The Cosmetic Surgery Recovery Secret Dr. Koehler Swears By

Announcer (00:02):
You are listening to Alabama the Beautiful with cosmetic surgeon, Dr. James Koehler and Kirstin Jarvis.

Kirstin (00:12):
Hey, Dr. Koehler.

Dr. Koehler (00:14):
Hey, Kirstin.

Kirstin (00:16):
You want to know what we're talking about today?

Dr. Koehler (00:18):
Please tell me.

Kirstin (00:19):
This is one of your favorite subjects. I feel like I say that a lot. Lymphatic drainage massage after surgery.

Dr. Koehler (00:28):
That's my favorite. Why is that my favorite?

Kirstin (00:31):
I'm just joking.

Dr. Koehler (00:32):
Okay.

Kirstin (00:32):
It's kind of a boring subject. I was just trying to spice it up a little bit.

Dr. Koehler (00:35):
Oh, okay. Yeah. Well, let's talk about it.

Kirstin (00:37):
Okay. What is lymphatic drainage massage?

Dr. Koehler (00:43):
Well, it's a type of light pressure massage that massage therapists use to help mobilize the tissue fluid to the lymph nodes. And so when patients have procedures like liposuction or tummy tuck, there's going to be tissue fluid, a fluid that builds up within the tissues, and so to help get the patients to recover quicker and get their swelling down, massage therapists will use light pressure to help push that tissue fluid towards the lymph nodes. And the lymph nodes are what carry tissue fluid back into the bloodstream. And so what we're really trying to do is to help get the swelling down after surgery and get people recovered quicker. That's ultimately what we're trying to do.

Kirstin (01:37):
So you said a lot of times you recommend this after liposuction. What cosmetic procedures is this helpful for? What else?

Dr. Koehler (01:46):
I mean, I think that the biggest procedures it benefits is liposuction and tummy tuck. I don't know if any of my patients have done it after a breast surgery, but I'm sure some people have certainly could be done. And I've heard of people doing it after a facelift surgery even to help mobilize the swelling after facelift surgery. But most commonly it's done after body lifts, tummy tucks and liposuction. That's what it's done most commonly.

Kirstin (02:13):
When is the best time to start?

Dr. Koehler (02:17):
Well, some doctors have different thoughts on this, and some people start it kind of really early. But for me, I usually would be like, don't do anything the first week. Let's just get you through the pain. And if there is discomfort, let's get you through that. Sometimes patients have drains, and a lot of times we'll get those out before they start lymphatic massage, but not always. So it's usually about a week to 10 days. I'd say that we'd be starting the lymphatic massage. And the big thing about it though is, or at least in our area, not every massage therapist really understands lymphatic massage. And on top of that, the ones that do are kind of booked out. And so you've got to plan ahead if you want to do lymphatic massage. You can't just have the surgery and go, oh, hey, who could I go see for lymphatic massage?

(03:09):
Because when the therapists are doing lymphatic massage, they're going to want to see you two or three times a week for the first few weeks. So to be able to, and they're not long appointments, but still they got to get you on the schedule. So you got to plan this in advance. So if you're thinking, oh, I think I'd really like to do lymphatic massage to kind of help my swelling down quicker and get a quicker recovery, then you need to do that at the same time your scheduling your surgery, or maybe sooner even. But you need to know when your surgery is. So usually a week out after the surgery and talk to the massage therapist, make sure they're comfortable with it, and then yeah, they'll see you two or three times a week to do this light pressure massage. It's different than regular massage.

Kirstin (03:54):
Okay. What happens if you skip it? Does that slow down your recovery at all?

Dr. Koehler (04:01):
I think you can still end up at ultimately the same point without it, but definitely people who do lymphatic massage after their surgery, the fluid doesn't build up as much. They don't complain of at the end of the day being just really bloated and swollen. And I have some friends of mine that actually in other states that actually have somebody in their office that does that, and they swear by it. They think it makes a big, big difference.

Kirstin (04:33):
So what are the benefits? Does it help with bruising and swelling?

Dr. Koehler (04:37):
Well, I've heard people claim it helps with bruising. Definitely swelling. Swelling is the big one, and it helps. The thought is that if you can help mobilize this tissue fluid, you're going to get less fibrosis and scarring in the deeper layers and maybe potentially less risk for things like seromas. So where fluid builds up in pockets, and when people get a seroma, that sometimes has to be drained surgically. You can't just massage it out. So getting that tissue fluid mobilized to the lymph nodes will definitely help get that swelling down quicker. And again, it's important to get a person who understands it because you got to know where the lymph nodes are because you got to be directing the fluid in the right direction.

Kirstin (05:22):
Well, that kind of leads to my next question because I know you can buy oils and roller balls and cups and stuff on Amazon to be able to do a lymphatic drainage massage at home. So is that something that you can do yourself or should it always be done?

Dr. Koehler (05:37):
Yes.

Kirstin (05:38):
Okay.

Dr. Koehler (05:39):
No, you can definitely do it yourself. And I think there's some nice little videos and things online to help people. It's not complicated. You can't use heavy pressure. You got to know where you're trying to massage the fluid to. And after had a few sessions with a lymphatic massage specialist, you'll kind of see what they're doing. I mean, if you have somebody that can help you do that, I mean, the thing is there's incisions, and so you cannot be massaging in the wrong directions, and you can't be tugging on the incisions. And so having an experienced professional is important, but let's say you're a little further along where everything's kind of more or less healed. You can continue to do lymphatic massage and you can do it yourself and with those tools. But I'd say early on, you want to definitely have a professional do it because you don't want to open up your incision or maybe use too much pressure. So a trained person is what you want to do at first, but then once you've sort of seen it and done it, and maybe now we, instead of being two or three weeks out of surgery, we're four or five or six weeks out, well, you could do it yourself. You're not going to hurt yourself at that point by doing it, and it'll probably help.

Kirstin (06:48):
Do you have any favorite massage specialists close to us that you like to refer people to?

Dr. Koehler (06:54):
Yeah, we definitely have some people. If you contact our office, we can certainly give you their names. I'm not going to speak it out online. I mean, there's definitely some people that we like we've had good luck with and they know what they're doing and patients like them, but there's a lot of people around. But again, you need to ask if you're going to just use any massage place, you need to ask them are they experienced in treating these patients.

Kirstin (07:27):
Are there any specific people that should not get it? Or any risks involved?

Dr. Koehler (07:32):
If somebody's rough or they don't respect early postoperative incisions, or they're maybe an incision that's maybe not fully healed in their, I mean they get bacteria from some kind of oils or stuff like that into your incision, that would be, I don't say there's no major contraindication, but somebody's got to be careful in those, especially if they're starting massage earlier than a week. If a doctor likes their massage earlier than the week, you want an experienced person doing that.

Kirstin (08:04):
Is there any correlation to lymphatic drainage, massage and great final results? Or is it just mostly about healing faster?

Dr. Koehler (08:14):
I think mainly it's about healing faster. But I would say there are exceptions. When people get high definition liposuction done where you're kind of etching and carving out abs, that's a procedure where if you're not really diligent about getting the fluid out and getting things to stick down and heal down, you can end up with maybe more fibrosis and a result that's not nearly as good. So there are certain procedures where I'd say it may definitely influence the outcome of the procedure. Maybe not all of them. I do think it's beneficial, but people that do the sculpting of the abs high def stuff, like you're going to want to have lymphatic massage as part of your recovery process, no question.

Kirstin (09:01):
Okay. Do you have a burning question for Dr. Koehler or me? You can leave us a voicemail on our podcast website at AlabamatheBeautifulpodcast.com. We'd love to hear from you. Thanks Dr. Koehler.

Dr. Koehler (09:13):
Thanks, Kirstin.

Kirstin (09:14):
Go back to making Alabama beautiful.

Dr. Koehler (09:16):
Alright, I'm doing it.

Announcer (09:21):
Got a question for Dr. Koehler? Leave us a voicemail at AlabamatheBeautifulpodcast.com. Dr. James Koehler is a cosmetic surgeon practicing in Fairhope, Alabama. To learn more about Dr. Koehler and Eastern Shore Cosmetic surgery, go to easternshorecosmeticsurgery.com. The commentary in this podcast represents opinion and does not present medical advice, but general information that does not necessarily relate to the specific conditions of any individual patient. If you enjoyed this episode, please share it and subscribe to Alabama the Beautiful on YouTube, apple Podcast, Spotify, or wherever you like to listen to podcasts. Follow us on Instagram @EasternShoreCosmeticSurgery. Alabama the Beautiful is a production of the Axis, theaxis.io.