MLD treatment (manual lymphatic drainage treatment) is wonderful post liposuction. We’ve talked lots on this site about how it can help alleviate healing, stimulate your peripheral nervous system and improve where you’re dealing with loss of function and movement. Also, what it involves and so on. We’ve looked extensively on clinical research about MLD treatment therapy, and this is why we can claim that it is hands down something you should do if you have had vaser liposuction. You will heal slower without specialist post lipo MLD treatment.
However, what can you do to support your healing process between MLD treatments?
MLD treatment can be intensive, or more of a maintenance phase. What each session involves and the type of treatment you receive will vary throughout this period and involve techniques and timelines based on your underlying healing.
Each session we’ll evaluate your therapeutic needs. And if you’re asymptomatic, it’s possible that we maintained a longer period between sessions. And this is why what you do between is important.
Exercise and joint movement.
Exercise doesn’t have to mean that you’re at the gym breaking into a sweat. It can be very gentle movement but still be an 
effective way to boost your lymphatic flow after you’ve had lipo. If you just flex and extend your muscles and joints, especially your calf muscles and diaphragm, this will improve your lymphatic flow through your system. You can do this regardless of your genetic development and ability, age progression and how swollen your movements are.
As a caveat, ALWAYS check with your surgeon before you start any kind of new exercise. But once you’ve done this, you also need to address your frame of mind.
Olsen and Olsen did some research in 2005, a commentary on that was, “You need to expect limits on your normal activities and exercise during your recovery.” The American Society for Aesthetic Plastic Surgery (ASAPS) also cautions liposuction clients to “avoid strenuous exercise for four to six weeks because it can trigger unnecessary fluid retention to the treated areas.”
What are gentle forms of exercise that can boost lymphatic flow?
- Going independently for a walk, although gentle, can be effective at increasing your lymphatic flow
- If your legs are swelling, range of motion exercise similar to those you’d do on a flight can be great. Doing them once or twice an hour is a lovely idea as this can increase blood flow for up to 30 minutes at a time.
But a note of caution.
Too much exercise, too soon on in your recovery process, can increase your swelling. So listen to your body and when you’re tired, rest. Even shopping for a few hours can be a step too far (literally) when you’re just out of surgery.
An issue with listening to your body is if you’re experiencing some numbness, which is common. This can make it difficult to know if you’re overexerting yourself. And because we haven’t been in for stem cell transplantation, or bone marrow treatment, plastic surgery is something we have done to ourselves, our empathy with ourselves can also be lacking. But it’s important to remember, whatever the reasons behind your condition, you have still had invasive surgery and your need to heal is still the same.
Just a note on feeling numb. This is totally normal. Melvin A Shiffman MD says in his book, “decreased sensation or sensory loss may occur, but is almost always temporary (2006).
Read Exercising after plastic surgery
Diaphragmatic (belly) breathing
When you belly breath, you activate your diaphragm. This boost our body’s lymphatic flow, which is “clearly dependent on respiration,” Foldi & Foldi 2012.
This is interesting because this is just the body doing what the body does naturally. However, even though if you watch a child breath, you’ll see their little tummy moving up and down as we grow older, for some unknown reason, we stop doing this. Many think this could be due to anxiety and stress in adult life. Courtney in 2009 noted that 83% of people with anxiety have breath dysfunction and take shallow breaths.
How to tell if you belly breathe.
Place your hand over your belly button. If your belly moves out when you take a breath, then you’re belly breathing. However, if it barely moves, or even sucks in as you inhale, then this is shallow breathing and can be adapted.
This will help you get the hang of it if you’re struggling.
External compression.
We wear appropriately matched compression garments after lipo and tummy tuck and although they’re uncomfortable, their benefits are results changing. So pretty much any doctor, good or bad, requires you to wear one.
These garments help to decrease swelling by providing resistance, which helps limit your swelling and encourages your lymph vessels and nodes to draw excess lipid storage away from the areas you’ve had surgery.
Most of our clients come for their first appointment wearing the compression garment that their surgeon has prescribed. A word of warning: we mean them to be so tight they are uncomfortable, you’ll notice when they become loose, you’ll get more lumps.
They also ensure that your skin sets back in the right place. When the surgeon goes in with their cannula, they separate tissues, creating acute damage to the main types of human tissues. Once your operation is complete, these need to stick back together in an aesthetically pleasing way. Your garment helps this. And we’ve seen some horror stories where patients haven’t worn their garments and then their skin rumples and sticks in the wrong place. If it’s been a while and you haven’t had appropriate aftercare, the only way forward is more surgery.
The research on compression garments
ASAPS recommends that liposuction patients “wear a compression garment over the treated areas for four to six weeks to control swelling and promote skin contraction.” They also note regarding tummy tucks, “reduces the likelihood of loose or sagging skin after an abdominoplasty. The compression garment also helps to control the swelling (of fats and proteins), resulting in a shorter recovery period.”
Dixit and Wagh agree. “Some methods that are commonly employed to minimise post operative oedema (swelling or edema) are: applying an optimum compressive garment immediately after surgery… providing manual lymph drainage in the early post-operative period. In our experiences, gentle liposuctioning an optimum compressive garment and early lymphatic drainage massage helps to accelerate the clearance of oedema,” (2013).
Schafer says that, “compression garments are essential to recover after liposuction. They apply pressure to the treated area to keep the tissue from shifting as the patient moves.” They “help control the pain and swelling.” We often recommend our patients add a foam insert to their compression garment. Here he says; “We may use a foam insert under the garment to reduce the possibility of blood or other fluids collection (and decrease bruising).” (2011). We also find that when foam inserts are used, they give a better aesthetic finish as the garment doesn’t dig in in the same way and therefore they decrease lumps forming.
Shiffman comments, “persistent lymphoedema in the area of liposuction can be distressing to the patient, this may be due to excessive trauma to the tissues, but liposuction is a traumatic procedure causing so called internal burn like injury. Proper compression is usually the key for prevention of onset of symptoms” (2006). It’s not unusual for us to see patients who have damaged venous systems as a result of lipo, and then develop acute and chronic conditions as a result of their lack of specialised aftercare activity.
Foam is your compression garment’s friend
Many of our clients don’t like to use the foam that their cosmetic surgeon has given them. It smells, they say, and they don’t like the way it sticks to their skin. (You can put them through a gentle washing machine cycle, by the way…)
When you have foam pads placed under your compression garment, it puts constant but gentle pressure on any patches of swelling. These are usually on your torso, but can be elsewhere, such as your arms and legs. This helps any non waste products to be reabsorbed by your body.
The role of foam in post lipo healing.
The upshot is that if you use foam, it helps to distribute compression evenly, this makes your garment more effective and thus reduces swelling from the area. The downside is that you’ll often find pockets of fluid build up below this extra pressure points. But your surgeon can drain this, although we’ll usually get rid of if via MLD treatments.
What is too tight?
If you’re experiencing pain (rather than discomfort) light-headedness or dizziness whilst you’re wearing your compression garment, then this is probably too tight and we can work with your surgeon to find a solution. However, a few MLD treatments will reduce your swelling such that a previously too tight garment can become OK in a few sessions. It’s usual to go down at least one or often two sizes as you heal.
The other side is that if your compression garment is too big and you should expect to buy several garments in smaller sizes as your body heals.
In the same way we mentioned rumpling earlier, if you wear a bad fitting garment that bunches at the sides, you can expect fibrous tissue to develop. We can get rid of this during your sessions, often using deep oscillation, but if you can avoid this by getting a good fitting garment, all the better. And always check how smooth your lines are when driving and sitting. Shiffman says, “following liposuction, folds in the garment can result in indentations and subcutaneous fibrosis. The garment should be checked on the first postoperative day and the patient informed of how to prevent or limit folds in the garment (especially an abdominal binder) 2006.
With the increase in surgeries abroad, it’s important to ensure that you are wearing a good fitting compression garment when you travel and please walk around during your flight and/ or at rest stops. Also book extra MLD treatments after your trip to help your body cope and avoid regression.
To book your post surgery MLD treatment in Central London or Romford, Essex, call or text us today on 07757 946023
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