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 a 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 cannulas or micro-cannulas inserted under the skin (subcutaneous layer) that dislodge the fat cells which are then vacuumed out of the body. The procedure does cause a bit of micro damage within the subcutaneous layer, there is some damage to the small blood capillaries and also to the lymphatic collectors which are responsible for collecting the lymphatic fluid and routing it to lymph vessels and lymph nodes and eventually to rejoin the blood circulation.
The problem here of course it that more fluid is being 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 but in the meantime the area will be compromised as fluid drainage from the area slows.
A short time after the procedure massage is often carried out, especially if there are open drains. Here a relatively firm massage stroke is used to push lymph fluid and blood tinged anesthetic 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.
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. The depth of these oscillations can reach to a depth of 8cm within the body.
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 which is the a major route of lymph flow from the lower body. The issue is of course that deep strokes here pushing through the place of surgery would not be appropriate. 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 will be seen much 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: