Richmond Park Therapies

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Surgery causes physical trauma by cutting through or disrupting (eg with a liposuction cannula) 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).

 

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 (called 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.

 

Why is it so important to reduce swelling? Swelling at a surgical site can cause issues with the speed of healing because it can pull the wound open presenting an infection risk, or pop stitches at skin or subcutaneous levels jeopardising the integrity of healing tissues and creating an untidy scar line. Swelling also increases the risk of seroma developing. Seroma are essentially pockets/holes left where tissue has been removed by surgery (eg 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.

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How soon after surgery can I have MLD?

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With the consent of your medical professionals 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 abated somewhat.

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How many post-surgical MLD treatments will I need?

 

It depends on the type of surgery you have had and how much of your body is involved.

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It is helpful to consider MLD treatment according to its main purpose at various points around a patient's surgery:

 

1)  Pre-operative MLD (ideally 1-3 sessions in most cases)

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Preparing your body for surgery by having 1-3 MLD sessions in the week prior to your operation is highly recommended to detoxify ahead of the heavy use of anaesthetics, antibiotics, painkillers etc. MLD will improve circulation in the area undergoing surgery, boost immune response and get you used to being in a state of increased lymphatic flow, as well as helping to relax your nervous system ahead of the big day..

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2) Post-operative MLD 'Intense Phase' (as prescribed by the surgeon, the average being 10 sessions)

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The primary goal of an intense phase of MLD is to reduce inevitable swelling in damaged tissue and to keep it 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, or if seroma does develop, MLD helps to drain that fluid off naturally rather than having to resort to a surgical solution. 

 

Most surgeons will now prescribe an MLD treatment schedule for their patients on discharge from hospital, eg for extensive liposuction this might be: daily in the first few days, every other day in the second & third week, weekly for a further 2 weeks and then once a month for maintenance up to 5 months, or eg after a hip or knee replacement, this might be 3 times a week for 3 weeks.

 

Where an MLD schedule has not been medically prescribed, the therapist 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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3) '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 loads the newly growing lymph vessels and increases the likelihood that cross-scar connections can be re-established. MLD treatment about once a fortnight 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.

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How does the Consultation/Booking process work?

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If you wish to book MLD for post-surgical care, please contact the therapist (Nina) as soon as possible ahead of your surgery, in order to outline your requirements, check her availability for your intended period of convalescence and to ask any questions you might have. If you think you may need treatment at home before being mobile enough to visit the clinic, you will need to obtain a separate quote for any off site appointments.

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When planning to have a number of Intense Phase MLD appointments in close succession, it is best to book these in at the same time as the therapist operates more or less to capacity and availability cannot be guaranteed to suit your schedule at short notice after your 1st visit.

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After booking, you will be sent a Post-Surgical Health Form to complete online, which will supplement what you may have already told the therapist about your surgery. Please do this as soon and in as much detail as possible, it enables the therapist to begin planning your treatment schedule with sufficient time to contact you for further clarification if necessary.