Lymphatic Massage Therapy Reduces Fibrosis after Liposuction

Fibrosis is considered as one of the most frequent complications that may interfere negatively and significantly the patient's satisfaction after liposuction surgery.  Fibrosis is the formation of hardened plates in the subcutaneous tissues denoting temporary or definitive irregularities on their surface and affecting affect the body contour.

Studies have shown that in the "Liposuction Group (LG) and Liposuction Abdominoplasty Group (LAG), a gradual decrease of classification levels was observed, specifically in relation to tissue fibrosis. Initially, the LG patients were divided into the highest levels (L2 and L3); and 70% of the LAG patients were classified as L2. After the application of this protocol, 62.5% and 50% of patients from both groups had the fibrosis reduced completely; the remaining ones showed the lowest degree of fibrosis, classified as L1.

Before and After Photo Liposuction (VASER Liposuction with Brazilian Butt Lift)

"The association between manual lymphatic massage drainage and the therapeutic ultrasound reduced the swelling and the tissue fibrosis and made pain disappear in liposuction and lipoabdominoplasty PO period."

Reference:

Igor, et al.  Manual lymphatic drainage and therapeutic ultrasound in liposuction and lipoabdominoplasty post-operative period.  Indian J Plast Surg. 2014 Jan-Apr; 47(1): 70–76.

Kim et al.  Analysis of postoperative complications for superficial liposuction: a review of 2398 cases.  Plast Reconstr Surg. 2011 Feb;127(2):863-71

Lisboa FL, Meyer PF, Alves DK, Wanderley SC. Protocolo para avaliação fisioterapêuticados níveis de fibrose cicatricial em pós-operatório de lipoaspiração associada ou não à abdominoplastia. Reabilitar. 2003;19:11–8.

Soares LM, Soares SM, Soares AK. Estudo comparativo da eficácia da drenagem linfática manual e mecânica no pós-operatório de dermolipectomia. RBPS. 2005;18:199–204.

Tacani RE, Alegrance FC, Assumpção JD, Gimenes RO. Investigação do encaminhamento médico a tratamentos fisioterapêuticos de pacientes submetidos a lipoaspiração. O Mundo da Saúde. 2005;29:192–8.

Lymphatic Massage after Liposuction

One may notice a hardness or lumpiness to the areas treated with liposuction and/or with other body contouring procedures (such as fat injections for what is popularly known as the Brazilian Butt Lift).   This post-surgical lymphedema is caused by inflammation and trauma from the cannula (instrument that sucks out the fat) moving under the skin.  Channels are formed by the cannula that can fill up with fluid and the tissue also becomes swollen.  Manual Lymphatic Massage helps to move the fluid by gently pumping it back into the lymph vessels.  Reducing the swelling can reduce discomfort and may reduce contour irregularities after a   liposuction procedure.  Without Lymph Massage (LDT or MLD) the inflammation can evolve into fibrosis (a permanent hardening of the tissue) or a seroma ( pocket of serum) can form.  It is imperative that one should follow the post-operative protocol of your plastic surgeon to achieve the best possible results and avoid developing fibrosis and even possibly contour irreguarities.

Clinical studies have shown that lymphatic massage also improved the clinical outcome after a cryolipolysis procedure.   The study had shown that post-treatment manual massage resulted in a mean fat layer reduction was 68% greater in the massage side than in the non-massage side as measured by ultrasound at 2 months post-treatment.  At 4 months, mean fat layer reduction was 44% greater in the massage side.   Histological results showed no evidence of necrosis or fibrosis resulting from the massage.

I do NOT recommend receiving a general therapeutic, deep tissue or Swedish Massage in lieu of a lymphatic massage therapy after a liposuction procedure.

Emmanuel De La Cruz MD, PLLC

Plastic & Reconstructive Surgeon, Houston Texas

References:

Boey, et al.  Enhanced clinical outcome with manual massage following cryolipolysis treatment: a 4-month study of safety and efficacy.  Lasers Surg Med. 2014 Jan;46(1):20-6.