If any of your surgery is going to include skin removal (e.g. mastectomy, top surgery, breast lift, tummy tuck), you want your posture to match what you want it to be after surgery (otherwise, if you’re in a contracted posture when the surgeon makes their marks, too much skin may be removed), so I recommend deep tissue massage leading up to surgery (but no less than 7 days beforehand), to open up any areas that need it.
2-3 days before surgery, I recommend a full-body session of manual lymph drainage to make sure your lymph is already flowing well and that your skin glides easily along the structures underneath (which will make for better results).
After surgery, the body has been severely traumatized (which affects the mind, too!), so the most important things first are to bring down inflammation and to help the brain and body feel safe again.
I’ll perform MLD as soon as 48 hours after surgery (wearing gloves!) if the doctor requests it, but I usually prefer to wait until a week out, to encourage complete rest during week 1.
I gauge everything else by how well the client is healing. I prefer to focus on MLD, gentle scar manipulation, and gentle range of motion techniques during weeks 2-6. Keeping things moving–whether it’s lymph or tissues–is crucial.
I may start incorporating gentle massage cupping as early as 4 weeks to assist with lymphatic drainage in any spots that are beginning to harden. (I only do dynamic cupping, where the cup is being continually moved, not left in one place. I also don’t do any cupping over an incision until the scab has fallen off, at which point I can use cups to help lift the scar and mobilize it.)
Most commonly, I’ll see clients for one hour 3x/week for a couple of weeks, then slowly lengthen the time between sessions based upon how they’re feeling.
I always tell my clients to be prepared to be absolutely miserable for a full 6 weeks (not everyone is, but SO many people wish they’d known it could take so long to start feeling human). And if they’re having a BBL, I tell them to be prepared to have to have someone else drive them to their appointments for a few weeks, because the special pillow doesn’t work well enough for everyone at first (especially for clients with shorter legs who may find they can’t reach the car’s pedals when they use the pillow).
I also tell them that during the 6th week, they’re going to feel enough better, and be sick enough of being out of commission so long, that they’re going to be tempted to do something stupid and overdo it. They may even tell themselves they “deserve” to do ___. Then I say, “Please don’t do it! Hear my voice in your head: ‘Be gentle and loving with yourself! You’re not ready yet!'”
After that point, if there was lipo involved in the surgery, I don’t do deep tissue work until 12 weeks out. If not, I go by how well everything is healing. Unless there was some kind of complication, I usually don’t need to do any lymphatic work after 12 weeks.