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Post op Massage frequently asked questions

One of the biggest mistakes that people make with cosmetic surgeries is not planning enough recovery time, nor investigating the best methods for enhancing recovery. Lymphatic drainage is becoming essential both before surgery and after.  Many patients experience pain, swelling, sleep disturbances and bruises after surgery and have few options to handle these uncomfortable symptoms.  Without proper support, healing can be limited, and recovery can take much longer than anticipated.   
Lymphatic drainage vessels can be cut and damaged during surgery which lead to reduced healing, the appearance of scar tissue and uneven skin texture.  Decongestion of the lymphatic system is essential to bring back normal texture, definition and tone of skin.  Numerous studies have shown the benefits for: - liposuction  - breast augmentation or breast reduction  - breast reconstruction  - facelifts  - forehead lift, brow lift  - blepharoplasty (eyelid surgery)  - abdominoplasty (tummy tuck)  - fat injections (e.g. Brazilian butt lift) 
Lymph drainage around the areas of liposuction and other plastic-surgery treatments greatly facilitates healing, helps to smoothen areas and eliminate lumps and indentations, contouring the skin so that your procedure is less noticeable over time.  It also helps with normal movement of the skin and reduction of scarring.  In Europe and South America, surgeons have been prescribing lymphatic drainage on a pre- and post-operative basis for decades, and the treatment has been established as standard practice. In the US, the benefits of the treatments are only now being fully appreciated. 
Typically, plastic surgeons recommend that their patients receive anywhere from 2 to 3 sessions per week for up to one month following their surgery (10-20 sessions). In South America, it’s not uncommon to receive this essential therapy even more often which may explain the incredible results cosmetic surgeons are famous for in those countries. 
Lymphatic Drainage can even be extremely beneficial to an upcoming plastic surgery procedure. You should have your treatment 24 to 48 hours before surgery. This treatment will help prepare your body’s immune system for the surgery, helping to fortify it against the upcoming trauma. 

Lymphatic Massage is NOT a Traditional Massage

Contrary to what you might think, lymphatic massage is not a traditional massage like deep tissue, Swedish massage, or hot stone. It is a specific technique that is both specialized and advanced. Additionally, it should never hurt. I constantly have clients ask me if the massage will be painful—because the image of draining fluids from your lymphatic system doesn’t invoke scenes of serenity. However, it is actually quite pleasant and relaxing.

During the massage, I use gentle rotating, and pumping motions to gently move lymph fluid through your body. Sometimes I incorporate gentle vacu-therapy or massage cupping for additional post-surgical support when indicated. I never use heat with my massage technique, as that can increase edema in the surgical area. Also, never receive a deep tissue or therapeutic massage in place of a lymphatic massage—the results will not be the same.

The Number of Treatments You Require Depends on Your Surgery

Another common question is how many post-surgery massage treatments do I need? Typically, I recommend at least one or two treatments before your surgery. After surgery, that number changes based on the type of surgery you had. Some people benefit from 4-6 treatments, while others might require up to 10-12 depending on the number of surgical areas and how the body is recovering. In rare cases, I recommend more than 12 post-surgery sessions in consecutive order. However, general lymphatic massage is good practice whether you’ve had surgery or not.

Support Your Lymphatic Massage Post-Op with These Tips

Drink plenty of fluids.

I can never stress this enough. Drink plenty of clean, mineral-rich water before and after your massage for the best results.

-Eat a healthy diet.

Nutrient-dense foods also support your body from the inside out. Grab fruits and vegetables (especially those on my top lymphatic friendly foods list) and chow down before your surgery.

-Don’t stay on the couch or in the bed.

After your surgery, and more importantly after your massage, it’s tempting to stay in bed or on the couch, but you actually need to move. Movement, such as walking, helps pump the lymph fluid and is supportive to your healing process. If you feel tired after your session, then honor your body by resting, but remember to incorporate some type of movement that is comfortable for you at the different stages of your healing process.  And, of course, always follow your Doctor’s direction.

Above all, remember that other types of massage can hinder your healing process. It’s critical that you hire a certified lymphatic therapist to administer your lymphatic massage. Make sure they have experience aswell. Check their certifications and reviews, or you can just choose to book an appointment with me!


Post-op recovery is not a fun process, whichever way you spin it. But it can be made quicker.

See, the big part of the recovery process is about waiting until the swelling goes away.

Whether it’s eyelid surgery or liposuction, some post-op swelling is always expected as part of the healing process. 

atic massage is the prime choice when it comes to reducing swelling, as it removes the fluid build-ups lying under your skin.

But that is not the only reason why you should be concerned.

These fluid build-ups, if untreated, eventually can cause your skin to harden, and for swelling and bruising to happen.

Otherwise known as fibrosis, it is considered one of the main complications after plastic surgery.

While it is definitely not a very common side effect, nor a particularly dangerous one, it can be unpleasant and very unaesthetic, causing pain and visible scars near the surgical site.

Since it unblocks your lymphatic system, lymphatic massage can help you kill two birds with one stone:

  • Speed up your recovery by detoxicating your body and reducing swelling

  • Avoid very unpleasant and unappealing complications by removing fluid buildups


Lymphatic massage is extremely helpful after:

  • Liposuction

  • BBL procedures

  • Tummy tuck

  • Facelift and necklift

  • Rhinoplasty

  • Breast augmentation and reduction

































Q: Is it possible to do lymphatic massage at home by yourself? 

A: At this point, you might be fairly certain that lymphatic massage is a good thing. Perhaps you even think it might be worth trying doing it at home, by yourself.

While, technically, it is possible, I do not recommend it.

Not because we don’t believe you can—because you might not feel the same effect afterwards. And, while it’s not a required procedure by any means, it does play an important role in any patient’s post-op recovery.

Performing a proper lymphatic drainage manually requires:

  • Knowledge of the lymphatic system (knowing the key ‘clutter points’ and ‘exit pathways’)

  • Understanding of the underlying post-op tissue and fluid build-ups (in order to remove them)

  • Expertise with the massage itself (applying the right amount of pressure at the right places might simply be impossible without a physician’s help)


So, again, just to be clear: I do not think that you’re not capable of performing a lymphatic massage.

But since it does require knowledge and expertise, it is difficult to perform all of the steps optimally, which can ruin the entire outcome. It is effective for facial, abdomen, thigh and other post-op treatment areas.

I do mean it when we say that manual lymphatic drainage is extremely important in post-op recovery, and the best thing you can do is to leave it to people who do it for a living.

Besides, it can get really boring doing this by yourself.



Q: Why do I need Lymph Drainage Therapy after my liposuction, Smart-lipo, Cool Sculpting or other cosmetic surgery procedure?

A: You many notice a hardness or lumpiness to the areas treated with liposuction Smart-lipo, or Cool Sculpting especially in the abdominal area and even more so if combined with other body contouring procedures (such as fat injections for what is popularly known as the Brazilian Butt Lift) This is normal right after your procedure. This post-surgical lymphedema is caused by inflammation and trauma from the cannula (instrument that sucks out the fat) moving under the skin. Channels are formed by the cannula that can fill up with fluid and the tissue also becomes swollen. Manual Lymph Massage helps to move the fluid by gently pumping it back into the lymph vessels. Reducing the swelling can reduce discomfort. Without Lymph Massage (LDT or MLD) the inflammation can evolve into fibrosis (a permanent hardening of the tissue) or a seroma ( pocket of serum) can form. Many doctors prescribe Lymph Drainage Therapy after liposuction or other plastic surgery procedures to make sure their patients get the best possible results from their procedure. 

Q: Is Lymph Drainage Therapy a deep massage?
A:  No, although it may seem that deep massage would assist in decreasing the hardness following liposuction, it would actually increase the circulation to the treated areas making it harder to evacuate the lymph fluid. Even though MLD is extremely light work, it is the most efficient way to reduce swelling and bruising. It is based on scientific knowledge of the anatomy and physiology of the Lymphatic System. It is a myth that deep massage and heat are beneficial in healing after liposuction. The Vodder Method and the Chikly Technique are widely accepted forms of Lymph Drainage Therapy performed in hospitals and clinics all over the world. So, even though it may seem to you that a deep massage or other forms of therapeutic or Swedish massage would be helpful, it is not.

Q: Does MLD help get rid of bruising?
A: Yes. That is one of the best applications of MLD. Bruises are an accumulation of cellular debris and old red blood cells in the tissue. Lymph Drainage Therapy greatly reduces healing time for bruises by cleansing the extracellular spaces where these substances are trapped. 

Q: Is Lymph Drainage Massage Painful?
A: Performed properly it is not painful. The Vodder Technique is the most respected method of Manual Lymph Drainage (MLD) over the world. It is NOT traditional massage. It is a specialized, advanced bodywork modality that uses a gentle, rotating, pumping motion that moves the lymph fluid without increasing the blood circulation. Increasing the blood circulation with deep massage and heat can actually inhibit the movement of lymph fluid by changing the permeability of the lymph and blood vessels. Do NOT receive a general therapeutic, deep tissue or Swedish Massage in lieu of MLD.






Q: How many treatments will I need?
A: It is ideal to receive at least one or two MLD treatments prior to a procedure. There are many different things that can influence healing. Some patients get 1-6 treatments post-operatively and that is enough, especially if the only area of liposuction was the legs, knees, or flanks. People getting liposuction to the abdomen often find they require up to 12 sessions. Occassionally a client will need more than 12, especially if they had "Smart-lipo". Also, patients who get multiple procedures at the same time (lipo and a tummy tuck, or lipo and a buttock enhancement; Brazilian Butt Lift) may need more sessions than someone who only gets one procedure.





Q: What is an MLD treatment like?
A: After an initial consultation,   you will undress, lie down on a massage table in the face-up position, covered modestly with a sheet. The atmosphere is the same as a massage treatment room with dim lighting and soft music. Although you are in a massage setting, it is important to understand that MLD is a specific form of bodywork designed to efficiently move lymph fluid in your body. MLD is completely different from a deep tissue, Swedish or relaxation massage that you may be expecting or have had in the past. Stimulation of the Lymphatic System activates the para-sympathetic nervous system producing an automatic physiological relaxation response. Many clients fall asleep. Only the area being worked on is undraped at any time. Gentle, rotating, pumping motions with the therapist's hands and fingertips begin at the collarbone area, then focus on areas where there is a concentration of lymph nodes...the underarms, abdomen, groin and back of the knees. Usually the entire session is performed with you lying in the face-up position because all of the areas of lymph nodes that need to be decongested are located on the front of the body, although some surgeries do require the patient to turn side to side or face down for a short time if tolerated.  Starting on the back (even for fat injections to the buttocks) would not be indicated because it is necessary to open up the major lymphatic areas on the front of your body before the backside of the body can drain. It is very important to decongest the areas of drainage in the groin, abdomen, underarms and collarbone areas before sending extra lymph fluid to them. Directing lymph fluid to nodal areas without opening the lymph nodes up first increases the discomfort and overwhelms the nodes, leading to increased recovery time. Each session is 30 minutes to an one hour.



Q: How often is MLD applied?
A: The first week it is suggested that sessions be daily, every other day, or 2x a week if possible. The second week, every other day or 2 x a week reducing in frequency after that. It is not possible to get too much MLD and the sessions can be scheduled at your convenience.




Q: How soon after my procedure can MLD begin?
A: It is possible to begin within 24 hours. Most people wait until they can comfortably drive themselves to appointments



Q: Does Lymphatic Massage Does Not Force Fluid Out Of Surgical Incisions?

A. I'm  not even sure when this became a thing, but the popularity of what I call “Lymphatic Evacuation” is insane on Instagram right now. In cosmetic surgery recovery homes and med-spas across the country, massage therapists are using extreme measures to relieve fluid pressure in the body by forcing it out—literally out—through incision sites, in some cases opening up closed incisions to do so. 

I understand the appeal of this technique, I really do. When you’re swollen and can barely move, you tend to prefer dramatic action in order to feel normal again as quickly as possible, and Lymphatic Evacuation is as dramatic as it gets. The excess fluid bypasses the lymphatic capillaries, lymph nodes, and kidneys altogether and escapes through a hole. But there is one big, glaring problem with this method, especially when done outside of a medical facility by those who are not licensed nurses or medical professionals: risk of infection. Speaking of infection I DO NOT remove drains or stitches it is not within my scope or practice and should be removed by your physician. 


“Lymphatic Drainage, a.k.a. Lymphatic Massage is a very gentle technique, using a light touch. It most definitely does not involve opening an incision to squeeze fluid out, or squeezing so hard that it pops open an incision.
Run away from anyone suggesting that!”

— Dr. T Fiala, Fiala Aesthetics


Q: Is Lymphatic Massage Is Not An Ultrasound Treatment

A: NO, Search “lymphatic drainage massage after lipo” on YouTube and among the top ten results, you’ll find at least two videos showing the above procedure. However, this is not Lymphatic Massage, it’s Ultrasonic Cavitation—a treatment that employs a surgical device using low-frequency sound waves to vibrate fat cells, liquefy them, and flush them out through the circulatory system.

While some physicians encourage the use of Ultrasonic Cavitation after surgery, others find it ineffective at best. According to a summary of doctor’s responses to the effectiveness of this treatment posted on

Yes the machines work, but the results are nothing like liposuction. …With a machine the fat removal is the same in all areas so it is a more of a general reduction of fat and not a specific removal.

If you have 3-5 inches of waist that you want to reduce, your best option is more traditional fat removal, such as liposuction. Non invasive machines, even the FDA approved ones, are pretty subtle when it comes to results in the mirror.”


Thus, while Ultrasonic Cavitation may be what you’re looking for, it is still not Lymphatic Massage.

With all the misinformation out there, it’s important to know the difference between these different treatments and the risks involved with each. If you’re not sure which of these procedures your chosen massage clinic if offering under the guise of “Lymphatic Massage”, please be sure to ask what you can expect—are there machines involved? Do they use a light or heavy touch? Will fluid be pushed out through your incisions? Make sure you know the answer to these questions, and if you don’t like the answer you receive, keep shopping until you find someone offering true Lymphatic Drainage Massage Therapy.

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