How to Find a Good
Plastic Surgery Recovery Therapist
What Does Plastic Surgery Recovery
Massage Certification Actually Mean?
Here is some information you won’t want to hear, but you really need to know.
At this point in time, plastic surgery massage certification doesn’t mean much of anything.
It is a new industry that is currently developing, so there is no over-sight in terms of licensure of this unique profession that would ensure a certain level of training before someone can work on you.
That means that anyone and everyone can make up whatever they want and call it “Plastic Surgery Recovery Certification.” Then, they make a few YouTube or TikTok videos and throw up a few Instagram posts, and Boom! They get followers who spread their message far and wide.
People then take their courses, assuming that these people offering the courses actually are trained with accredited institutions and are licensed to do the work they are training others to do.
The problem here is that these self-declared “experts” may have little to no training themselves.
How is this possible?
Because the plastic surgery recovery industry is completely unregulated, anyone can just declare themselves an expert and start working on people. This is really a scary thing because it puts you, the consumer, at serious risk for your health.
Social Media Influencers vs. Legitimate Therapists
This comment may ruffle a few feathers because there are a few people out there who are both legitimate therapists AND social media influencers. Good for them! I hope that they are able to propagate good information via social media channels and help people with sound advice.
The social media influencers I am referring to here are not those few people. Instead, I’m talking about folks who are not trained or licensed themselves, and whose tag lines on Instagram often read something like “Want to be part of an industry that is predicted to be a $2.4 billion business by 2024?”. Typically, these influencers don’t care who signs up for their course. They don’t check people’s licensure, they just let people sign up and collect their money. The courses that they offer are all of 1-2 days long, have little (if any) basis in science, and at the end they hand out a certificate saying that so-and-so is now “Plastic Surgery Recovery Certified.”
This is truly frightening because it means that people who have had no training in anatomy and physiology are now working on people who are fresh out of surgery and who are in a very fragile state. For reasons of safety, this type of work should only be performed by people with the highest levels of training.
On the other side of the coin, there are a handful of very well-qualified therapists who have literally had hundreds, if not a couple thousand of hours worth of training in how to safely work on the human body. These people have carefully chosen their training in specialized subjects and have built a skill set unique to working with people after surgery. These people are often licensed massage therapists who hold advanced training, but some people in other related disciplines such as physical therapy may also be among this group.
The rest of this article goes through the different types of training that a qualified therapist may have. Since most people outside of the bodywork profession do not understand credentials that are available, I go through each one step-by-step to help you better understand what your therapist knows with various degrees of legitimate training.
How to Assess Your Lymphatic Therapist’s Credentials
Licensed Massage Therapist (LMT)
Licensed Massage Therapist (LMT) – most states require 500-600 hours of training. This is for someone to do entry-level, Swedish massage (spa style) and possibly basic deep tissue work.
A person who is a basic LMT should not work on a person after surgery for 6-8 weeks for several reasons. They do not have specialized training in working with people in a fragile state. This is not covered in standard massage training.
Advanced courses exist for therapists to learn how to work around surgical sites so as not to disturb them, infection control, and very importantly how to vary one’s pressure so that it does not cause pain, injury, or increase inflammation. Some (but not all) medical massage courses teach these skills.
Massage therapists are not allowed to work with bodily fluids. It is strictly forbidden and out of their scope of practice. Intentionally forcing fluids from incisions, reopening incisions, applying bandages, and other such practices are grounds for getting their licenses revoked. Actions such as this should be reported to the state massage board.
Massage therapists should never, under any circumstance, touch an open wound. Someone with wound care training and appropriate licensure may do this. If a bandage needs to be applied during a session, it must be done by the client.
The most a massage therapist can do is clean the sheets and table if there is accidental leakage from incision site. This happens sometimes if a person has had surgery in the week or so prior to their appointment. This is a different matter as the drainage was not intentional and the therapist did not do anything to intentionally cause the drainage to happen. It just occurs sometimes when clients change positions or get up from the table.
Lymphatic Massage Class
Some massage therapists take a 1-2 day course in “lymphatic massage,” and sometimes a school will touch on what lymphatic work is in basic training. By that, I mean they mention it, and it usually does not include actual training. If it does, then it is more often incorrect or incomplete training.
In truth, there is no such thing as lymphatic massage. Manual Lymphatic Drainage (discussed later) is often called “lymphatic massage” because people who are not therapists find this to be an easy way to describe it.
So, what does a person know who has had a course in “lymphatic massage”? It is hard to know because the courses can be taught by literally anyone whether they have proper training or not.
In my personal experience, my initial massage training to get licensed had a brief demonstration of “lymphatic massage” that was very vague and largely incomplete with technique that really wasn’t very effective. Had I have said “I know how to do lymphatic massage” after that training, I would have been doing a grave disservice to my clients. (Fortunately, I didn’t ever make this claim.)
When I was doing my medical massage training there was a class in “lymphatic massage” that was taught by someone who was truly MLD certified. That training was accurate, but as it was only 16 hours, it was very basic. We were told that with that level of training we could do basic lymphatic massage for detox/general health purposes. We were explicitly told to avoid anyone with lymphedema or anything surgical prior to the 6-8 week mark. In retrospect, I believe this was an accurate recommendation.
Manual Lymphatic Drainage (MLD) Certification
Manual Lymphatic Drainage certification is something that is taught by only a handful of schools around the US who are approved by the Lymphology Association of North America (LANA). The main schools are KLOSE Training, Academy of Lymphatic Studies (ACOLS), and the Norton School of Lymphatic Therapy.
MLD certification is a 40-hour course that teaches a good, solid foundation of how to reduce swelling using the lymphatic system. A person who has completed an in-person course for MLD certification from one of the aforementioned schools should have a very good grasp on the lymphatic system and should use effective techniques.
This is the most basic level of training in lymphatics that someone should have prior to working on someone soon after surgery. That being said, it would be best if they also have some training in working with fragile populations. Examples of this would be training in oncology massage, elder massage, or something similar.
Certified Lymphedema Therapists (CLT’s)
Certified Lymphedema Therapists are the people who are best suited to working with patients who have undergone plastic surgery. They have undergone a very rigorous training of a minimum of 135 hours. This training includes the MLD certification mentioned earlier plus advanced lymphatic drainage techniques that are helpful for surgical situations when scars are present and it is necessary to re-route fluid a different way. (There are “highways” under the skin and sometimes some of those roads are no longer passable due to surgery, CLT’s know how to work around these “roadblocks.”)
Additionally, CLT’s get extensive training in compression which is a fantastic skill set to help advise plastic surgery clients on fajas, arm sleeves, and sometimes compression stockings. Incorrect compression (too tight or poorly fitted) can result in worse swelling. CLT’s can make sure you are compressed with enough force to be effective while still ensuring your safety.
Most CLT’s are Physical or Occupational Therapists (PT’s and OT’s, respectively). However, other professionals may carry this credential. MD’s, DO’s (Doctors of Osteopathy), DC’s (Doctors of Chiropractic), Registered Nurses (RN’s), and Licensed Massage Therapists (LMT’s). Most of these professionals will either be employed by a hospital or have their own practice and you will likely not find many (there are some) who work on plastic surgery recovery.
The people who tend to be the most available to the plastic surgery market are the massage therapists. Massage therapists who are also Certified Lymphedema Therapists are very well suited to post-operative care. They possess not only the ability to reduce swelling, but they may also have skills such as myofascial massage which can help with tissues being stuck a few weeks after liposuction, and possibly scar massage. You need to check each person’s educational history to find out what particular skill set they have.
CLT-LANA is another designation in this group that you may see. These people are CLT’s who have some experience under their belt, and who have taken their knowledge to another level. The Lymphology Association of America (LANA) offers an optional exam for CLT’s who want to prove a higher level of knowledge. CLT-LANA is the highest certification that a person can achieve in the area of lymphology short of being a doctor who specializes in lymphatics – a lymphologist.
Other Professionals and How They Can Help
Registered Nurses (RN’s) are frequently people who help out in plastic surgery post-op care. They are often hired in the first few days to help with changing surgical dressings, bathing (in whatever form that takes – often sponge baths), dressing, getting up and down, etc.
The great benefit of being an RN is that you can do things that some other professions can’t do. RN’s can work with wounds whereas massage therapists cannot. The drawback is that their skill set is not super applicable after a week or so if a person is healing normally unless they are also MLD certified, a CLT, or have a massage license and training.