What Is (And Isn't) Lymphatic Drainage Massage

Lymphatic massage (also called Lymphatic Drainage, Manual Lymphatic Drainage, etc.) used to be a shy, yet powerful little modality that was almost unheard of outside certain circles. But with the increase in social media use came the boost in popularity of cosmetic surgery and, by proxy, Lymphatic Massage. Spend ten minutes researching plastic surgery on Instagram and not only will you come away with a short list of #bodygoals, you’ll know that your future liposuction, breast augmentation, or Brazilian butt lift should be followed with a regimen of post-op Lymphatic Drainage Massage.

But now that the treatment has become more mainstream, a lot of poseurs have swarmed the field. Several new therapies have popped up—all calling themselves Lymphatic Massage—confusing millions of scared, achy post-oppers who are just trying to get the swelling under control and recover from surgery in peace.

So first, let’s establish what a Lymphatic Drainage Massage is:

Manual Lymphatic Drainage is the application of light, flowing strokes of massage in specific patterns with the goal of alleviating lymph edema.
— ScienceDirect.com
Manual Lymphatic Drainage.gif

I’ve been doing Lymphatic Drainage Massage since 2006 and let me be honest: it’s not a very exciting massage for the client. It can be hard for people to believe that such a light, unobtrusive technique could possibly have any real benefit, especially when compared to a standard Swedish Massage. I’ve had people climb off the table after their first session and blurt, “That’s it?”

In my opinion, this is the reason why the “alternative” Lymphatic treatments have gotten popular to the point of eclipsing the real thing—they’re more dramatic, they make people feel like “work is being done”, and they align closer to what a typical person associates with a massage or spa treatment.

Allow me to address three common misconceptions and explain what a Lymphatic Drainage Massage is not.

#1. Lymphatic Massage Is Not A Deep Tissue Massage


(Please note that I’m using the term ‘deep tissue’ here in the colloquial sense.)

If I had a nickel for every time this common misunderstanding reared its ugly head in my clinic, well, I’d have a whole lot of nickels—but it’s not the client’s fault. Many of them come home to Boston after having both surgery and a few massages done in another state, and they contact me looking to continue the treatments they started. They walk in and give me the tentative, fearful look of someone who has been abused and expects me to abuse them further. They usually announce that they’ve taken ibuprofen before leaving home.

The lymphatic system is a delicate network of capillaries resting just underneath the surface of the skin. Pressure exceeding the weight of a quarter flattens the capillaries and prevents the fluid from moving. If you can imagine the effect on water flow through a garden hose if you step on the hose, this is exactly what happens if too much pressure—even moderate pressure—is used to perform lymphatic work. It is counterproductive at best; being heavy-handed and rough with a delicate post-op body can produce more pain, bruising, and swelling than is already there. The client may even pop a suture and need to seek the care of a surgeon (sometimes not even their own, if they had their surgery done in another state or country) to close it up again.

Unfortunately, this is a big one that new clients tend to insist on—they feel the massage is not effective if it doesn’t hurt.

#2. Lymphatic Massage Does Not Force Fluid Out Of Surgical Incisions

Lymphatic Evacuation.gif

I’m not even sure when this became a thing, but the popularity of what I call “Lymphatic Evacuation” is insane on Instagram right now. In cosmetic surgery recovery homes and med-spas across the country, massage therapists are using extreme measures to relieve fluid pressure in the body by forcing it out—literally out—through incision sites, in some cases opening up closed incisions to do so.

I understand the appeal of this technique, I really do. When you’re swollen and can barely move, you tend to prefer dramatic action in order to feel normal again as quickly as possible, and Lymphatic Evacuation is as dramatic as it gets. The excess fluid bypasses the lymphatic capillaries, lymph nodes, and kidneys altogether and escapes through a hole. But there is one big, glaring problem with this method, especially when done outside of a medical facility by those who are not licensed nurses or medical professionals: risk of infection.

Lymphatic Drainage, a.k.a. Lymphatic Massage is a very gentle technique, using a light touch. It most definitely does not involve opening an incision to squeeze fluid out, or squeezing so hard that it pops open an incision. Run away from anyone suggesting that!
— Dr. T Fiala, Fiala Aesthetics
Not recommended.
— Dr. V. Erella, Aspira Plastic Surgery & Med Spa
I can’t imagine that anyone would do this but you are correct in assuming infection a big risk. Incisions must be left to heal.
— Dr. G. Commons, MD
... It is below the standard of care for a non licensed MD to reopen [the incisions] to continue this type of drainage.
— Dr. J. Blinski, Blinski Plastic Surgery

Lymphatic Evacuation may indeed have a place in post-op recovery, especially if performed by licensed nurses… just don’t call it Lymphatic Massage.

#3. Lymphatic Massage Is Not An Ultrasound Treatment

Ultrasonic Cavitation.gif

Search “lymphatic drainage massage after lipo” on YouTube and among the top ten results, you’ll find at least two videos showing the above procedure. However, this is not Lymphatic Massage, it’s Ultrasonic Cavitation—a treatment that employs a surgical device using low-frequency sound waves to vibrate fat cells, liquefy them, and flush them out through the circulatory system.

While some physicians encourage the use of Ultrasonic Cavitation after surgery, others find it ineffective at best. According to a summary of doctor’s responses to the effectiveness of this treatment posted on RealSelf.com:

Yes the machines work, but the results are nothing like liposuction. …With a machine the fat removal is the same in all areas so it is a more of a general reduction of fat and not a specific removal.
If you have 3-5 inches of waist that you want to reduce, your best option is more traditional fat removal, such as liposuction. Non invasive machines, even the FDA approved ones, are pretty subtle when it comes to results in the mirror.
— RealSelf.com

Thus, while Ultrasonic Cavitation may be what you’re looking for, it is still not Lymphatic Massage.

With all the misinformation out there, it’s important to know the difference between these different treatments and the risks involved with each. If you’re not sure which of these procedures your chosen massage clinic if offering under the guise of “Lymphatic Massage”, please be sure to ask what you can expect—are there machines involved? Do they use a light or heavy touch? Will fluid be pushed out through your incisions? Make sure you know the answer to these questions, and if you don’t like the answer you receive, keep shopping until you find someone offering true Lymphatic Drainage Massage Therapy.