We know that physiotherapy is prescribed after knee replacements and hip fracture surgery so why don’t we see prescriptions for more surgeries including plastic surgery?
It is not a common thought to prescribe such therapies after a breast augmentation, tummy tuck, or even liposuction but according to research, it should be! Any time the body is cut into and changes to shape, size, look occur we are inevitably changing the way we move and use that part of our body.
Scars can create adhesions to nearby tissues that can change and limit movements, and in some cases cause discomfort or pain. Post-operative scars can also become hypertrophic causing unwanted limitations and cosmetic changes. Research suggests a few options for treating scars and preventing the formation of hypertrophic scarring including: silicon bandages, scar taping, compression therapy, skin care and manual therapy including massage therapy and physiotherapy (Meaume, S., Le Pillouer-Prost, A., Richert, B. et al., 2014). Manual therapies can also be used to improve function, range of motion, and decrease pain associated with scars (Shin, T.M. and Bordeaux, J.S., 2012). When undergoing plastic surgery, the goal is typically to improve the look, feel, or function of something and in order to do this it is important that the scar tissue is treated with care and consideration.
Another common side effect of plastic surgery procedures is swelling and in some cases a progression to fibrosis. The human body naturally responds to trauma, including surgery, by activating an immune response and trying to heal the surgical site as quickly as possible. Part of this process requires excess fluid to rush to the area to help in the immune healing response. Although this is what we want to happen, sometimes our bodies send too much fluid and then it has a hard time recovering this liquid. This is when we see swelling. In order to help the body recover that fluid more effectively we can wear compressive garments. This helps support the natural lymphatic flow. Another method of improving lymphatic flow is by using a manual therapy technique called manual lymphatic drainage (MLD) which should be performed by a certified lymphedema therapist. When examining the impact of compression therapy and manual lymphatic drainage on swelling and pain levels post liposuction and lipoabdominoplasty it is observed that both techniques as well as therapeutic ultrasound are beneficial (Masson, I. F., de Oliveira, B. D., Machado, A. F. P., Farcic, T. S., Júnior, I. E., & Baldan, C. S., 2014).
It is no secret that physiotherapy and massage therapy techniques can have a huge benefit to plastic surgery recovery. It is important that all manual therapies are performed by a therapist that has experience and knowledge of dealing with post-operative protocols and are certified in lymphedema therapy. By combining great surgical technique with ongoing post-operative care we can help to improve and encourage great outcomes for cosmetic procedures.
References:
Masson, I. F., de Oliveira, B. D., Machado, A. F. P., Farcic, T. S., Júnior, I. E., & Baldan, C. S. (2014). Manual lymphatic drainage and therapeutic ultrasound in liposuction and lipoabdominoplasty post-operative period. Indian journal of plastic surgery, 47(01), 70-76.
Meaume, S., Le Pillouer-Prost, A., Richert, B. et al. (2014), Management of scars: updated practical guidelines and use of silicones. Eur J Dermatol 24, 435–443. https://doi.org/10.1684/ejd.2014.2356
Shin, T.M. and Bordeaux, J.S. (2012), The Role of Massage in Scar Management: A Literature Review. Dermatol Surg, 38: 414-423. https://doi.org/10.1111/j.1524-4725.2011.02201.x