Why is MLD recommended after surgery? such as liposuction, tummy tucks, facelifts, c-sections and joint replacements...

Surgery causes physical trauma by cutting through or disrupting various layers of tissue, damaging delicate lymphatic vessels which normally drain waste fluid and cellular debris from that area. As a result, with the body's increased inflammatory response to surgery bringing increased blood circulation to the area to help it heal, excess waste fluid builds up causing an oedema (tissue swelling). This inflammatory response (including lymph) is a healing response, and a good sign of the body and immune system doing what it is meant to do.  However, it can use some assistance at this time to function more efficiently.  

​When there is swelling at a surgical site it can cause issues with the speed of healing as it may pull the wound open (presenting an infection risk), or pop stitches at the skin or subcutaneous levels (jeopardising the integrity of healing tissues and creating an untidy scar line). Swelling also increases the risk of seroma developing. Seromas are essentially pockets/holes left where tissue has been removed by surgery (ie: liposuction), which can fill with lymph, leading to a lumpy, uneven appearance. MLD helps drain seroma of their fluid and decreases the chances of that trapped fluid hardening over time and becoming fibrotic. Read more about seromas here.
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MLD is a completely pain free, light-touch treatment, so it can be applied around very tender areas such as incision lines without causing discomfort. It gently guides the excess fluid (lymph) from the surgical site, away to the nearest available lymph nodes where it is filtered and channelled towards deeper lymphatic structures, helping to reduce tissue swelling (and coincidentally bruising), until lymphatic vessels have begun to regenerate or until neighbouring lymph vessels have effectively compensated for the damage by taking on a greater drainage load.​

How soon after surgery can I have MLD?

With the consent of your surgeon and in the case of no post-surgical complications, MLD can be performed as soon as 24 hours after surgery. Basically, the sooner you start MLD, the better its effects are likely to be. Many people choose to start MLD on Day 2 or 3 after an operation as this is when they might typically feel more stable as the immediate effects of their surgical medications have subsided somewhat.

How many post-surgical MLD treatments will I need? 

This is not a straightforward question to answer, as it does depend on the type of surgery you have had, how much of your body has been involved, and how your surgery went overall.

​Most surgeons will now prescribe an MLD treatment schedule for their patients on discharge from the hospital or their clinic. For example, an extensive liposuction surgery may have daily treatments in the first few days, every other day in the second and third week, weekly for a further two weeks and then once a month for maintenance up to five months. Another example could be post hip or knee replacement, where MLD treatments might be prescribed three times a week for three weeks and then reassessed.
 
If an MLD schedule has not been medically prescribed to you, Anne will suggest what she believes will be optimal for your situation based on her experience with similar cases. Feel free to get in touch to ask about this prior to booking an appointment, as it is a good idea to understand how many visits you're likely to need, and to get them scheduled in, before your first visit.
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It is helpful to consider MLD treatment according to its main purpose at various points around your surgery:
 
PRE-operative MLD (ideally 1-3 sessions in most cases)
Preparing your body before surgery by having 1-3 MLD treatments in the week prior to your operation is highly recommended to detoxify ahead of the heavy use of anaesthetics, antibiotics, and painkillers etc. MLD will improve circulation in the area undergoing surgery, boost your immune response and get you used to being in a state of increased lymphatic flow. As an added bonus, MLD will also help to relax your nervous system ahead of the big day.
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Post-operative MLD (as prescribed by the surgeon, the average being 10 sessions)
​The primary goal of the immediate post-operative phase of MLD is to reduce the inevitable swelling in affected tissue and to keep the swelling down to a minimum in the weeks immediately after surgery. This in turn helps minimise the risk of developing complications such as seroma and fibrosis. If a seroma does develop, MLD may help to drain that fluid off naturally, rather than having to resort to a surgical solution. 
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Maintenance’ MLD (typically 5 sessions)
Once the intense post-surgical phase of MLD has ended, the risk of swelling, seroma and fibrosis have decreased and MLD's focus shifts from controlling oedema to stimulating lymphatic vessel regeneration and regrowth. Regrowth happens between the second and fifth months after surgery, it is a specific window of regeneration during which the severed lymph vessels grow back through the damaged areas.

Maintenance MLD stimulates and supports the newly growing lymph vessels and increases the likelihood that cross-scar connections can be re-established. MLD treatment about every two weeks until the end of month 2, and then once a month in months 3-5 have been shown to make a difference to the extent of lymphatic vessel regrowth.
First Appointment Recommendation:

For your initial visit, we recommend a 60-minute MLD treatment to assess your needs and discuss a personalized treatment plan.

Future sessions can be 30 or 45 minutes to focus on targeted areas of concern. Alternatively, you can choose to incorporate your lymphatic treatment into any regular massage therapy session for added benefits. I look forward to helping you feel your best!
Image: Pixabay, Pexels, Unsplash, Wikimedia Commons
Resources:  www.vodderschool.com
Disclaimer: The information provided on this website is shared to the best of our knowledge and is intended for educational and informational purposes only. While every effort has been made to ensure accuracy and reliability, please note that Anne is not a medical doctor. The content shared is based on research from clinical papers, reputable sources, and professional experience in the field of massage therapy. This information should not be considered a substitute for professional medical advice, diagnosis, or treatment. Always consult with your healthcare provider or a qualified medical professional before starting any new treatment or therapy.
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Anne the RMT

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59 Bruce Street - Wortley Village
London, Ontario N6C 1G6
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