph nodes just above the pubic bone and the cisterna chyli which runs in to the thoracic duct and is the a major route of lymph flow from the lower body. The issue here is that deep strokes pushing through the place of surgery would be very painful and inappropriate. DOT on the other hand will activate these areas at the same time as moving lymph from the surface which will effectively clear both areas and therefore will minimise any bottle necks along the lymphatic pathways.
2. Another side affect is tissue fibrosis where sometime after liposuction the tissue can start to harden, sometimes quite unevenly. Again MLD helps to reduce the fibrotic effect but by altering the frequency and intensity of the Deep Oscillator to target these hard areas the results may be progress quicker.
3. Very much related to fibrosis is scar tissue, many clients have an abdominoplasty (tummy tuck) or a breast liftas well as liposuction. These procedures will invariably cause some scarring. Because of its gentle but powerful application, DOT can be used a lot earlier on the scar tissue after surgery and therefore can lead to a better outcome much quicker.
Here is a link to the therapists map in UK and Ireland if you are trying to find a therapist in your local area:
More information about deep oscillation and Physiopod:
liposuction can benefit a lot of people, it can also be an expensive mistake.
Make sure you do your research before you make your final decision. The following paper from 2013 talks about unfavourable outcomes of liposuction:
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