Post-Op Manual Lymphatic Drainage Information

I typically see 3 – 6 post-op clients per day. ‘Post-op’ as in those who have had surgical procedures such as Lipo, Mommy Makeovers, Tummy tucks, Breast augmentation, and BBL’s, in various combinations. First time appointments are longer, as I go over the same information with each new client.


I made a video going over most of what I share verbally – but it’s 17 minutes long! I’m wordy, I know. I thought I’d put that info out in print, in case you prefer reading instead of watching a lengthy video.





Massage in Recovery Houses and Surgical Centers vs. Manual Lymphatic Drainage

I hear horror stories from women who have gotten ‘massages’ within their surgery centers or recovery houses: Shear torture, agony, tears, fainting, crying, rushed, no empathy, etc.

Let me assure you right now – Manual Lymphatic Drainage is NOT painful and is NOT what you would typically find in the locations mentioned above. It is light, superficial, rhythmic, relaxing, and unless you are a chatty-Kathy, many of my clients are so comfortable they sleep through their treatments!


Furthermore, the ‘massages’ performed often entail pushing fluid to an external drain. I ask, why do this when your body has its own system built in for alleviating and eliminating excess fluid? I know many women hesitate booking the much-needed and highly beneficial post-operative sessions because they fear paying someone to inflict pain on them. I get it! I’ve had first time clients take pain medication in dreaded anticipation of pain.


I hope you are relieved to read the information I’m about to share, and not skimp on treatment that really is a vital part of your recovery process.


But…before I go on, I want to say a few words about incisional draining. Unless performed under Dr’s orders/supervision in a sterile setting – it is both ILLEGAL and DANGEROUS. Anyone, other than a nurse working within a medical facility or Dr., who opens your incisions back up for the purposes of draining fluid is 1) breaking the law, and 2) endangering you. Your body sealed your wound for a reason; to prevent outside invaders from endangering your life, and to prevent infection.


What is Manual Lymphatic Drainage? Or MLD?

My explanation is pretty simple. MLD is the manual manipulation of a system already a part of your body design. We manipulate it to turn it on, and make it work more efficiently, for the purposes of, in this case, helping you to heal faster, be more comfortable during the healing process, and to have a second set of eyes and hands on your healing tissue. A trained therapist looks for the development of fibrotic tissue, seroma’s, and even infection, which can all occur post-op.


Fibrotic tissue is the development of cells that bond together during the healing process that causes lumps and bumps under your skin. It often forms because of wrinkles and creases in compression garments. If found quickly, and addressed, the ‘scar tissue’ is easily broken up and your body absorbs the cells.


Seroma’s are pockets of fluid that form outside of the lymphatic system. Sometimes MLD can have a positive effect on them, but sometimes it requires a trip back to your Dr., where they can apply a topical numbing agent, and remove the excess fluid with a syringe.


Infection is self-explanatory.


I see fibrotic tissue development in over 50% of my client base. It is very common and if left untreated, it will become permanent scar tissue. Seroma’s are less likely, and I rarely have had a client to experience infection, but the rare case does happen.


How exactly does MLD work?

The lymphatic system is closely tied to both the cardiovascular system AND your immune system. Looking at the cardiovascular system, you have your heart, blood, veins and arteries. Blood circulates around your body because the heart pumps it. The Lymphatic system is also all over your body, however, it has no pump. The only way lymph fluid moves through your body is through muscle contractions, or, if you come to see someone like me who manually moves it.


Within the lymphatic system itself, your body is divided up into quadrants. You are separated down the mid-line from left to right. You are separated at the belly button from top to bottom. Everything from the right mid-line over, and belly button up, is ‘pushed’ to the right axillary area. Push is not a pressure term – it is a directional term. Everything from the belly button down and from your legs up, fluid is pushed into the inguinal area of your body. Your abdomen, axillary area, and inguinal area, have a large concentration of lymph nodes. We push the fluid to the node bed found in the quadrant, and then the nodes filter out the fluid for toxins and cellular debris, and then your body eliminates the waste and extra fluid. Typically, ALL quadrants are cleared in post-op work.


As I said above, the drainage itself is light, superficial, rhythmic, and relaxing. Putting a lot of pressure on the skin would have the same effect as stepping on a garden hose – you block the flow of fluid.


How does the elimination part work?

The body has a few choices for elimination. First would be through sweat. Hopefully, post-op, you are not doing anything that would work up a sweat. But after an MLD session, you can break out into a sweat just sitting around doing nothing. The other options your body has for elimination would be through your bowels and urine output. Many people experience looser stools after a session, and you most definitely would expect to see an increase in urine output for 24 – 72 hours after a session. The closer you are to your surgery date, you could expect your urine to be dark yellow, or even orange, and potentially have flecks of old blood. This is very normal. Remember, your body is eliminating waste. Any bright red blood in either your stool OR your urine would prompt an immediate call to your Dr. This is NOT normal. Furthermore, even the smell of your urine can change.


How will I feel after a session?

Most clients get off the table in less pain and more comfortable and looser feeling in their skin. For many, this ‘better’ feeling just continues. For some people, while they physically feel better, they can also feel a little sluggish, or wash-out post session. My hypothesis on this is that those folks are under a bigger toxic load. The work we do doesn’t differentiate between toxins that were already there, and new stuff from your surgery. IF you are someone with a greater toxic load, just know that it gets better with each session.


How often or how soon post-op should I get MLD?

Unless your Dr. has given you specific instructions on how many sessions they want you to have, I typically see my clients twice per week for 4 – 6 weeks post-op. I can start working on you the day after surgery. If you have an external drain, I can work around that. But I do NOT push fluid to that external drain. The time frame on how many sessions you need can vary based on several factors: 1) how healthy you were going into surgery, 2) what procedures you had done, and 3) how well you follow healthy post-op protocols.


My clients travel all over the world for their procedures. Each Dr., has different post-op directions. It boggles my mind that there is no ‘standard’. I can tell you that I’ve had Dr’s. call me totally amazed at what they’ve seen MLD can do for their patients, and compare the quickness of recovery from those that get MLD vs. those that do not and converted them into avid advocates of MLD. My opinion, gained from education and years of hands-on experience: This is part of the process that you do not want to skimp on. After spending your hard-earned money to get the body you want, why jeopardize the results. MLD WILL help you to heal faster, more comfortably, with better results.


A word on garments.

Compression garments are your friend, your abrasive friend who keeps you company, and occasionally rubs you the wrong way, but that you know you need in your life. They should be thought of as your contouring tool. Your new body will form to the garment, so it needs to fit appropriately. While I do not fit clients, I know your garment needs to be tight, to the point of being almost uncomfortable. Generally speaking, if you can fit your finger between your skin and your garment, it is too loose.


If you garment gets wrinkles or folds in it, you new body will mold to those irregularities. This is the greatest cause of fibrotic tissue development.


What can I do to speed healing?

These are the following tips for the best post-op self-care I give to ALL of my clients.

1) Drink at LEAST a gallon of water per day. It may seem counter-productive if we are trying to eliminate excess fluid to drink more water, but it is vital to a good recovery. The new cells need the hydration, and it helps with the elimination process.

2) Eat healthy nutritious foods, from all the food groups! Your body is forming new cells, and those cells are being formed by the foods you eat. It is true that WE ARE WHAT WE EAT. Try to avoid processed or junk food! You’ll be scheduling more lipo before you know if you don’t! I encourage all of my clients to eat fresh pineapple and watermelon. Both are hydrating fruits, with fiber, but pineapple is especially helpful as it has an enzyme in it called Bromelain that is an anti-inflammatory. Yes, you can get Bromelain supplements, but your body will always do better with a nutrient that comes directly from a food source over a supplement.

3) Wear your garments appropriately.

4) Get off your pain meds! Pain medication slows down healing and will encourage constipation which will make you feel more bloated and swollen than you already feel. Use whatever over-the-counter medication your Dr. suggested, like Advil or Tylenol.

5) Move your Body! Remember above when I said that lymph fluid moves with muscle contractions? If you are sedentary, fluid will pool. The sooner you are up moving around the faster you will feel better.

6) Get rest. You have put your body through trauma, albeit controlled trauma. You need to give your body time to heal. There needs to be a proper respect given to both keeping your body moving, without overdoing it, and allowing for it to rest. If you do not give your body the time it needs for recovery, the recovery process will take longer. I’ve seen it! Many times. Make proper plans for returning to work, post-op. Your body will be healing and changing for 4 – 6 months post-op. Have realistic expectations.


Post-op MLD sessions with me are typically more than an hour and less than 90 minutes. It varies based on how well you’re following self-care protocols, and the procedures you had done, and if and how many complications (fibrotic tissue) we need to work out. For those who have had tummy tucks or breast augmentation, I also do scar work – or work to help you have the prettiest smoothest least visible scar possible. Bottom line, we work until we are done.


I hope you found this helpful. To book a first appointment with me requires a phone call: 412-328-4540

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