MLD for Post Surgical Recovery - How to heal faster from your tummy tuck, mommy makeover, BBL, breast reconstruction or Lipo procedure
Within the past decades a whole new form of post-surgical healing has emerged – Post Surgical Manual Lymphatic Drainage.
While there are therapists trained to perform MLD for Lymphedema, and other health and wellness purposes, they are not necessarily trained or believers in applying MLD to patients recovering from cosmetic or non elective procedures. . Evidence of it's growing popularity is in the number of post op clients who call saying their surgeon "prescribed" MLD as part of their followup protocol.
The Lymphatic System
The Lymphatic System is a complex pathway of specialized capillaries, trunks, and nodes which assist in returning fluids back into the circulatory system. As a passive system, it has no central pump, like the heart, to move fluids. That task is left to the vein like structures to "pump" fluids,
The post-surgical case for MLD
Inflammation. (and fibrosis). It all really comes down to inflammation. Surgery is trauma. And trauma triggers a trauma response. Part of that response is swelling. Swelling is a normal part of healing, but it can be uncomfortable and chronic swelling can lead to other issues. Manual Lymphatic Drainage helps the lymphatic drainage system function at a peak level to draw fluids away from a swollen area. Stimulation of the lymphatic system increases the rate at which the body removes waste, dead cell particles, and inflammatory agents from our tissue.s Accelerating the lymphatic flow has been demonstrated to reduce swelling and bruising in the injured region. Studies indicate that as the volume of fluid at the injury site is reduced, rehabilitation time may be shortened. Manual Lymphatic Drainage (MLD) can play an important role in post-surgery recovery to reduce inflammation but also by playing a role in the reduction of pain, stiffness and bruising,
You may receive Post-Surgical MLD treatments within 3 days after surgery.
Doctors who know of Post Surgical MLD will sometimes suggest treatment as soon as 3-days after surgery. This early intervention assists with helping to minimize bruising and swelling. However, some doctors suggest or even mandate patients wait from 2-6 weeks after surgery before receiving treatment. With a Doctor's permission, I will work on clients generally beginning 3 days to a week after surgery. No work will be done on or near an incision this early - only after it has healed. Generally after 2-3 weeks all work is safe unless there are complications with your surgery.
Your MLD Therapist should have wound care or medical training if you have issues with your surgical site.
One current trend we are seeing is that patients are flying out of state or out of the country for cosmetic procedures that are more affordable. Often the client returns home with a paper of "instructions" and there is no real medical followup. MLD itself can only do so much, and some Doctors are simply passing the patient responsibility forward. If you are experiencing any issues such as abnormal oozing, sharp pain. redness that is abnormal or other signs of infection, please seek competent local medical care or see your doctor if local. MLD therapists only do what they do which is limited.
Pushing fluids and tissues out from unhealed incisions is NOT MLD
There is a "understanding" in various places in the United States and abroad that the way to get lymphatic fluid out of your body is to reopen the incisions and push fluid out manually. First, this process is outside the scope of practice (100% illegal) for any massage therapist or MLD therapist in any of the 50 United States. Unless the person performing this process is a nurse or similarly licensed healthcare worker in a clinic with biohazard bags, gloves, face shield, gowns, etc., they should not be doing this. If you are a surgery patient and someone wants you to do this, or to do this to you, run.
YouTube videos are NOT an alternative to hands-on MLD - But I can show you Self Care MLD strokes you can do at home
When time and budget allow, MLD is best performed by a trained therapist, however not everyone has the time or budget for a series of visits. One challenge with online videos is that you never know what you are getting. I see massage videos all the time that contradict the actual work. Further it is easy to "mimic, " maybe, but if you don't know the "why" behind what you are doing, or know if you are doing it right, you may be doing things contrary or ineffective to the healing process. If you want to do MLD self care at a minimum, book a treatment with some extra time and go home with a self care routine that you know will be effective.
MLD does NOT use brushes, tools, cupping, bamboo sticks, rollers, or creams.
MLD uses only the hands and is performed without oils, lotions or creams. It involves movement of the skin in particular directions, and gentle pressure toward the body. Any other technique, tool, cream, or even cupping, is not part of the Post Surgical MLD process and should be avoided. If you have a therapist who is insistent on using creams, tool, cups or rollers, just say “No!” and tell them to use hands only. If they refuse, simply end the session and leave. There are instances where cups and tools can be used during the healing process, but it is not for lymphatic drainage.
You Deserve a Better Healing
In all cases, a post-surgical lymphatic drainage session should be gentle and complete, Post surgical MLD is an excellent way to help promote the healing process and is appropriate for almost any surgery or procedure.
I treat clients in my Needham, MA office who have had procedures such as lipo-360, mommy makeover, breast reduction or augmentation, Brazilian butt lifts, abdominoplasty (tummy tucks), cool sculpting, brachioplasty, facelifts, hip replacements, shoulder surgeries, lumpectomies, mastectomies and reconstruction, gender affirmation surgeries. . If your situation involves Lymphedema, active cancer or is in general more complex, my colleague, Virginia Murphy, is available to handle almost special care cases from her nearby Hanover studio, She has hundreds of hours of training in oncology massage, lymphatic systems and manual lymphatic drainage. We would like to be your healing partner. Together, we see clients on Martha's Vineyard as well, me year round, Virginia from spring to fall.
Original Article written 10/17 - updated 5/2019 with resources
UPDATE / PART II TO AN ARTICLE WRITTEN 10/17
With this subject coming up more and more online and with clients, here are some further thoughts utilized t.
Breasts aren’t usually invited to the self-care party—despite the fact that there’s a restorative practice for pretty much every other part of the body (hair included). But there’s an argument, more than one, for incorporating full chest and breast massage into your treatment.
“Massage is a wonderful, stress-relieving, detoxifying practice for the whole body,” says natural beauty expert Jessa Blades.
“It’s odd that we don’t massage the breasts [in the West].”
And no, you don’t need to be pregnant or nursing to reap the rewards, a fact the holistic wellness world’s been clued in to for ages. “In Ayurveda, if you get a full-body massage, your breasts are massaged too,” Blades notes. “It’s odd that we don’t massage the breasts [in the West].”
Breast massage may provide huge psychological and emotional benefits, especially for those recovering from breast disease and the aftermath of invasive treatments.
While this work is not even close to being mainstream at the moment, that’s starting to change as word gets out about the physical and emotional benefits the practice produces. And lets not forget about choice. There is an emotional long tail effect about subconsciously feeling the need to "hide" them.
Breast health is too often ignored until after a problem arises. It’s an area of the body with powerful associations that sometimes makes women hesitant to seek care, despite the fact that the vast majority experience discomfort at some point.
Breasts are often compressed with sports bras, constrained by underwire, or enhanced with padding. This can restrict the flow of lymph, the clear liquid derived from blood that contains disease-fighting cells called lymphocytes. It is widely speculated that chronic impairment of lymph drainage may be implicated in many breast health problems, including cancer.” This is the case for not wearing a bra.
Therapeutic breast massage also loosens the tissues of the chest, shoulders, and neck, using a combination of deep-tissue massage techniques, movement, breathing, and stretching. Whether your breasts are healthy or compromised, every woman can benefit from this work, and it can be a powerful aid to emotional healing or healing after surgery or radiation therapy.
If you are It is important that you find a therapist who is qualified; trained and experienced with this work. Just as it is surprising to many clients, it is surprising to many therapists. A qualified therapist will be able to explain the work, discuss benefits, address curiosities, fears and or/concerns, go over the protocols for consent and choice - and ultimately help determine if you might be a good candidate for this work.
I have created an FAQ page that for the moment is password protected. It contains further discussion, FAQ's, and other information along with testimonials. If you would like to access it, please go here
Here is a list of prior blog posts for further reading on this topic:
If you have had breast massage and would like to share your story, it may help others - please send me an email.
Not all cultures view breasts with the same sense of fascination and conflicted sensibilities and childishness as we do in the US in particular. Breasts are simultaneously elevated and shunned. It is an odd duality, again seemingly leftover from the the arrival of the puritans. We are still living with their ghosts. I am certain somewhere out there I will be criticized for even writing this post, however I was asked to create a small post on the importance of breast massage and since it is so difficult to find, some self care suggestions.
The breasts have been used in symbolism since time immemorial. They have represented love and fertility, as well as sex and pleasure. But dream interpretation theories show that in the deep recesses of our minds, for men and women alike, breasts symbolize something even more integral--our primal need for motherly love, support, security, care, and nourishment, because their function as an organ is to give just that.
The breasts serve not only physical needs of sexual intimacy and breastfeeding but also energetic needs. Likewise, the state of breasts and changes in them can be clues as to what emotions are being processed or need processing. In this way, caring for your breasts is caring for your soul. A beautiful statement by Susun Weed in her book Breast Cancer? Breast Health! sums up this idea: “We cannot nurture others fully or well unless we also nurture ourselves.”
In terms of the mind/body connection - never have I seen an area of the body correlate so well with what is manifesting within a person’s heart and mind. Both men and women often go to their doctors with a feeling of discomfort in the chest, without any cause found after numerous tests and scans. But the discomfort is real—the causes are often too subtle for Western instruments to detect. Ayurveda can recognize these subtle sensations as signs of imbalance.
Ayurveda ( a 5000-year-old healing wisdom tradition from India, teaches in order to maintain a state of balance, the whole person must be addressed—no part of the body or energy is excluded) relies on massage as preventative medicine, and traditional ayurvedic massage doesn’t overlook the breasts as in the West.
Jennifer Johnson, spa director of the Chopra Center writes "Over years of work, we found that many women work through complicated issues with their breasts, confusion from oversexualizing, and shame carried through various belief systems, and also that women very rarely touch their breasts," says Johnson. "We also saw women confronting complicated emotions after recovery from breast surgeries—everything from biopsies, lumpectomies mastectomies, reconstruction, and augmentations. I have written on this topic before here and if you are interested please go over and read my prior post. But for now, back to the self care. Here is a basic 10 15 minute ritual that will help you get connected to your body, and can be practiced with frequency.
A Simple Breast Massage Ritual
Practice breast massage frequently, taking special care to notice the health and condition of your breasts and note fluctuations around your monthly cycles. Daily, weekly, whatever you can do. Not only is this ritual good for your physical health, it is grounding and could be a key to your emotional well being..
Ayurvedic medicine favors Sesame as a nourishing and neutralizing base oil. One oil I use daily is cold pressed almond oil. Add essential oils if you are comfortable with them or simply use as is.
Stand or sit in front of a mirror.
That's all there is to it. Pleas let me know your thoughts on this article, if you found it helpful, and feel free to share it.
~ with Aloha
Breast massage therapy, although uncommon in many massage practices, and sometimes controversial on the health front, should be a higher priority for women and their physical, emotional and spiritual wellness.
How Ayurvedic Breast Massages Can Help Promote Lymphatic Flow
Why Your Breasts Need To Be Massaged
updated 10/2017 with resources
This post is dedicated to a friend and fellow therapist, Barbara Heard, who has had the passion and dedication and courage to lead the way to normalize full chest and breast massage, de-sexulize it and make or keep this work legal in her state, and other states, Her mission is to properly educates the public, therapists and public officials about why this work is important. First and foremost, what is full chest and breast massage? It is not sexual, in fact it is exactly the opposite,
When receiving full chest massage done with professional, neutral, totally non sexual touch one has the most amazing holistic experience of feeling their chest as an integrated part of their body. Full chest massage on men is very common but discouraged or assumed to be sexualized on women, in America mostly,
Massage of the anterior chest wall is effective treatment for injuries to the chest, shoulders and neck. Full chest massage with pressure applied to the muscles deep to the breast tissue with consistent firm flow over the rib cage helps both tone and relax the chest muscles as needed, just as happens when we massage the muscles on the posterior rib cage, or other parts of the body. The effect is to enliven the rib cage so that it gives better support to the shoulders and neck, which relieves tension and discomfort in these areas and assists in treating neck and shoulder injuries.
Massage of the anterior chest wall and breasts facilitates experiencing one's breasts as a normal and natural part of our bodies.
By encouraging easy breathing, releasing tension in the muscles and bones located in the chest, and encouraging healthy flow of blood and lymph, chest and breast massage can support overall physical wellness, as well as mental, emotional and spiritual well being. It is effective as part of treatment protocol for shoulder and neck injuries.
Breast massage with a treatment focus
Breast massage can also effectively treat conditions such as scar tissue, lymphedema and other cancer related issues, recovery from mastectomy, recovery from breast reduction or breast augmentation procedures, problems with lactation, and swelling related to cycles.
Reclaiming an often lost natural connection to parts of the body
Informed Consent / Supporting public safety: You always have the right and the responsibility to direct any therapist not to massage any part of your body which you prefer to be avoided. The informed consent protocol designed by Barbara includes a full detailed explanation and written detailed consent. This is designed to support public safely by preventing incidents in which clients receive unwanted touch. It is not universal, as not all states allow for this work, but where it is legal, the protocol should be applauded and adopted. It removes shame, keeps the client in control and promulgates the idea that the human body is normal, in all shapes and sizes.
For more information on Barbara's work click here
For a European perspective click here
Interested in learning more? Check out these resources
Chest & Breast Massage Resources
online articles & websites
Breast Wellness: article by Debra Curties, published in 2003 in ABMP magazine. ~ Debra Curties is a well respected author in the field of breast massage education. She is the author of the book entitled Breast Massage. Debra lives and works in Canada.
Breast Massage: article by Kellum Johnson ~ how to do breast massage, along with some insightful comments. Kellum Johnson is a massage therapist licensed in Texas.
Breast Massage Therapy: information on website of Tony Ruggeiro in Texas ~ summary of benefits of breast massage, and more. Tony Ruggeiro is a massage therapist in Greensville, South Carolina
Breast Massage Good for Mothers Before and After Delivery: article by Phyllis Hanlon, published in 2013 in Massage Magazine. Phyllis Hanlon is a professional author and frequent contributor of articles in Massage Magazine.
Breast Massage from a Massage Therapist: Have you considered it?: article by Pam Fitchner in WHOlife, Wholeness & Wellness Journal of Saskatchewan, Canada. Pam Fitchner is a massage therapist in Saskatoon, Canada. She also facilitates workshops on breast and belly and complementary health.
A series of blogs articles on breast care and massage: article by Aristide M. LaVey in the Massagewallah blog. Aristide M. LaVey is a massage therapist who practices in Los Angeles, CA.
Breast Massage: on the Brink of Understanding? article by Karrie Mowen (Osborn) in the ABMP website, first published in 2001. Karrie Mowen is/was a contributing editor of the ABMP Massage & Bodywork magazine.
Female Breast Massage for Better Health: article by Nancy L. Ring on an ABMP supported website, published in 2009. Nancy L. Ring is a massage therapist in Cornell, Michigan.
Desexualizing the Touch Experience – A Proactive Approach: article by Cherie Sohnen-Moe, published in Massage Today. Cherie Sohnen-Moe is a highly respected massage therapy educator.
Innate Traditions, postpartum care: an organization offering training on postpartum care for women, a holistic system of care which honors women's physiological design. Rachelle Garcia Seliga’s work is dedicated to midwifing a cultural shift that honors innate wisdom, personal authority and the sanctity of Life.
Breastnotes.com: BreastNotes.com was created to help people to understand the breast: its development and growth patterns, its function and purpose, its role in various societies, its care, and its problems. It has information about going without a bra, health practices, cancer and lots more. One could spend days reading this fascinating website!
Post Surgical Therapy for Mastectomy and Implants an article by Paul Lewis on the Massage Therapy Canada website.
The Happy Breast Book by Cheryl Chapman
Breast Massage by Debra Curties
Therapeutic Breast Massage 1hour 48 minute DVD by Meade Steadman, published by Aesthetic Video Source.
short video by Barbara Helynn Heard: this 2+ minute video on YouTube demonstrates how I massage the chest as part of a fullbody, wellness focused massage for both men and women.
short video by Barbara Helynn Heard: this 3+ minute video on YouTube demonstrates how I massage the chest as part of a fullbody, wellness focused massage for women.
Abhyanga Ayurvedic Massage: this 2+ minute video introduces a full body Ayurvedic massage which integrates the full chest into the treatment.
Ayurvedic Massage at Indian Spa: This video shows the chest and abdomen being massaged as an integrated whole starting at 12:45.
Breast Self Massage In this brief, how-to video, Aubrey Lesicki, BS, LMT, teaches the PHAST technique of breast self-massage. The PHAST breast self-massage technique is a quick, simple way to manage your breast care, improving breast circulation as well as the quality of the tissue texture.
Phluff Your Girls and the Happy Breast Book with Cheryl Chapman: Cheryl Chapman is a breast health advocate & teacher & lectures on breast health nationally.
short video showing movement of diaphragm a YouTube video
Video showing full Breast Massage
Another Video showing full Breast Massage
This article was written from and excerpts taken with permission from Barbara Heard
A Really Good Massage Blog
I write about things that I myself need to be mindful of. ways in which I would like to improve. It is not from the perspective of preaching - but rather writing helps me work out what I myself need to do - we are all in this together.