Manual Lymphatic Drainage
MLD 101
FAQ (Frequently Asked Questions)
How can MLD help after surgery?
Discomfort, swelling, and bruising are common after these procedures and the flow of lymph can be interrupted by the surgery, which can result in reduced healing, fibrosis (scar tissue, dimpled, uneven skin and the possibility of developing seromas (pockets of serous fluid). MLD decongests the lymphatic system, bringing back normal texture, definition and tone to the skin and reduces swelling and bruising. If you have multiple procedures simultaneously (liposuction, breast work and tummy tuck), MLD will be even more necessary to address swelling and tissue hardness.
Does deep massage have the same effect?
It would be easy to think that deep massage would be helpful, especially to reduce hardness after liposuction but it increases circulation to the treated areas, making it harder to evacuate the lymph fluid and thereby making the problem worse. Even though it may seem to you that a deep massage, therapeutic or other type of massage may help decreasing the hardness following the procedure it is not. A deep massage is contraindicated after the procedure as it makes harder to evacuate lymph fluid and also could damage the surgery. The lymphatic system is located almost immediately under the skin, so it takes just a small amount of extremely light pressure to get it moving.
Why is Manual Lymphatic Drainage important after plastic surgery ( Tummy tuck, Liposuction, face Lift or any other plastic surgery)?
After a plastic surgery procedure, water retention, swollen, hematoma or lumpiness to the areas treated. This is normal right after your surgery. This post-surgical lymphedema is caused by inflammation and trauma from the cannula used to suck out the fat. The channels that are formed by the cannula become filled up with fluid and the tissue around become swollen. Manual Lymph Massage helps to move the fluid by gently pumping it back into the lymph vessels, reducing the swelling, retention of fluids and pain after the surgery. Without Lymph Massage (MLD) the inflammation can evolve into fibrosis (a permanent hardening of the tissue) or a seroma (pocket of serum).
Can MLD help get rid of bruising?
Yes. Bruises are an accumulation of cellular debris and old red blood cells in the tissue. MLD significantly reduces healing time for bruises by cleansing the extracellular spaces where these substances are trapped.
Do I need a referral for MLD?
No. Although many doctors recommend MLD, it is also perfectly fine to self-refer.
When can I have my first Manual lymphatic drainage after the surgery?
As directed by your physician. It is possible to begin within the next 24 hours. The sooner you start your drainage the better. For best result, we normally recommend having the first drainage 24 hours after the surgery or at any time within the first 5-7 days; as MLD is gentle enough and drastically reduces the appearance of bruises, swelling, stiffness, burn shooting pain, scars, lumps, bums and soreness that often occurs after the surgery.
How many MLD sessions should I have?
This will depend on your surgeon’s recommendations, but it is usually a minimum of 6-12 treatments post–surgery for liposuction and possibly more for other combination-types of surgery.
How often is MLD applied?
One session a day for 7 consecutively day or every other day for the first week is recommended. The second week, every other day, the third and fourth week twice per week, followed by maintenance; one per month for the next 5 months for best results.

For best post-surgical results 12 sessions at minimum are strongly recommended :
1 week-7sessions
2 week-3-4 sessions
3 and 4 weeks 2 sessions
After 5 months: 1 session per month

It has been over a month since I had my procedure. Is it too late to begin MLD?
No. The healing process after these types of procedure is several months. If it has been over a month since your procedure, you can still get the smoothing benefits of MLD. If it has been over 6 months since your procedure and you are still feeling lumps and hardness you should contact your doctor to make sure you have not developed fibrosis or a seroma.
Why Is Manual Lymphatic Drainage Important?
A working lymphatic system is essential to the body’s ability to regenerate tissues, drain fluids, filter out foreign substances and toxins, detoxify, and maintain a healthy immune system. The lymphatic system is complex and made up mostly of nodes and lymph vessels working together to achieve these aims. The lymph itself carries fatty acids, hormone cells, immune cells, proteins, and toxins to be processed by the lymph nodes. When the body is under stress, fatigued, experiencing infections, fighting a disease process, or—in certain cases—recovering from surgery, the process may be slowed down.
Manual Lymphatic Drainage benefits include enhanced quality of the skin, particularly in 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 Manual Lymphatic Drainage that solves these kinds of problems. For all of these reasons, Manual Lymphatic Drainage can be very important for those who need it.
Manual Lymphatic Drainage After Cosmetic Surgery
Cosmetic surgeries all produce swelling to some extent because it is part of the body’s normal healing process. Some cosmetic surgeries, such as liposuction procedures and tummy tucks, disrupt the natural pathways taken by the lymphatic system because of the location of the surgery. Other regions of the body, such as the nose after rhinoplasty, produce swelling that can last for a long time—even up to one year. Other cosmetic procedures that impact the face can also produce months of swelling. However, because of the extensive areas of disruption, tummy tucks and liposuction procedures are usually the cosmetic surgeries with the greatest amount of lymphatic swelling.
When the lymph drifts out into surrounding tissue after a surgical procedure disrupts the normal lymphatic pathways, swelling is the result, but there are ways to combat this problem.
Who should not have an MLD Massage?
With such light contact, any danger of causing damage to tissue is small. However, there are a few conditions that are contraindicated. These include acute inflammation, malignant tumors, thrombosis, phlebitis or anyone with major heart problems. Your safety is our priority. If you have health conditions, please let our practitioner know.
What are some common possible side-effects?
Relaxation is certainly one! Other positives are increased urination and increased energy. Decreased swelling will come rapidly. Dizziness when first sitting up is common, and diarrhea and nausea can occur later in the day. The lymphatic system really is our body’s cleaning network.
What Happens During a Treatment?
MLD is a specific technique that is both specialized and advanced, so you may be asked to fill out a questionnaire and record card. The therapist will guide you. The entire session is usually done lying in the face-up position, since all the majority of lymph node areas that need decongestion are situated on the front of the body (although some surgeries require the client to move side-by-side, or face-down if tolerated for a short time).
Lymph fluid will be directed to nodal areas for elimination, by using feather-light pressure and circular movements. MLD is performed in a concentrated manner to one area or quadrant of the body. The treatment takes an average of 45mins-120mins.
Do I Have to Wear Post-Surgery Garments to Assist With Manually Lymphatic Drainage?
Yes, definitely! Compression garments help the entire process. They prevent the buildup of too many toxin-carrying fluids in any one area of the body and help the body keep excess fluids from sticking around where they don’t belong. They also make Manually Lymphatic Drainage more effective, keeping the body more receptive and ready for the process. It’s easy to find the right kinds of compression garments for after your procedure, and your cosmetic surgeon and post-op recovery specialist will be able to recommend the right garments for you.