As a therapist who works with Lymphatic Massage in Fitzroy North and post-cosmetic-surgery patients, I often get asked, “What’s the difference between MLD and Brazilian lymphatic drainage?” To answer this question, I often have to give people a background of my training as a Lymphatic Drainage therapist and what is happening to their body post-liposuction. What are the differences between Vodder MLD and Brazilian Lymphatic Drainage Vodder MLD, which is the therapy I offer for post-cosmetic surgery and also Lymphoedema management, is a very light, rhythmical, skin-stretching technique. It has about 100 years of history, and it has a strong research base for lymphedema management and is useful in postoperative recovery, either in cosmetic or orthopedic surgery. Brazilian lymphatic drainage, on the other hand, tends to be firmer, more continuous, and pragmatically geared toward reducing swelling and bruising after cosmetic procedures, but it has less scientific evidence to support any benefits. For post-cosmetic surgery lymphatic massage (liposuction, abdominoplasty, facelifts, tummy tuck…) I would strongly recommend gentle Vodder-style MLD, and here is why: Any surgery, including cosmetic surgery, is highly invasive for the body, and therefore, you will present post-surgery with High skin sensitivity Swelling and bruising Pain A gentle approach, as Vodder MLD, would allow: Reduce the swelling with a pain-free approach Take away exceeds inflammation Help reinforce skin sensitivity As the healing process progresses and you move from the acute to the sub-acute healing phase (week 2 to week 3), we can start applying stronger pressure to break down fibrosis. What people call “Brazilian Lymphatic Drainage” “Brazilian lymphatic drainage” (BLD) is a manual therapy that is getting famous thanks to social media presence and some influencers talking about it. It is a practice which often refers to faster, more continuous wave-like movements and sometimes firmer pressure than Vodder MLD, and involves the usage of oil too. Those who offer Brazilian Lymphatic Drainage claim a faster recovery after aesthetic procedures (reducing bruising, local oedema, and tissue stiffness), even though clinical literature that looked into BLD in aesthetic and post-op settings, like randomised trials, describes this technique as debatable, and furthermore, the evidence of its efficacy is limited compared with Vodder studies. What does the research say? Systematic reviews on MLD (Vodder used often) show MLD is commonly used for decongestive therapy in Lymphoedema patients. The quality of the evidence varies, while effect sizes are moderate for some outcomes. Randomised trials that compare Vodder MLD with other modalities (e.g., compression, pneumatic compression) report benefit for symptoms and arm volume in breast cancer-related lymphedema and postoperative swelling in some surgical contexts. An early RCT explicitly used the Vodder technique and showed benefits in arm lymphedema management. Recent reviews and clinical articles regarding plastic-surgery literature highly support the use of postoperative lymphatic massage. The recommendations are to receive MLD one to three times a week, in the early recovery phase, for reducing swelling, pain, fibrosis and improving comfort. That said, often that information is shared by the surgery clinic staff after the surgery; therefore, it’s always better to choose a clinic that is clear and transparent about the post-surgery recovery, and not only about the surgery itself. When looking for studies about the Brazilian Lymphatic Drainage massage, it is hard to find something that is specific enough about this technique, and that doesn’t mix data and trials with other techniques, like bandaging and exercises. Therefore, it’s hard to evaluate the quality of this technique in terms of the RCT protocols. MLD – What works for what? Practical comparison For lymphedema (medical swelling after lymph node removal/cancer). When someone presents with lymphedema, the best choice is Vodder-style MLD as part of complete decongestive therapy. I don’t do this recommendation only because I offer this service, and I know its potential, but also because Most RCTs and meta-analyses have evaluated MLD (in Vodder style) as the safest and evidence-based treatment that has enough relevance for this type of presentation. For early post-operative care after cosmetic procedures (e.g., liposuction, abdominoplasty, facelifts, tummy tuck). In any given surgery, along the acute phase, the body is a high state of inflammation and the site of surgery would be delicate to touch for several weeks post surgery, indeed a gentle approach to the area is highly recommended, so Vodder-style MLD is way safer compare to Brazilian Lymphatic Drainage, because the tissues are fragile; MLD at this stage in time, it would helps reduce oedema and bruising and promotes comfort. Many plastic surgeons recommend MLD early and frequently in the first 2–6 weeks. Later phase (2–6+ weeks): While healing is progressing and you step into a sub-acute phase of recovery from the post-cosmetic surgery, firmer or more targeted techniques, which recall what Brazilian Lymphatic Drainage can be used to address residual fibrosis/stiffness, always with the surgeon’s clearance. That said When dealing with post-cosmetic surgery fibrosis, even Vodder MLD would include firm pressure. That’s how fibrosis is broken down. For general wellbeing, detox/relaxation, cellulite or fluid retention Gentle MLD (Vodder) is great for relaxation, reducing mild fluid retention, and supporting circulation without soreness. Good for regular wellness maintenance. Brazilian-style DLM is often used in aesthetic clinics for body contouring and cellulite care; people report feeling less heaviness and faster visual improvement, but the high-quality evidence is more limited, and outcomes vary with practitioner technique. MLD Safety & Contraindications – What You Need To Know In my practice, I am selective about who I offer MLD, especially after cosmetic surgery, and here is what I would look out for: Active infection Uncontrolled heart failure Acute deep vein thrombosis (DVT) Untreated cancer without clearance Fever Recent major bleeding or unstable medical conditions Liver or Kidney conditions After cosmetic surgery, you have to make sure to follow the surgeon’s recommendation about antibiotic intake, and or other medications. MLD can not start unless you are cleared of all the above. So, which do I recommend, Vodder or Brazilian Lymphatic Drainage? It is now quite clear that at Melbourne Massage and Treatment, for MLD, either […]
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