At VISAGE, we believe firmly in lymphatic drainage as a way to help and speed up recovery after plastic surgery. All our patients are offered multiple sessions. We also see patients from other clinics for their post-operative treatment as only a few places in Toronto offer such a service.
Manual lymphatic drainage (MLD massage) was developed in the 1930’s by Emil and Estrid Vodder (the Vodder method) and is widely prescribed by physicians in Europe, Brazil, the United States and Canada.
There are many well established benefits of the Vodder Method.
- MLD Removes metabolic waste, excess water, toxins, bacteria, large protein molecules and foreign substances from the tissues.
- MLD, through its gentle rhythmical precise hand movements, alleviates pain by greatly reducing the pain signals sent to the brain.
- MLD relaxes the sympathetic nervous system, thus helping to relieve stress.
- MLD supports and enhances the action of the immune system.
- MLD helps the body to heal more quickly from surgical trauma.
- MLD helps to minimize scar formation by increasing blood.
Most of us know about arteries and veins running in our bodies. It just happens that when arteries become smaller and smaller, down to capillaries, some fluid returns to the heart directly via the veins but some fluids come out of the vessels (extravasation) and pour in the interstitium (i.e. surrounding tissues). This fluid is increased with surgery as part of the healing mechanism, bringing along cells, nutrients and proteins for the healing phase. That extra-vascular fluid is then slowly picked up by a third vessel system called the LYMPHATICS. Lymphatics carry the lymph. Lymph is a yellow liquid that can be thought of as the fluid in which some blood cells travel. Lymphatics are not easily visible during surgery and many get severed during each procedure we, plastic surgeons, perform. Lymphatics form a complex network of vessels which drains to nodes – the lymph nodes. We find many lymph nodes in the body, but there are larger and important groups such as the ones at the groin, axilla (underarm), and neck regions. Lymphatics are also important in fighting infection and in removing toxins. Interestingly, we have twice as many lymphatic vessels as we have blood vessels.
Most plastic surgery procedures also involve a certain amount of tissue bleeding and bruises. And many procedures involve liposuction and its tumescence solution where the plastic surgeon will infiltrate the tissues with a few liters of an adrenaline and local anesthetic-containing solution, adding to the amount of fluids in the soft tissues. Lymphatics also get severed during surgery. The more “injury” to an area, such as after a tummy tuck with liposuction, the more swelling and lymph in tissues. In some surgeries, such as abdominoplasty, where skin is elevated from underlying abdominal muscles, lymphatics must be cut and must re-establish continuity and grow together before they can remove the fluid from the area. If this does not happen fast enough and lymph hangs around, you have what is known as a seroma.
So it is now clearer why patients have the mandatory swelling post plastic surgery which one’s body will have to eliminate over a few weeks, sometimes over a few months:
- Arteriolar and capillary fluids
- Inflammatory healing fluids
- Old bruising fluids
- Added tumescence solution during the procedure
- Inevitable severance of some lymphatic vessels (tummy-tucks, facelift, arm lift, thigh lifts, etc.)
However, unlike blood vessels, which is pumped around by your heart, the lymph system has no pump. The pressure from your blood vessels and movement from your muscles push the lymphatic fluid around but this takes time.
With this in mind, it is easier to understand how and why a therapeutic manual lymphatic drainage (MLD) is performed and why it is important in one’s recovery.
Basically, MLD is a type of massage that uses light pressure and long, rhythmic strokes to increase lymphatic and blood flow to the affected areas. The soft nature of this is also important post-surgery as pain and tenderness are still present. Deeper body massage can follow 4-8 weeks post-surgery once the tenderness has subsided.
Lymphatic drainage massage can also improve, to a lesser extent, your skin texture by reducing swelling, puffiness and blotches, by giving you clean, healthy pores, by speeding up healing in scar tissue and therefore improving the appearance of stretch marks, by helping to reduce cellulite.
MLD has a powerful relaxation effect as well by reducing the sympathetic nervous system so come for your treatment unhurried, calm, and plan a relaxing post-massage downtime.
Lymphatic drainage massage usually takes place in a heated room; warmth is an important factor in increasing lymphatic flow. You are also likely to be more relaxed if you’re not cold. Your therapist will usually carry out lymphatic drainage massage with you on a massage table, while you’re draped in discreetly placed towels.
Our therapist will probably work her way up from your feet. Lymphatic drainage massage uses very light pressure, as well as long, gentle, rhythmic strokes and soft pumping movements in the direction of the lymph nodes. The main lymph nodes are in the neck, armpits, and groin.
In surgeries where lymph nodes are removed for disease, as occurs after breast cancer mastectomy, injury to lymph nodes and lymphatics can lead to accumulation of fluid within the limb or area of injury, a condition known as lymphedema (swelling due to lymph). MLD and compression garment are often recommended.
Swelling after cosmetic plastic surgery is always expected. There are a number of techniques to decrease swelling, such as quilting sutures, compression garments, elevation of the affected body part and icing of the area to decrease the amount of blood coming and hence the amount of swelling. Once swelling is present, though, massage can help greatly. Lymphatic drainage is a type of massage to help empty lymphatics in the area of surgery that has retained lymph. It is a very superficial massage and is more like a firm stroke rather than a deep tissue muscle massage. Lymph is pushed through the lymphatics, and swelling decreases.
Lymphatic drainage is a useful and beneficial ancillary procedure to cosmetic surgery procedures such as tummy tucks and liposuction where there are large areas of damage to lymphatics. For smaller areas of cosmetic surgery, such as the nose after rhinoplasty or face after a facelift, patients can massage themselves, but for larger areas, help from a massage therapist trained in lymphatic drainage is well worth any cost.
Lymphatic drainage massage benefits include enhanced quality of skin, particularly on the face. Skin looks more youthful and alive when its cells are bathed in fluid, as when the lymph is flowing. That puffiness you might experience beneath your eyes after a hard night or a long cry? It’s lymphatic drainage that solves these kinds of problems. For all of these reasons, lymphatic drainage massage can be very important for those who need it.
Is it painful you may ask? In short, the answer is no. When people hear the word “massage”, they often think of deep tissue work. For clients who have just had plastic surgery, the last thing they imagine that they want to have is a massage on their swollen, sensitive and often bruised bodies. However, MLD is pain-free, offers tremendous healing benefits, and believe it or not, it is actually quite relaxing.
Dr Marc DuPéré