Most clients can safely receive manual lymphatic drainage (MLD) around 72 hours after surgery, or when incisions have have closed. This of course is also dependent on being cleared by your surgeon to receive this work. With this said, if you are a few weeks out from surgery and have just found out about MLD, it's not too late to begin. If you are experiencing discomfort due to swelling, lymphatic drainage can help at any stage.

This is a question not easily answered. This depends on a number of factors, including: what type or procedure(s) you had, your lifestyle, your age, your health history, how you are eating and hydrating during healing, how well your compression garments are fitting, etc. In general, most clients benefit from coming at least 2 times per week in the first and second week after surgery. As you heal and progress, and swelling or firmness starts to reduce, often times we begin to schedule one session per week for about 4 to 6 weeks. By around the 6 to 8 week mark, we typically begin to stretch this time out a bit further to one session every 1 & 1/2 to 2 weeks until you are a full 12 weeks out from surgery. Most of your active healing takes place in the first 3 months, so it's most beneficial to receive Manual Lymphatic Drainage during that window. A quick note here: the more procedures that you have at once, for example, a "Mommy Makeover" the more sessions you might need. You will also likely need to do perhaps 3 sessions per week for the first couple of week. Your body is working hard to heal several areas at once and sometimes it can take a while to get swelling to a more comfortable level. Additionally, as you reach 8 to 12 weeks I am also monitoring your incisions and the quality of the tissue and scar tissue around it to insure things are healing optimally and as smoothly as possible.

Manual Lymphatic Drainage has been around since the 1800's, but has only become recognized in the last couple of decades. And it has only really been publicly recognized as a tool to help with post-operative healing within the last few years. In the 1800's it was impossible to prove the effects of MLD, much less be able to prove that lymphatic vessels actually existed. Lymphatic vessels are tiny (the width of a hair) and lay very superficially along the surface of the skin.

It wasn't until recent medical advances allowed us to visually SEE lymphatic vessels. Therefore, many surgeons were taught a very minimal amount about how lymphatic drainage can assist in post-operative healing and with swelling. However, some surgeons are catching on and are choosing to learn more about how Manual Lymphatic Drainage can help their patients recover.

Massage therapists have been practicing Manual Lymphatic Drainage for a while, but it hasn't been popularized until recently. Most of the reason that MLD has been becoming more popular is because more people have been sharing information on social media. If your surgeon didn't discuss lymphatic drainage with you, it may be because they haven't had a chance to explore how it can help. Surgeons' opinions, experience, and protocols can vary quite a bit. If you aren't sure where your surgeon stands, check with your surgeon's office to see if they recommend it for your specific procedure.

No. If you receive an actual Manual Lymphatic Drainage session from an educated and seasoned practitioner, it should not hurt. - It's a very light, gentle, but effective modality. If it hurts, they are either doing something wrong, OR the practitioner was actually doing what we call "Incisional Drainage." Many surgeons offices and practices in and around Miami (and in Latin American countries) have practitioners that practice a modality that pushes out fluid (a mixture of blood, lymph, and sometimes tumescent fluid) out of open incisions. Often the pressure is heavy, and patients/clients often report that they were in an intense amount of pain during these treatments. While I will not disparage another modality or practice, it is not something that I would personally recommend to clients as the body is already in a state in which there is a lot of inflammation occurring. Unless you are someone who is looking for dramatic results (i.e.- you want to look like a Kardashian or IG influencer) I really feel like incisional drainage is a bit overkill. BUT, if your surgeon is insistent on it, my advice does not surpass that of your surgeon. However, if you've had a few sessions and then travelled home, just know that your local MLD therapist will likely not be doing the same, although this can depend on state regulations. As a licensed massage therapist in the state of North Carolina, I could not legally, intentionally push fluids out of your body, even if I did believe if it was of benefit. Make sure you thoroughly research and vet your post-op providers.

Manual Lymphatic Drainage is a light pressure touch modality. The massage therapist or practitioner focuses on priming the "terminus points" at the collar bone first get the lymphatic system to start working faster and more efficiently. Then moves on to priming/stimulating areas of the lymph nodes. And finally they start using light pumping motions on the surface of the skin to help guide lymphatic fluid back to the closest lymph nodes. Essentially, the lymphatic system can become overwhelmed after surgery; having a hard time re-regulating itself and the amount of swelling that occurs. MLD after surgery helps "remind" the body where this fluid is supposed to move (to the lymph nodes) and helps guide it there. This is particularly important when I comes to liposuction. - The lymphatic vessel are housed in the layers of tissue under the skin. When fat is removed, many of those vessel and lymphatic structures are also removed or damaged. Not to worry though, your body will re-grow new lymphatic vessels. But in the meantime, it needs assistance moving lymphatic fluid. Incisional Drainage is exactly what it sounds like. - A practitioner pushes fluid out of open incisions with their gloved hands. This usually occurs in the first few days after a surgery and is mostly common in and around Miami and in countries like Columbia and the Dominican Republic. Hence why it has become more common in Miami, as many folks from those countries have immigrated to the Miami area. This type of work is usually done with a good deal of pressure and most people find it quite uncomfortable and even painful. (And while they may be pushing out some lymphatic fluid, the rest of what is pushed out can be tumescent fluid and blood.) While I am personally not a fan of Incisional Drainage, some surgeons (especially in Miami, Dominican Republic, and Columbia) recommend it for their patients. My stance is that the body already undergoes a traumatic experience with surgery, and inflicting more pain on the body can sometimes hinder healing where the nervous system is concerned. It can also increase inflammation. While I will never tell any one not to receive this work, as I am not trained in it and it is illegal for massage therapists in my state to intentionally work with a wound, I WILL implicitly recommend that you never let anyone re-open your incisions to push fluid out. - This practice increases the chance of infection and also can cause more noticeable scaring. Logistically there is no other surgery that I can think of where it is common practice for incisions to be reopened afterward. If someone suggested you do this after an appendectomy, you'd think they were crazy. So why should we suggest this with cosmetic surgeries?? And finally - Body Contouring is again, a modality that can be done using a practitioner's hands, button also incorporate machines and other tools. This is something that can be done on it's own - meaning you could get body contouring on it's own. But most people are curious about exploring it as an adjunct to their cosmetic surgery in order to fine tune their results. Typically I tell clients to avoid body contouring until after the 3 month healing period after surgery. This is because some of the work can be a bit more aggressive and you already are experiencing inflammation during the 3 months after your surgery. And you definitely don't want to you go using wood tools aggressively while you're still swollen and tender. Ouch! With each of these modalities, ALWAYS look into any practitioner you are interested in working with. - Check their training and credentials. Look for photos of their spaces to make sure that they maintain cleanliness and disinfect their space between clients (particularly if they do incisional drainage.) And look to see if there are testimonials from previous clients.

No. I do not drain seromas via needle aspiration. Nor do I remove drains. In the state of NC, only certain licensed medical providers can do so. It would be illegal and outside of my scope of practice to offer this. However, some surgeons whose clients I see often will first send a client with a seroma to me before trying to needle aspirate - as a conservative measure. Their goal is to try and get the patient's body to drain this pocket of fluid on its own. Sometimes that happens. However, if there are no changes, the surgeon will opt to aspirate on the patient's next follow up appointment. This is usually not painful and is a quick and simple fix. If you have travelled for surgery and had to travel home before your drains were ready to be removed - ask your surgeon for suggestions. Typically you will be advised to contact an urgent care facility or go to an emergency room to have it removed. The majority of doctors are reluctant to remove drains that they have not themselves placed in a client for liability reasons. But the easiest thing you can do is get instructions from your surgeons office on how to remove the drains yourself. - It's not fun or comfortable, but not painful either. Most clients find it unsettling, but it it's quick and easy to do. But you will need a second person to help you do so.