Will lymph drainage massage help after a Facelift?

Dr. Dean Kane Q & A.

Q.  I have heard a Lymphatic Massage helps against swelling after a FL. Is this true or just performed because of the placebo effect? It is quite expensive and the Danish doctor says at least 5 treatments are needed? Is there any research proving this?

A.  ​It is a natural and expected side-effect following surgery or injury to develop swelling and scar. If fact, this is how the body heals itself. In some patients, the swelling may be quite uncomfortable and compromise the result of the surgery.

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​I, too, recommend massage following surgery but it must be performed by you with proper instruction or a well trained individual who understands the post-surgical and healing process.
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​The warmth of your hands improves circulation, the pressure placed and the technique of massage applied changes during the process of healing. I have developed and recommend 3 basic techniques and variations:

1. ​Swedish massage: light moisturizing or gentle washing - like upward touching of the skin. This will assist in sensitizing or de-sensitizing the skin as the sensation returns. It is very useful for individuals who are reluctant to touch the surgical site as well.
2. ​Lymphatic, "squeegee" massage: firmer compression or moving pressure pushing a wave of fluid out of the swollen area of surgery or injury. It is likened to squeezing water out of a sponge. Studies have shown that retained swelling or edema creates a cycle of lymphatic obstruction and persistent swelling. Retained swelling over many months also creates more lumpy scarring and collagen bundles. Lymphatic swelling, I believe, will assist in remodeling collagen in the direction to best match your facial contour, so massage firm but gently always in an upward direction.
3. ​Shiatsu, deep pressure or deep scar massage: directed deeper accentuated pressure with a rolling or rocking character to break up the lumpy collagen scar formation. Such lumpy scar, if it forms, does not occur for 3-4 weeks after surgery so do not use this technique unless your surgeon directs you too. It is followed by long strokes of lymphatic massage.

I recommend these techniques 3 to 5 times a day for very short periods of time.​

​Lymphatic and Shiatsu massage may also create different levels of trauma to the tissues or break sutures placed specifically to suspend or hold tissues in place.

​More IS NOT better.

DO NOT perform such therapy without the specific instructions of your surgeon. If deep scarring or reduced function occur, your surgeon may recommend physical therapy for other alternative techniques and ultrasound therapy.

​Higher protein, low carbohydrate diets also assist in healing and swelling reduction due to the hormones this dietary balance generates in the body.

Most importantly, consult your surgeon regarding the use of these or other techniques in assisting your healing following facelift or any other surgery or injury.

​I hope this has helped.

All the best!

I'd like to improve my eye area upper and lower. Would fillers and/or Botox would be a good combination?

Dr. Dean Kane Q & A

Q.  I'd like to improve the look of my eyes without a large expense. I'd like to get rid of the bags and wrinkles under my eyes, the crows feet and my frown lines.

A.  ​I will answer your request in a very comprehensive way. As you point out, cost and maybe recovery time are an issue and this may determine your satisfaction for the goals you set and expectations you have.
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​Thanks for sharing you photo. This is helpful but you will need a in-person consultation to examine you and review your options.

Various options for facelifting, minimally and non-invasive facial enhancements and skin texture improvements are available according to the skin laxity and areas of lift or tightening you wish or need. Both surgical and minimally invasive / non-surgical options are listed below.

Surgical lifts would be likened to pulling the bedspread and or top-sheet of your bed up to the head-board and removing the excess material.

Minimally invasive procedures such as fillers provide volume such as adjusting a pillow under the bedspread. Botox and Dysport act by pulling the top-sheet which drags the bedspread upwardly. If the bedspread (or skin) continues to fall to the foot of the bed despite fillers, Botox or Dysport you will need to consider a facelift.

Non-invasive options such as laser and light therapies, skin tightening products and technologies perform their tightening and smoothening of the skin similar to sending your bedspread to the dry cleaners. A more refreshed, even colored, glowing smoother and tighter spread covers the surface of the bed.

The most popular of the fillers, Restylane and Perlane, a jelly-like clear skin filler is used to fill lines, wrinkles and folds. Juvederm and its longer lasting "cousin" Juvederm Ultra Plus are similar skin fillers, used to soften and fill the nasolabial ("parentheses") and marionette folds, the brow ("number 11") lines and fill and lift the cheeks and lateral brow or chin. Voluma is the longest lasting, up to 2 year duration HA filler. Each one is used to expand or volumize the loss of tissue associated with expression, weathering or aging. All the fillers come with numbing anesthetic!.

Non-surgical facial contouring is possible with fillers such as Radiesse, a bone mineral for the nose or cheeks, jaw and chin as well.

Scuptra is the latest of the injectibles stimulating collagen at different levels of the skin adding volume but primarily firming and adding resistance to the formation of wrinkles, folds and descent.

Botox and Dysport too have been found to rebalance excessive facial expression, provide a non-surgical brow lift and lip lift and reshape the nose, as well as reducing wrinkles!

Your photo does show significant dry skin, loss of elasticity, folds and wrinkles.

Dr. Obagi's new, second generation ZO Skin Health programs may be added to personalized chemical peels, light and laser resurfacing and tightening and will, smoothen and even the color of your skin. It is the basis for all skin rejuvenation in our practice.

IPL and fractionated lasers such as CO2 and erbium and now RF (radiofrequency) are additions to smooth the texture of the skin, tighten and reduce red and brown uneven pigmentation.

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​If you can pinch more than an inch of skin along the jawline in front of your earlobe, you should consider a surgical option to redrape and remove extra skin.

​You may consider: a traditional face and neck lift, short scar face and / or neck lift.

The recent resurgence of the S-Lift (created in the early 1900's), also called by other names as the Quick-Lift, Lifestyle-Lift, Swift-Lift, Soft-Lift, MACS-Lift and others; are a single modification of the S-lift targeted to elevate sagging lower cheeks jowls and lateral upper neck. The shorter scar, limited undermining and second layer lift achieve the "quicker" procedure but not necessarily the quicker recovery or the improvement you desire.

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​Face lift and / or neck lift or any of the other procedures and their combinations should be discussed following a proper examination by a Board Certified Plastic Surgeon who performs all of these options so you will not receive a biased approach because he or she is limited in their skills.

I hope this was helpful!