Lymphatic drainage after liposuction, in Seville

We don't operate, which is why your surgeon can send you here

In Seville, almost everyone offering post-lipo recovery also performs surgery. It works for their own patients and leaves everybody else going in circles: no surgeon refers a patient to another surgeon's practice.

There is no surgery here. We work from the report of whoever operated on you: their timings, their instructions about the garment, the incisions and the areas to leave alone. Between one follow-up and the next we are the hands; the decisions stay with them.

What is going on under the garment

The cannula tunnels through the fat and, on the way, breaks small vessels — including the lymphatics that used to drain that area. The body answers with inflammation and with fluid that no longer leaves the way it used to. That is why you are often more swollen a few days later than on the day itself.

Then the tissue heals. Internal scarring isn't visible, but you can feel it: when it lays down unevenly you get hard patches, steps and adhesions — what everybody calls fibrosis. It explains a good deal of why two people with the same operation end up with different results.

Bruising that tracks downwards with gravity, numb patches, tightness first thing in the morning: alarming, and normal. Knowing which things are and which aren't is part of the session.

What we do at each stage

Week one and month three are not the same treatment, even though both go by the name drainage: the pressure changes, the areas change, and so does the point of it.

• Early weeks, once your surgeon gives the go-ahead: very light manual lymphatic drainage, keeping clear of incisions and drain sites, moving fluid towards the routes that still work.
• Once healing allows: drainage continues and we start working the tissue in the areas that are hardening, before the fibrosis organises itself.
• Later stage: less drainage, more hands-on work on fibrosis and adhesions, mobility, and a gradual return to training.
• Ultrasound when it matters whether what we are feeling is fluid or tissue, because the two call for opposite things.

The garment does half the work, and that half is yours

We see you a couple of hours a week; you take the garment off for the session and we put it back on properly before you leave. The rest of the time it is the garment holding the tissue while it settles, and wearing it the way your surgeon told you does more for the result than any single session.

At every visit we look at how it sits: a rolled edge, a seam digging a groove or a size gone loose all leave their mark on tissue that is still soft. If it needs adjusting, we say so and you check with your surgeon.

One clarification, because plenty of people are told otherwise: drainage doesn't wash anything out of you. What moves is fluid, into the routes you already have. What decides the outcome is compression, movement and time.

What to show your surgeon, and what shouldn't wait

Part of our job is to look. These are the things we will tell you to ring your clinic about, even if they seem minor to you:

We diagnose none of it. We spot it and hand you back to the surgeon who operated, with your progress in writing. That is what a centre that doesn't operate is for.

• A temperature, or an area getting redder and warmer.
• Pain that climbs day after day instead of easing off.
• A wound that opens or starts leaking.
• An area that swells quickly and feels soft and under tension, like a pocket of fluid.
• Without waiting for anyone: pain or swelling in one leg only, or breathlessness and chest pain. That means urgencias, the emergency department, not a phone call.