Structural Balance after Plastic Surgery

Updated: Jan 29





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Structural balance is key to the success in the beauty of the shape and grace of the body. Plastic or Cosmetic surgery is great for sculpting the body to look the way we want, but if the body isn’t structurally balanced it cannot carry itself in a graceful manner. If the body is not structurally balanced it is easier to damage muscles and joints.


Postoperative care is a key component in the journey of healing and finding that body shape that is desired. It is imperative to success. The question is: What post-operative care should I invest in for the greatest success?


The answer is that there are many steps to be taken. Even before you begin the journey you do your research about the doctor who will be doing the surgery you want. You interview them and set the date. That’s awesome! Now, what about your aftercare? What about your pre-operative care? You need to work on your body pre-operatively to have better success. I often hear: “Really, Jill? The point of the surgery is that I didn’t want to work at it.” Ok. Ok. I get it. And sometimes I hear, “Jill, I have done so much exercise and my body never changes.” Ok, I hear you. It is more than exercise that I am referring to.


Well, it is more than that. Yes, you should be doing some exercises in preparation for surgery. Why? There are a couple of reasons why. First, if you are shrinking your fat cells prior to surgery then the doctor will be able to remove more fat cells. Once a fat cell is there it is permanent. You can shrink it or grow it, but your body doesn’t just eliminate it. Liposuction was created for that reason. So, exercise is a good way to shrink the size of the fat cells so that more fat cells can be removed. The next reason is for the muscular integrity of your frame. During your recovery, you will be going between 6 to 12 weeks without any exercise and perhaps longer for strength or weight-bearing exercise. This can cause some atrophy of the muscle. In turn, this can cause muscle stiffness and pain. If the muscles are healthy due to exercise this process is slowed. And one of the greater reasons (well in my opinion) is that this will increase your lymphatic health; which in turn increases your immune system. The lymphatic system depends on your muscles to move the lymph. The movement of muscles moves lymph. This will allow your body to recover more quickly and the swelling to reduce faster. This is also another reason I recommend getting manual lymphatic drainage (MLD) 3-5 days prior to your surgery.


Now let's talk about post-operative care. Before the surgery, you interviewed your doctor, chose them, and scheduled. What about your MLD therapist? Have you interviewed the person you will be spending hours with every week for the 12 to 18 weeks (maybe longer) after your surgery? Is she or he qualified? What are their credentials? Yes, I know I harp on this. The reason I bring it up so often is that I have seen so many go to a massage therapist or esthetician that claims they do lymphatic massage for post-operative care. The issue is that the people saying they are qualified having only taken a six-hour course in a day and then think they are qualified because some teacher told them so who was told by someone they were and so on. Here is a question. How many hours did they study the lymphatic system and the anatomy and physiology involved in the care of the lymphatic system? Was it two hours? Was it 35 hours? Who would you find more confidence in? Someone who studied the system for 2 or 35 hours? Certified Lymphedema Therapists spend a minimum of 35 just on anatomy and physiology. This does not include the process of performing manual lymphatic drainage or compression. This is just to understand how the body is put together and how the flow and the actual workings of the body happen. This portion of the training informs the student what it is they are doing and how the work they do on a patient actually affects their body as a whole and even just in the specific area they are working. This allows them to understand if there is some form of complication that has occurred or is obstructing the workings of the system. When a therapist takes a course that is six hours long, the most common course out there right now is the course that is 2 hours of lymphatic drainage, 2 hours of machine-assisted contouring (ultrasonic cavitation and radio-frequency), and 2 hours of wood therapy. So, they don’t even study the function of the system for 2 hours. They simply jump straight into technique. No understanding of anatomy and physiology; no science behind what they are doing; no protocol. – No thank you! A Certified Lymphedema Therapist is also a Lymphatic Drainage Therapist (the CLT is the higher certification and LDT is the lower certification). A Lymphatic Drainage Therapist has 45 hours of MLD training. This includes anatomy and physiology. The CLT has 135 hours of training and has taken the Complete Decongestive Therapy Course. CDT utilizes MLD and compression techniques to reduce the body (this in reference to edema or excessive lymphatic load). We learn not just MLD techniques and protocols we also learn compression techniques and protocols. And one thing that I find imperative to this training is that we are trained to the why a specific technique or protocol is employed. Part of our jobs as CLTs and LMTs (licensed massage therapists) is patient or client, respectively, education. If we don’t know what or why we are doing something how are we to educate our patients or clients.


Ok, so you’ve interviewed your therapist and booked your pre-operative and your post-operative care. You have done your first few weeks of MLD. Now what? Well, your massage therapist/CLT will begin doing body contouring. This can be manual or machine-assisted. I personally prefer manual body contouring, but many opt for the machine-assisted as there is no discomfort. There is a need for manual even when it is machine-assisted. The fact that manual contouring is needed in addition to machine-assisted is why an esthetician is not qualified. Estheticians are not licensed or trained to do massage. If you hadn't had surgery then an esthetician can certainly do machine-assisted body contouring.


Machine-assisted body contouring would be ultrasonic cavitation; radio-frequency; micro-current with LED therapy; vacuum cupping; and electro-muscular stimulation. There are other machines, however, these are the ones that I offer. Some doctors want the patients to begin the machine-assisted body contouring in week three. Others want to wait until week 6. My opinion is that it depends on the surgery and the feel of the tissue. I don’t recommend MABC prior to the six-week mark no matter the surgery. If we are talking Mommy Makeover with a Tummy Tuck; then my recommendation is 12 weeks or when the body feels ready (there is a change in the response in the tissue that is distinct).


Manual Body Contouring involves Instrument Assisted Soft Tissue Mobilization (IASTM); manual therapies (deep tissue massage techniques); Lypossage; Fire Cupping; and Wood Therapy. In my opinion, there is really no exact week to start this. It is truly a matter of the response in the tissue. Sometimes while I am working on someone I will find some fibrotic webbing has developed in the second week. I will work on that as I go without tools – gently. Fibrosis doesn’t really begin until week 3 so there is no point in doing any of the other therapies prior to that. Sometimes the fibrotic tissue was there prior to surgery – actually I will amend that to be typically there is fibrosis in the fascia prior to surgery that needs to be addressed. This fibrosis will affect the shape, so it needs to be addressed. Now how it is approached and how aggressive the work will depend on the response of the tissue. When you are in this phase, please do not take muscle relaxants prior to the session as the body’s responses are muted and can lead to an inappropriate technique being applied, before you reach this stage take all the meds you need and are prescribed even if it is a pain killer or muscle relaxant. Generally, by the time we begin this stage, you won’t need pain killers or muscle relaxants.


So you have been cleared to exercise. Do you just go to the gym and work out exactly as you have before? I wouldn’t recommend it. Your center of gravity has changed. You are still not familiar with your new body, but you still have muscle memory. That memory and the signals that are sent need reprogramming. My recommendation is to see a personal trainer for a minimum of ten weeks post-op once you have been cleared to strength train (weights). A good personal trainer will focus on your form and structural balance before just pumping and toning the muscles. A good personal trainer isn’t going to push you into cross-fit directly after surgery.



I do have a personal trainer that I send people to at this stage. I have interviewed him at length. We have discussed the needs of patients that have had BBLs or Tummy Tucks with muscle repairs. He doesn’t instruct his clients to do insane vertical jumps on narrow platforms. He focuses on form and structural balance. He understands the need to retrain your core to communicate your new center of gravity. He will teach you how to lift properly with your new shape and form. He will watch you while you do a squat so that you can adjust your legs to get the best form. He doesn’t just tell you what to do and then leave it. He pays attention. This trainer is Jeff Hernandez. He can provide workouts for you to do at your own gym or in your own home. He will listen to your situation and create a plan with you for your needs. Jeff is at Has Fit Gym off McCollough just a block south of Northstar Mall. I recommend you contact him at least a month in advance of when you think you will be ready. Interview him then schedule with him. You can text Jeff at 210-725-8670.





If you have any questions please send me either a text at 210-985-9911 or email me at Jill@HealingEnergy.Rocks.





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