WOMEN’S HEALTH

LYMPHATIC RECOVERY

Rachel Fincham delves into bridging the gap between surgery and recovery with post-operative lymphatic therapy

Despite excellent surgical care and detailed aftercare protocols many patients still find recovery less predictable than expected. They leave with information packs and clear instructions, yet the reality of healing is rarely simple. The challenge isn’t a lack of information. It is learning how to apply it to a body that doesn’t behave like the example in the info pack. Post-operative lymphatic therapy helps bridge the gap between written guidance and lived experience.

WHY LYMPHATIC THERAPY MATTERS

Surgery reshapes more than the visible surface. Beneath the skin, the lymphatic network is interrupted in ways that change how fluid moves. The vessels that maintain fluid balance are often cut or disrupted or in liposuction cases, removed along with the fat. When tissue is excised or repositioned, original drainage routes don’t behave as they once did. Fluid that previously moved through predictable pathways now increases and stagnates. The result is swelling, tightness and that deep full feeling many patients describe.

Post-op Manual Lymphatic Drainage (MLD) supports the lymphatic system while it regenerates. It guides fluid into safe, intact territories and avoids directing flow across fresh incisions or areas of tension.

Routing is tailored to the surgical map: where tissue was removed, where lymph vessels were disrupted and which pathways remain viable.

Applied with this anatomical awareness MLD helps protect sutures, reduces the likelihood of seroma or fibrosis and creates the conditions needed for healthy scar formation and easier movement.

EARLY INTERVENTION AND COLLABORATION

There is no universal start point for MLD. Some surgeons prefer treatment within the first few days, while others suggest waiting until tenderness settles or dressings lighten.

In most cases, drains are removed before the patient leaves hospital, so therapy usually begins once wounds are sealed and comfortable positioning is possible.

A gentle early session helps promote healing, settle swelling and give patients confidence in their progress.

Collaboration makes a significant difference. Compression guidance varies between surgeons. One may recommend continuous wear for several weeks; another may prefer phased reduction. I share short updates when needed, especially if something doesn’t look typical like localised heat, asymmetry or firmness.

Clear communication builds trust and helps keep recovery aligned across the team. Patients notice when their care feels consistent and healing often follows a smoother path.

INSIGHTS FROM CLINICAL PRACTICE

Each procedure has its patterns. After a tummy tuck (abdominoplasty), patients often mention evening swelling in the upper abdomen and lower back tightness. Early sessions focus on diaphragmatic breathing, gentle decongestion and practical posture support. Even small improvements like sleeping better or tolerating garments more comfortably can make a big difference.

High volume 360 liposuction commonly leads to patchy firmness around weeks three or four. Short regular sessions work better than long gaps between appointments. If fibrosis forms, MLD may be combined with oscillation therapy or mild negative pressure therapy.

Breast reduction patients may develop swelling along the lateral chest wall, with postural tension in the shoulders. Combining lymphatic work with breathing and mobility cues helps restore expansion. Once wounds are closed, gentle scar glide work supports long term comfort and reduced swelling.

Patients want to know what’s normal and how to interpret the shifts in their body day to day. Progress might mean less tightness, lighter movement or clothes fitting comfortably again. Clinics can help by assigning a post-op MLD specialist before surgery and providing a clear, consistent aftercare guide, aligning expectations and preventing minor concerns from escalating.

PROFESSIONAL STANDARDS & TRAINING

Genuine lymphatic drainage in a surgical context requires clinical understanding of anatomy, surgical procedures and their effects on the lymphatic system, healing timelines and contraindications. Anything else risks irritation, bruising, tissue damage or worse.

Safe post-operative MLD is grounded in recognised systems such as Vodder or Földi training. Each session begins with a check for common issues followed by treatment shaped to the surgery and stage of recovery. When clinics partner with trained MLD specialists, outcomes are consistently stronger. Post-operative MLD is no longer seen as an optional extra, it’s an essential continuation of care.

RACHEL FINCHAM

Rachel Fincham is a post-operative MLD specialist based in Cheltenham, UK. Trained with the Dr Vodder School and Petra Erving’s Aftercare Academy, she provides advanced lymphatic drainage and recovery support through her practice, Lymphara Clinic.