Is lymphatic drainage massage necessary after a tummy tuck? How does it help with recovery?

In 1999, I presented my work on Manual Lymphatic Drainage at the Annual Conference of the American Society of Lymphology Chicago, Illinois
August 21-22, 1999. My study was called Manual Lymphatic Drainage Therapy (MLD): An Integral Component of Postoperative Care in Plastic Surgery Patients. My study found that MLD with Deep Tissue Massage significantly shortened the postoperative recovery phase in these patient groups.From the time I started Plastic Surgery in 1985, I had found that all aesthetic and reconstructive plastic surgery patients prefer a short postoperative recovery phase so that they could return to normal activity and that the sensation of the operated areas felt "normal".  In my study two Vodder-trained MLD therapists performed a series of postoperative treatments on the following patients groups; 
1.Liposuctions of Abdomen
2.Breast ReductionsTummy Tuck (Abdominoplasty)
3. Facelift
4. Breast Augmentation
5. Mastopexy Liposuction of buttocks, hips, and thighs.
 The therapist performed MLD + deep tissue massage 1-2 times per week for the first 3-6 weeks following the given procedure. As subcutaneous fibrosis (scaring under the skin) developed, deep tissue massage was incorporated into the session. The end point of therapy was decided by the patients' subjective feeling that the operated area felt 'almost' normal. I have always found that patients who do NOT undergo postoperative decongestive MLD therapy, have a predictable and consistant postoperative course, which includes postoperative swelling which peaks 2-4 days following surgery and is followed by soft tissue fibrosis creating lumps and bumps under the skin of the operated area by postoperative day 14-42. The extent of the swelling  (edema) and stiffness and bumpiness (fibrosis) depends on many variables: 1) the operated location (dependent areas like knees and ankles) swell more), 2) the patients activity level of the operated part 3) fluid retention in the operated part and 4) previous surgery on the same area. Without MLD postoperatively, I have typically seen complete resolution of postoperative swelling (edema) and stiffness in the tissues of the operated areas, between 9 months to 18 months following these types of surgeries. In the 5 groups listed above who underwent MLD and Deep Tissue Massage, postoperative swelling and fibrosis resolved within 6 weeks to 3 months, thereby shortening recovery significantly. Because all surgical patients typically prefer a shortened postoperative recovery phase and since 1996 I incorporated a postoperative regimen of MLD for ALL my postoperative patients,  so that they have significant decrease in swelling, pain, and subsequent soft tissue fibrosis to their operative site. By six weeks my patients typically say their operative site(s) feel "normal" again. I hope this helped.

Everyone is different, and I would be for the final answer to your plastic surgeon. In my experience, lymphatic massage has been helpful in reducing the normal swelling from an abdominoplasty more rapidly than I would normally expect. This has been personal observation, and I know of no studies that showed this, but after a 35 years of plastic surgery practice and several thousand abdominoplasties, I believe it is helpful and certainly has no down side.

In my 27 years of practice I have had patients do massage and patients not do massage. To this day I see no influence on long term results. In my opinion, while it can temporarily move fluid it adds cost, can be quite uncomfortable properly done, requires more visits and does not influence the result. While I don't "recommend" it. I have no objection if patients wants to do it.