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Q & A For Liposuction Clients

Massage - Connective Integration Massage Therapy - Arlington, Texas

Please read the Q & A before contacting the office.


*Session time will not be scheduled if you have one or more of the following: inflammation, fever, bleeding or oozing from the surgical openings. Surgical drains must be removed before you are seen. I am not a doctor nor do I work under the scope of a doctor. My sessions are not that of what you receive in Barbados nor in Florida. A doctor's or surgeon's clearance is required before you are seen.

How soon can I schedule a appointment for Manual Lymphatic Drainage (MLD)?

You may start Manual Lymphatic Drainage 1 to 7 days after surgery for face, breast, mid section, flanks, inner thighs and arms augmentation/liposuction. All surgical incisions that have not healed completely must be covered with a bandage. *Your drains must be removed and you cannot be leaking fluid from incision areas.

Do I need a medical release?

You must obtain a medical release from your surgeon's office if you are under six weeks post operation. Any post surgical complication requires a release. Chiropractor's note are not accepted. You will not be seen if you have a drains, blood clots or an infection such as cellulitis, necrosis, staphylococcus or MRSA

"I cannot lie on my back or stomach".

Side lying position will be used for those that cannot lie on their bottom or stomach. Clients that have had a Brazilian Butt Lift (BBL or fat graph) will need to bring their own BBL pillow to their session. I do have a breast pillow for those that may need one. No standing massage will ever been used for your session. 


How many Manual Lymphatic Drainage (MLD) sessions will I need?

It is recommended to start with two to four, 30-minute MLD sessions per week during your first two weeks post operation. After two weeks post operation, session time will extend to 1-hour for light massage, myofascial release and manual lymphatic drainage. Each session is a case by case assessment to determine what is right for your post operation needs. 

What is the costs of post cosmetic manual lymphatic drainage and massage?


The cost is $50 for a half hour session and $90 for 1 hour session with Manual lymphatic drainage and massage. This may include two or more modalities such as connective tissue release, gua sha, craniosacral therapy,  vacuum cupping, and/or gentle massage with radio frequency therapy. An assessment will be made to determine what you will need.

Do you accept insurance?

No, I do not.

What form of payment do you accept?

Cash or credit cards are acceptable forms of payment. Checks or money orders are not accepted.

I only want a certain area worked on. Do offer touch ups for certain areas such as abdominal, gluts, arms or thighs?

Yes, touch up services are $50 per half hour for returning clients.

Do you offer discount packages?

No, I do not. Due to the time, effort, training and tools I use the cost of each session is more than fair market price. 

Do I need a MLD session daily after post operation?

The first week of your surgery you may need multiple sessions back to back. After a week it could be considered excessive to do so. Check with your surgeon to clarify. Your surgeon should had given you instructions for self care along with a protocol for self massage between your MLD sessions. You should be massaging the areas morning, noon and night to reduce hardness and lymph fluid. If you are not doing this I highly recommend doing so. There are videos on YouTube on self massage after liposuction.

How many times a week will I be able to book?

Most post cosmetic clients book once a week. Others book two to three times per week. Each client's needs are addressed on a case by case assessment. 


Do you recommend that I invest in Manual Lymphatic Drainage (MLD) and massage before my surgery?

Yes, I recommend that you invest in at least two sessions or more of MLD, connective tissue release and massage before your surgery. This will aide in preparation of the surgical area for your surgeon and may reduce complications.

Does manual lymphatic drainage hurt?

No, it does not. Only 5 grams of pressure is applied to the skin to stimulate the lymphatic system. Clients that are further along in their healing process may request massage with their session. I cannot guarantee you will have discomfort due to post surgical procedures. 


Do you perform deep pressure on liposuction patients?

No, aggressive massage will be used. It can take anywhere from 3 to 6 months to heal. Too much pressure after your first several weeks of surgery may cause undue stress, trauma and injury. In some cases it may cause surgical incisions to re-open, muscle injury and/or in rare cases a possible hemotoma to occur. Nerves, tissues and muscles are sensitive to the touch in most cases. Most clients after a liposuction or augmentation are unable to adapt to deep pressure techniques. Deep pressure may cause aggravation to the surgical area as well. No deep pressure techniques will be used. If you seek deep pressure or aggressive massage after liposuction please look for services elsewhere. 


Can you "push" fluids out of my surgical incisions or drains? Another therapist in Florida did it, so why can't you?

No. First, it is out of a massage therapist scope of practice in the state of Texas to do so. Second, I do not deal in bodily waste or fluids - that is hazardous material and waste. I do not reopen surgical incisions. That is a surgical procedure that needs to be done in a doctor's office. You will need to go to a therapist that is under the scope of a surgeon's license. From my experience the procedure does not allow the body to naturally heal by allowing the lymphatic system to do its job by "forcing" fluids out of incisions or drains.  


After any surgery you will have discomfort, numbness, fluid retention and bruising. When this type of procedure is performed after surgery may cause unnecessary discomfort, pain and trauma. This procedure is not true lymphatic drainage. If you seek this procedure please seek services elsewhere.

How much pressure do you use for Manual Lymphatic Drainage (MLD)?

I use very light feather like strokes to stimulate the lymphatic system. No more than five pounds of pressure is used. Just think of a dime gently being moved across your skin. You will also notice that when MLD is applied it will relax the parasympathetic nervous system creating a calming and therapeutic effect. I use a combination of Chikly and Vodder methods for MLD. Manual Lymphatic Drainage is not a massage!


It's been months since my liposuction surgery. My doctor just recommended Manual Lymphatic Drainage and massage therapy. I have hard solid mass of scar tissue and swelling. Will manual Lymphatic drainage help?

Hard lymph or fibrosis and scar tissue will be addressed first then manual lymphatic drainage technique will be applied afterwards. Scar tissue will suppress the lymphatic system from doing it's job. It will take time to reduce scar tissue and for the area to drain. This is why it is extremely important to start MLD sessions as soon as possible after surgery. You will need the Post Liposuction MLD with massage, cupping and radio frequency.


My doctor says I have fibrosis.

Fibrosis conditions will require more sessions than an the average MLD session. In a case of fibrosis I recommend a 30-minute castor oil pack treatment before a regular session of MLD and massage.

I have keloids. Will your services assist with this condition?

Yes, depending on how your body heals after surgery you may see a increase of keloids. Like any other condition it takes time do reduce them. Vacuum cupping,  Gua Sha, myofasical release and RF may help with this condition. 

I have scar tissue due to fibrosis. Can MLD help?

Please review the previous question on fibrosis. You will need more than lymphatic drainage. The course of action would be to break up the fibrosis adhesion's with medi cupping, myofasical release, massage and other techniques. Remember fibrosis is not a easy fix and may take multiple sessions depending on the severity of the scaring. In severe cases surgery may be involved to remove fibrosis tissues. 

I think I may have a "botched" surgery. Can you determine that I have? What Can I do?

I cannot diagnose if you've had one or not. I can recommend several excellent surgeons so that you can contact for a further consult and diagnosis. 


Sometimes fibrosis of the tissue will occur when the area has been bound too tightly, acquires an infection or client does not invest in manual lymphatic drainage after surgery. You may have a seroma underneath the fibrous tissues. Consult your surgeon to find out if you do indeed have fibrosis and/or a seroma. Keep in mind fibrosis may ruin your procedure.


I have loose skin after MLD. Will it go back?

When the tissues and muscles are saturated with lymph it may stretch the skin. It may take several weeks if not longer for the skin to go back into shape after surgery. If your doctor performed liposuction and did not remove excess skin that could be why. Speak with your doctor about your excess skin. Most doctor's will perform touch up's after four to six months after your first initial surgery. As your doctor for more information. A collagen supplement is beneficial for tightening the skin after surgery.


Vacuum cupping, skin rolling and radio frequency are found to be beneficial for tightening the skin after surgery.


I have scar tissue from a previous cesarean. Will Manual Lymphatic Drainage (MLD) help?

The manual lymphatic drainage technique will not break up scar tissue. I will use other methods to break up scar tissue then apply MLD. 


Do you insert drains or tubes so that the lymph can drain?

No. Surgical drains are inserted during surgery by your surgeon not by a massage therapist. Not only is this out of my scope of practice but can be dangerous if you acquire the services of someone that is not trained to perform the procedure. It may cause injury and infection. As a massage therapist we do not handle bodily waste nor do we re-open incision areas. It is against the law for a Texas massage therapist to do this.


The tubes or drains are removed two to three days after your liposuction surgery. There should be no need to get fluid removed by way of a syringe or tubes unless you have a seroma or a pseudo seroma. In a case of an on going seroma, a pen-rose drain can be inserted by your surgeon. Seroma is a condition where fluid is trapped between the muscle and the connective tissues causing swelling in the liposuction area. Do not treat a seroma on your own. Consult your doctor for further instruction and treatment.


Can manual lymphatic drainage assist with a seroma? 

Each case is different. Please consult your doctor. Your doctor may need to drain the excess fluid with a syringe (usually a simple procedure at the office) or add a pen-rose tube so that you may drain. If your doctor has recommended a lymphatic drainage session you may proceed. 


After my surgery my incision/liposuction area is "hot" or inflamed. What do I do?

Please contact your doctor immediately. You may have an infection such as cellulitis or a hematoma. Your doctor will make an assessment then prescribe you the necessary medication you need. Mild inflammation is a natural part of the healing process when a medical procedure is performed. Always check with your surgeon or doctor to make certain that you do not have a infection.

I think I may have cellulitis. Will manual lymphatic drainage help?

I will not see a client if it is suspected that they have this condition. Cellulitis is caused by skin bacterial infection. In most cases those that have cellulitis will have a hard, swelling, red rash (not limited to hot and tenderness) that will be located in the surgical area. To prevent a more serious condition from occurring such as phlebitis you will need to contact your doctor for treatment immediately. Your doctor will assess a treatment plan that will include antibiotics. It is extremely important take your medication as directed to prevent cellulitis from spreading to other areas. 


I have a hematoma. Can I get manual lymphatic drainage?

The area in which the hematoma is located will be avoided. You will need a doctor's release before you are seen. 

I have a hernia. Can I get manual lymphatic drainage? Will you be able to repair the hernia as well?

Yes, you may schedule a appointment for MLD but the area will be avoided. You will need to consult with your primary doctor or surgeon about repairing the tear. I cannot repair a muscle tear and it's out of my scope of practice to do so.


I have numbness in my flanks and abdomen. Is that normal?

Yes. in some liposuction patients it can take up to 6 months or longer to get feeling back in areas where liposuction was performed. Sometimes the liposuction tool or laser will scrap muscle tissue and nerves creating a raw, sore like sensation.


My flanks are tight. What could be causing this?

The most common area where clients complain of tightness is the flank area. When healing occurs scar tissue will form in the area of surgical procedure. After surgery the body will begin to repair itself by producing collagen to create new connective tissue to support the muscles, tissues and organs. Thus this process will create fibrous bands of thick adhesion's that shorten the muscle fibers creating a "tightness" sensation. The scar tissue formation will continue to form up to 3 to 6 months. This is why massages are important to reduce scar tissue restricting muscle movement.


My skin is itchy and it feels like something is crawling inside of me. What is that?

Most clients complain of a "itchiness" or crawling sensation after surgery. That is a normal sensation. The itchiness is the surgical area healing and the crawling sensation that is usually your lymphatic system draining or your nerves adhering back to the muscles and tissues. Consult your doctor for further assessment if you have any concerns.


Should I use my compression garment or binder?

Compression garments are recommended to reduce swelling after your surgery. Compression garments help aide in the body to heal faster. They can be used up to 6 months or more after your surgery. Follow your doctors' care instructions on how to use your compression garments. If you are seeing imprints or area becomes hard and rigid due to wear, go one size up to reduce injury and scar tissue formation until the swelling goes down. You can purchase a Tommy Copper compression tee or tank top to wear underneath your binder for additional comfort and circulation support.


Make sure your compression garment is firm while using lypo foam. When the garment is too loose it may cause the lypo foam to rub against the skin creating skin irritations and possible skin burns.

So that your skin can breathe and the lymphatic system can drain you may want to take off your garments 1-2 hours daily. 

I have deep indention's or grooves due to my compression garment or stomach board. Is that normal? Can this condition be corrected?

No, it is not normal. To prevent this from happening you'll need to purchase lypo foam for your garment/stomach board. You're surgeon will need to evaluate the condition and if necessary revisions may need to be performed. Consult your surgeon. 

Do you recommend stomach boards?

No, I do not because most of the time the board may cause complications with indention's, lines and swelling if not properly worn. 

I have have pain, fatigue and soreness in my legs. Is that normal?

Yes, your abdominal muscles are connected to your leg muscles. Sometimes you will feel discomfort in the legs following your surgery. If you notice discoloration, severe pain and discomfort, inflammation, headache, running a fever and/or have unusual swelling consult your doctor for further assessment immediately.


I can't heal after my surgery. What can I do?

Consult your doctor as soon as possible. Your doctor may need to prescribe antibiotics. You may try enzyme therapy and a probiotic to aide in the repair of the body. Make sure you incisions are covered with a band aid or gauge and you are using an antibiotic cream. You may clean area with hydrogen peroxide. Change out your gauges several times daily to prevent spread of a possible infection.


I just had a Brazilian Butt Lift. Will Manual Lymphatic Drainage (MLD) kill the fat cells?

No, MLD will not kill the cells. If anything it will help the surrounding tissues to heal, increase circulation, remove excess lymph and reduce swelling.


Do you use medi or vacuuming cupping?

Yes, in cases of scar tissue and fibrosis I do use medi cupping. When you come in for your first session I'll make an assessment if medi cupping is an appropriate tool to use. No cupping will be performed if there are signs of infection or sores. You cannot not have a hernia, hematoma in the area that will be cupped. Those that have liver or kidney conditions cannot be cupped. If your doctored performed sculpting/contouring medi cupping will not be used.


I have "bumpiness" after my liposuction procedure. How do I get rid of them?

It is normal to have bumps or lumps after liposuction. Swelling can occur up to six months after surgery. In some cases they will never go away no matter how much massage or lymphatic drainage sessions are performed. Your surgeon will perform touch up's after 3 to 6 months after your liposuction procedure. Check with your doctor to make sure you do not have an infection.


To reduce signs hard adhesions you will need to start your first lymphatic drainage session no later than 7 days after your surgery. Compression garments and lypo-foam are essential to reduce the signs of "bumpiness" and fibrosis. Compression garments should always be worn 3 to 6 months after surgery to reduce swelling and bumpiness. Always follow your doctor's after care advice.

I have hard pea size knots near my surgical incisions. What are those?

In some occurrences surgical sutures do not dissolve creating hard little pea size knots. Sometimes collagen will form around the sutures creating a hard adhesion about the size of a pea.  Eventually these little knots will come to the surface of the skin. You may remove them yourself but make sure you keep the area clean and bandaged to prevent infection. When this occurs pay close attention to the area making sure there no rash, swelling, or fever. If so contact your doctor. Bacterial infection such as cellulitis may occur due to suture rejection.

I have oozing, sores and my skin is turning black around my surgical area after a tummy tuck. Is this serious? What can I do?

You may have signs of skin necrosis. Skin necrosis is a medical condition when the skin begins to die. Please consult your surgeon immediately for medical treatment. Time is of the essence with this condition! If you doctor fails to treat this condition please consult another surgeon for a second opinion immediately! 


I had major complications after my surgical procedure and it's taking longer for me to heal. I am also depressed. What do you recommend?

In some cases a healing crisis will occur after a traumatic injury or surgical procedure. Please consult your doctor or counselor for assistance. 


Having a emotional and physical support system of understanding friends and family is essential for the recovery process.

I bloat/swell up more than normal. What could be causing my bloating/swelling?

After liposuction surgery your physiology of the body is never the same. It may take 3 to 6 months or more for the inflammation to subside after your surgery. The food and drink you are ingesting might be causing your bloat/swelling.  You'll notice swelling after eating things that are high in sodium or sugar. This is an inflammatory response. Check the content of sugar and sodium of the food and drinks you consume. Changing your diet to a low sodium and low sugar diet may assist with this dilemma.

*If you are prone to urinary tract infections (UTI) this also could be the case for your abdominal swelling as well.


Do you use any electric massagers?

Yes, in rare cases. 


Do you perform radio frequency?

Yes, this is included in the session price of the Post Liposuction MLD Session with vacuum cupping for $90.

Do you perform body sculpting?

No, I do not.

Is craniosacral therapy beneficial for post operation surgeries?

Case studies have shown craniosacral therapy to assist with healing after a surgery. In most cases central nervous system, lymphatic, fascia, venous and muscular systems are injured. Recovery times are sometimes reduced by restarting the cranial pulse and balancing the sympathetic and  parasympathetic nervous system. Craniosacral therapy is a option you may choose with your session at no additional charge.

Disclaimer: Massage therapy is not a substitution for medical treatment. The massage therapist cannot diagnose, treat or prevent disease. The therapist can only recommend products and services. Please consult a medical physician.

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