POST OP CARE plastic surgery group

Lymph drainage massage
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Karen Botha MAR reflexologist at Essential Feeling Gidea Park, Romford who specialises in fertility

 Dr Dan Marsh and Dr Mo Akhavani at the Plastic Surgery Group recommend post-op lymph drainage massage.

Lymph drainage massage is an important part of any plastic surgery procedure because it aids healing and improves the results of your cosmetic procedure. Dr Dan Marsh and Doctor Mo Akhavani started the Plastic Surgery Group in order to ensure that their patients received an excellent standard of service and care when they visited their Harley Street Clinic. And so they make it mandatory for their patients to have ten lymph drainage sessions post surgery with them.

Karen & Charlie Botha

Your post surgery specialists

Lymph drainage massage

Questions & Answers


What are the benefits of Lymph Drainage Massage and why do the Plastic Surgery Group insist on it?

When you have an operation of any kind, it doesn’t have to be a cosmetic procedure, you swell up (lymphoedema). It’s this fluid that your body uses to transfer waste out of your body, And to transport the good, healing properties to the site of surgery to help healing.


Why do you swell?

However, because this is tissue damage is acute, your body hasn’t expected that it is going to have to heal. And so whilst it sends the fluid to heal as best it can, this comes as an influx of fluid which leads to a buildup of the excess.

Essentially, think about a rainfall and the river levels rising.

At the same time, it’s important to understand how the lymphatic system works. If you look at it, you’ll see a network of lymphatic vessels and nodes that connect together. They look a bit like your veins which transfer your blood. But one major difference is that where your circulatory/ venous system is pumped by your heart, your lymphatic system doesn’t have such a pump. Instead, it uses movement and water.


Movement and water

Post surgery, you don’t move as much as you normally would and the pain and compression garment will naturally prevent you from wanting to go to the toilet so much, hence you typically will drink less.

And so fluid builds even more.

This could be where you’ve had your surgery, but in more chronic cases, you may find that a limb such as arm or arms, but more often your leg or legs will swell. You’ll look down and see that one compared to the other is bigger. And that it feels full and your skin is tight.

There’s several reasons for this, but gravity is a big one. It’s just where waste naturally is drawn to. And this is why it’s so important to treat your whole body.

plastic surgery group

What's the technique you use for treatment of lymphedema?

This is where manual lymph drainage comes in. We use gentle pumping techniques located on the surface of your skin to improve the flow of your lymphatic fluid. The touch is so light that it doesn’t hurt, even just a few days post surgery. All we do is lightly place our hand on your skin and stretch until the skin reaches its limit. We do this in several directions, often upward but sometimes downward, to support the direction that the fluid drains. This isn’t a massage that uses oil as we need to maintain friction with your skin. We also don’t work muscles which is why the touch is so light.

In additon, we will stimulate blocked nodes and glands e.g. axillary, while you’re undergoing your therapy. Both at the start and as we see more water swelling under your skin as we progress with your session. It’s normal for this to develop as we progress because your therapist is pushing the fluid up to six times faster than it would normally dishcharge so each node is under more pressure than normal.

This systematic clearing is why it’s important that you have an experienced therapist who can release these swollen areas during your sessions. Otherwise the effects become cumulative and if you try and do this at home you’ll often find you’ve caused more issues as this all collects with no exit point.

As an aside, lymph drainage can be used in treating conditions such as rheumatoid arthritis and the effects of cancer surgery including mastectomy of your breast. It helps you feel better as you’re not conscious of swelling when the fluid retention pumps away. But, also we can help your body to destroy the bacteria by giving a helping hand to filter it away from the site.

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How can you help yourself get the best possible results.

When you book with us, we’ll send you a list of our aftercare advice in case you have questions. However, it’s so important to understand that these are general guidelines.

Dr Dan Marsh or your other surgeon will always advise you based on your specific conditions and healing rate — he is in control at all times. But we assist. As will we when we see you. For instance, exercise is a big question we’re often asked about. And what is appropriate will depend on where you are on your personal road to recovery. If you’d like to book the red light therapy, then you can do this at each session (London). 


What will I wear for my session?

You’ll remove everything, including your compression garment, for your treatment and then cover yourself with towels before your therapist comes into the room. This is so we can access the nodes and so that your lymphatic system isn’t compromised with the pressure from the garment. If you have bandages or a sticky plaster protecting an area this will stay in place and we will work around it.


How will I know who to contact, you or my surgeon?

You can contact either of us, but we have enough experience now to know when your medical surgeon’s intervention is required in your treatments. We could either speak to e.g. Dr Dan Marsh on your behalf or advise you on when it is necessary to get in touch with them. This eases your tension about how your healing is progressing. But also lightens the load on the spacilist doctor team.

Woman having legs massaged with manual lymphatic drainage
manual lymphatic drainage romford & Central London near Harley Street

How do you perform lymph drainage?

We use a mixture of motions, in the direction that the lymphatic system naturally runs to speed up its circulation. Whilst these may seem simple, in that it’s a really light and gentle motion, the skill is in feeling what is going on under the surface of your skin. We often get clients calling us who have had lymphatic drainage massages elsewhere, saying that they have received no benefit.

Patients are referred to us from several reputable Harley Street clinics, such as Dr Dan Marsh at the Plastic Surgery Group, because our massages are effective at minimising infections and bacteria, as well as gently stimulating your immune system such that your body heals as fast as possible.

This is because we are experienced and can sense what is happening under your skin. Our clients often comment on how they feel a release as nodes clear. It’s like a rush. This is a tremendous relief and especially so when we combine it with diagrammatic breathing to help empty your lungs to improve the amount of fluid expelled from your cisterna chyli. MLD isn’t just about your lymphatic system, it’s about how it interacts with your organs, too.

manual lymphatic drainage massage



What is a seroma?

A seroma is a pocket under the skin that fills with fluid. It often happens in a space that is new, ie where you’ve had tissue removed. So you could find that if you’ve had a lumpectomy or mastectomy you run the risk of these. But also, they happen with cosmetic procedures.

Typically, in the incidence of liposuction or a tummy tuck, then because your surgeon, such as Dr Dan Marsh or Dr Mo Akhavani removes a large amount of tissue, then you could get a seroma. You’ll notice a pressure, or your skin may raise slightly in a way which seems unnatural.


Reduce swelling

In addition, the slight movements that we use in addition to a stimulation of your nodes e.g. in your abdomen, knee and groin will not only improve and protect your health, but they will reduce the symptoms of lymphedema.

This has the benefit of making you more comfortable as your swelling reduces faster, and also as we’ve said there is a massive improvement in your chances of avoiding infection. But also, our clients typically need to only wear their post liposuction compression garments for four out of the recommended six weeks to 2 months.

Now to be clear, it isn’t us that decides this, it will only ever be your surgeons decision in your post op checkup review. But by reducing swelling to a level that is manageable by your body, this helps everything that was separated during your surgery reset faster, because it’s not being disrupted by the physical volume of lymphatic fluids



If you’ve had a largish site of incision, people often find a localised collection of fluid at the dissection site. If this pocket doesn’t move, it can easily lead to presumed infection.

To put this into context, lymph fluid removes toxins from your tissues. If this remains stagnant, think about what happens to a stagnant pond. The disease that arises in your body are similar and this is why we can avoid infection when you have a properly performed lymph drainage massage by a professional therapist. We assist your body to drain this efficiently. And this is how we avoid developing a seroma.

This is why reputable cosmetic surgeons such as Dr Dan Marsh always insist on follow up care.


Reduce hard fatty spots

Sometimes you get hard fatty spots under the surface of your skin. If you think about when youcook a fatty meat in a pan, the fat melts, but then when it cools, it congeals together. This kind of thing happens to your body, particularly post vaser liposuction.

These hard fatty spots are often unavoidable, even with regular MLD (called manual lymphatic drainage). Although they are less likely to be as bad.

That’s why at Essential Feeling we’re prepared for every eventuality. We have two specialist machines that will help to break this down effeiciently — and painlessly!

Radiofrequency skin cavitation for fat reduction body contouring

What are the specialist machines included within my treatments?

The first is a deep oscillation machine which uses high-speed sound to run at 6mm under the surface and disrupt the source of these fatty lumps. We then combine lymph drainage to smooth this through your lymphatic system and encourage your body to remain healthy and looking good.

The second machine is an NHS grade cavitation machine, which also uses sound. But this uses a low frequency to disrupt the membrane of the fat cells so that your body naturally excretes it.

Both work and we will use whichever we think is the most appropriate to give you the best results. Based on our experience of being trusted to treat patients from Harley Street and Knightsbridge, clinics over the past ten years.

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