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Promoting healing after surgical procedures of all types, including cosmetic-themed procedures, is imperative for healthy recovery of the patient.

Promoting healing after surgical procedures of all types, including cosmetic-themed procedures, is imperative for healthy recovery of the patient.

Cosmetic procedures—and therefore, postoperative lymphatic drainage massage—has mushroomed in our nation in recent years. I have witnessed an increase in demand for lymphatic drainage treatments in my private practice in Tempe, Arizona, as cosmetic procedures have increased. According to the American Society of Plastic Surgeons, in the past decade, the number of breast augmentations has increased by 39%, breast lifts by 70% and tummy tucks by 85%.

One such procedure popular in the U.S. today is the mommy makeover. According to the ASPS, “The goal of a mommy makeover is to restore the shape and appearance of a woman’s body after childbearing. Many women notice changes in their bodies post-pregnancy. There are many areas of the body that can be addressed, most commonly the breasts, abdomen, waist, genitalia and buttocks.” The ASPS also notes that 62% of mothers would consider getting a mommy makeover if cost wasn’t an issue.1

I have employed manual lymphatic drainage with clients receiving this procedure. A mommy makeover may include many surgeries, including those noted above, within the same overall procedure. These are designed to reshape a woman’s body to restore figure and appearance after childbearing. Any combination of these procedures may be included within one’s makeover:

  • Breast augmentation
  • Breast lift
  • Breast reduction
  • Tummy tuck
  • Brazilian butt lift
  • Liposuction
  • Arm lift
  • Thigh lift
  • Vaginoplasty

With typical lift procedures, excessive skin can become tightened and tissue is reshaped, which makes the skin less pliable. If a Brazilian Butt Lift (BBL) is included, gluteal skin may not be addressed, so be sure to notice excessive skin upon the lateral or inferior margins.2 A lift is not the same as an implant, as lifts combat drooping and sagging of tissue whereas implants add size and volume to an area. The suffix “-plasty” refers to change; a vaginoplasty changes the appearance of the vulva and vagina.

The Role of Manual Lymph Drainage

Manual lymphatic drainage helps move lymph fluid by gently moving it back through the lymph vessels via a series of lymph nodes. Within each node are white blood cells called Lymphocytes which cleanse lymph fluid. After lymph travels through the lymphatic node network, clean lymph fluid returns to the heart to replenish blood plasma supply.

Keeping lymphatic fluid moving keeps metabolic waste and residual pathogens circulating out of the body. This allows the lymphatic system to become the body’s waste management system. Any surgical procedure will result in the formation of waste products via inflammation and tissue repair. Manual lymphatic drainage expedites healing of tissues and metabolic waste removal, thereby improving recovery time for patients.

It is important to take a detailed history with the patient prior to beginning lymphatic drainage or other massage treatments because every woman’s mommy makeover may be different in terms of which procedures are included. Inquire as to which of the procedures in the aforementioned list were included in their makeover.

Clients, Drainage, Lymphatic, Makeover, Mommy ⋆ Lymphatic Drainage for Mommy Makeover Clients

Common complications of a mommy makeover include scar asymmetry, hematomas, infections, pain and swelling. A massage therapist needs to wait for complications to subside before proceeding with treatments. Typical recovery times range from seven-to-10 days to several months depending on how many complications arise and the rate a patient heals wounds with their general immunity.

I generally follow the rule of waiting four to six weeks after surgery to perform massage therapy efforts. However, if a physician provides approval prior to four weeks, I feel comfortable performing sessions. As I work, I will scan undraped areas for signs of blood clotting. Signs include unilateral swelling, temperate change (warmer or cooler) upon the skin, color change of skin (darker or paler) and deep, aching pain that worsens at night.

Extra bolstering may be necessary with these patients. I have used a larger wedge-shaped bolster applied to allow lift to the neck and shoulders as well as normal circular bolster for the knees for extra comfort. For clients whose mommy makeover included the Brazilian Butt Lift, I have placed two soft blankets under the gluteal region for softer cushion support while client was supine. I suggest having a variety of pillows, blankets and bolsters of varying sizes and shapes to help support their limbs and torso as needed.

The Mommy Makeover Lymphatic Session

I will employ a combination of lymphatic drainage and myofascial release with mommy makeover patients. Here is my general protocol:

1. I clear the terminus, the region just lateral to the sternocleidomastoid muscle attachment superior to the clavicle bone. This is the site at which lymph from terminal ducts can drain into the superior vena cava leading into the heart. I will return to the terminus region to clear here after working each limb and also the abdomen.

2. I clear the abdominal region using a lymphatic approach. Approximately 70–80% of lymph travels through the abdominal region.

3. I perform myofascial release techniques within the abdominal region. I employ techniques that will create opposing skin forces as well as slow fascial mobilization to generate tissue healing within the regions recovering from scar formation.

4. I will clear the right arm, then the left. It is advised to clear the right arm as lymphedema may easily present in this limb. Pumping into the axillary nodes can begin clearing a path for lymph to exit the upper limbs more easily.

5. I will clear the right leg, then the left. Pumping into the nodes of Cloquet at the groin region can begin clearing a path for lymph to exit the lower limbs more easily.

6. Finally, I return to the terminus to complete an hour-long treatment.

I have trained the staff at CURV Body Lounge, a Scottsdale, Arizona, boutique-style facility where patients receive postoperative lymphatic drainage treatments following mommy makeover or similar procedures.

“With our focus on technique, knowledge, and making each patient feel we are with them every step of the way for their healing,” said CURV Body Lounge owner Jennifer Hall. “It is important to know about cosmetic surgery in order to perform your post-op massages correctly. Without the proper training you could potentially make the post-op healing process worse. Never stop learning both worlds, lymphatic drainage and cosmetic surgery.”

Hall said she likes to see patients come in every two to three days post-surgery to allow incisions to heal up. “Be sure to not touch the incisions and stay at least 2 inches away while they are scabbing up,” she added.

 It is beneficial to see clients one to two times a week for the first few weeks to help with their swelling and mobility. Complete healing post-surgery takes a good six to nine months, sometimes up to a year.

“Understanding the stages of post-op healing is key,” said Hall. “The body works pretty amazing in adjusting to the trauma.”

Footnotes

1. American Society of Plastic Surgeons, Staff, “Mommy makeover, Get Your Pre-Baby Body Back.” American Society of Plastic Surgeons (plasticsurgery.org), 2021. Accessed September 2021.

2. American Board of Cosmetic Surgery, Staff, “Brazilian Butt Lift.” Buttock Enhancement ABCS (americanboardcosmeticsurgery.org), 2021. Accessed September 2021.

About the Author

Jimmy Gialelis, LMT, BCTMB, is owner of Advanced Massage Arts & Education in Tempe, Arizona. He is a National Certification Board for Therapeutic Massage & Bodywork-approved provider of continuing education, and teaches “Professional Ethics for LMTs” and many other CE classes. He is a regular contributor to MASSAGE Magazine, and his articles include “Massage for Trauma: 3 Ways of Responding to an Emotional Release” and “This is How Proprioceptive Neuromuscular Facilitation Facilitates Muscular Function.”

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Clients, Drainage, Lymphatic, Makeover, Mommy


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