top of page

Cosmetic Surgery-A Field Guide to Expectations and Recovery


This field guide will focus on the healing process, as this is my specialty.

I have been a nationally certified manual lymphatic drainage therapist since 1998.

Specializing in post cosmetic surgery recovery and lymphedema and Lipedema maintenance.

This is a compilation of client’s stories and journeys mixed with clinical discoveries along the way.


Facial Work

Mirror Mirror on the Wall

Where did I go?

I see myself behind my eyes, but the reflection is not as I remember.

Contemplating a cosmetic procedure can be arduous, knowing you disappeared behind life’s journey but what is the risk, cost, procedure choice and healing process?

Questions to consider

1. What area of the face/neck/eyes will bring you back into focus?

2. What style of procedure is best for the desired look and longevity of the results. Is this a one and done or ongoing remodel?

3. Is this a new you or a refreshed you?

4. Is this a correction or smoothing and tightening?

5. Do you have patience for the new image to emerge or is there a demand for perfection now?

6. Is change easy for you or does change scare you?

7. Will you miss the old you or good riddance?

8. Post cosmetic surgery massage, is it right for me? Yes!

Continue reading for a client’s personal experience


When it comes to a facial procedure, it is essential to have realistic expectations, especially in the healing process.

Post procedure, the most common statements I hear are,

1. I wish I had known about the extensive swelling, numbness, and true length of healing.

2. I wish I was more prepared for the tight strap like tension at my throat and neck.

3. I wish I had understood rejoining the world would be more than 2 weeks.

Everyone heals differently and at different speeds. Generally, the younger we are the quicker it goes but not always. The new you slowly emerge over 3 to 6 to 12 months for some. The type of procedure, a tightening of loose skin or deep muscle restructure heals at different rates and patterns. A fresher toner appearance appears over time but you of yester year does not.

Supportive treatments

The addition of manual lymphatic drainage sessions, beginning at approximately 1 to 2 weeks post procedure, will expedite a quicker healing process. Moving out swelling, bruising, and softening scar tissue as it forms, shortens the healing time, and offers the best results possible.


Extreme Facelifts

An extreme procedure is available for those wanting a “New Beginnings Effect”, the Ponytail lift.

As the name implies, the facial tissue structure is lifted upwards, erasing all signs of the previous image.

Over the next year, a softening of contours and bone structure beneath emerges.

The two clients I assisted with this recovery had some of the most challenging emotional response to loss of their self in the early stages. Over time, the results were beautiful but getting to that point was a journey. Preparing emotionally is essential for our self-image. A static self-image is shattered to be reformed and reborn. Be prepared for this if who you are is directly connected to your image. Take time to develop an expansive since of self, fluid and evolving over time. We are not static nor is our body. Prepare your mindset for change.

Deep muscle restructuring

This procedure tightens the muscular structure but does not necessarily erase your image. Techniques are individual and unique depending on the philosophy of the surgeon. Shortening and relocating underlying muscles may shift your smile and facial expressions. Over time and use facial movement settles but this takes time. Swelling starts as an overall effect. It generally lessens at the temples and slowly contours down towards the neck. A neck lift swelling may start as a chimp monk look but slowly contours down under the chin. The deep neck muscles, cut and shortened, develops scar tissue at the center point under the chin. MLD and scar softening techniques, by a clinically trained therapist, will do wonders for softening and flattening the texture. Clients report a tight strap like feeling from the jaw to under the neck and throat. This will take up to 6 months to relax but at the 3-month marker scar tissue work will release this feeling. Generally, 1 session will do the trick. Some report headaches at the occiput, back of head. This is caused by the shortened muscles. Week 3 allows a deeper work to be applied, releasing the headache.

Those wanting a technical explanation; the galea aponeurotica, is a muscle covering the cranium attaching at the occiput and frontalis belly of the forehead. It stretches over the cranium, drawing the scalp back, lifting eyebrows and wrinkling forehead. When this muscle is over tightened it causes migraine, temple centered pain and neck aches. This is released with scalp release techniques. Many times, eliminating the pain immediately.

Knowing the effect wanted will assist in choosing the best surgeon for you.

Eye Lift

Overtime, skin, and muscles around the eye stretch and weaken. Fat may collect above and below causing puffy and droopy eyes. An eye lift will remove the excess skin and fat, eye muscles may be tightened. The healing process is less dramatic than the face and neck. Even though the work is done at the eye level, swelling may extend to the forehead and down the face. Generally, the lymphatic pathway from the eyes moves out towards the temples. It then moves down the side of the face towards the neck to the vena cava at the base of the throat. Above the brow, moves up over the head down towards the back of the neck. The plexus aspect of the lymphatic system has no boundaries. Fluids will move towards the closest nodes crossing all boundaries. This system is used extensively for lymphedema patients where all local nodes are removed, and fluids must be redirected to healthy nodes. This may cause swelling down the checks, lips, and chin to sometimes occur. A qualified therapist will know how to redirect the swelling for an efficient clearing. Quit often pockets of swelling collect at the inner most corner of the eyes. This will disperse over time. The longer you can hold off wearing makeup the better. Powders and mascaras may irritate the eyes while healing is ongoing.

Manual Lymphatic Drainage Massage, Your best Friend!

MLD is your healing buddy for a speedy recovery. Post cosmetic surgery massage is essential for best results.

The lymphatic system is part of your circulatory system. A plasma like aspect of blood, a thick protein which absorbs larger cellular debit. It slowly moves into the lymphatic vascular system, traveling toward nodes where macrophage’s dissolve the matter. The lymphatic fluid then rejoins the blood system at the vena cava located at the base of the throat. This is a passive system which moves with your breath and movement. Manual lymphatic drainage pulls the fluids into the vessels and moves it forward, increasing the movement by 10x its normal speed. This allows the bruising and damaged cells from the surgery to move out and the rebuilding of new tissue to be expedited.

The trauma to the tissue, following a facial procedure, and subsequent swelling may collect and harden, extending the healing time. A MLD session will soften the fluids and tissue expediting healing. It is recommended to book at least 1 to 2 sessions the week before surgery preparing the tissue. This supports less bleeding and bruising. Beginning at 7 to 10 days post op, sessions begin. Experience suggests 3 to 4 sessions closely spaced will move you through the worst of the swelling quickly. Following, 1 to 2 sessions for 2 to 4 weeks will address the forming scar tissue supporting the best results possible. A minimum of 4 sessions to 8 sessions to cover the full length of healing is suggested. Some continue weekly through a 3-month course of treatment. Some are quick healers and some slow, an individual plan based on your results will emerge as results appear.

Thank you to “J” for sharing her personal journey

1. I spent a lot of time researching my procedures ahead of time including interviewing multiple surgeons beforehand. I thought I was well prepared for what to expect post-procedure. I often referred to a website of another surgeon that showed day to day progression of healing, so I had a general idea of what to expect. I had one side of my face that really looked pretty bad immediately after the surgery. I wasn't prepared for how badly it looked. I soon realized that other photos shown online were the best-case scenarios of healing. I underestimated how long it would take for my eyes to fully heal.

2. I am still in the healing phase of my procedures so I'm not sure what the result will look like yet. I do feel much more confident when I go out in public now. Some of my incision sights are still very visible so I do my best to conceal them (i.e., wear makeup, wear my hair down, etc.)

3. I am still learning to embrace my new look. Each day it changes, and I look more and more like myself.

4.I am still healing. The incisions that had the most tension is still healing. I also learned that I am fortunate enough (I say this tongue and cheek) that my body chooses to "spit out" dissolvable stitches rather than absorb them. I think this is why I am still healing.

5. I had planned for my children to be away for a week after my surgery. Looking back, I would have preferred an additional week of rest and healing to look more normal. I was still very swollen after the 1st week. I did everything I felt I could to promote healing: red light therapy twice a day, listening to healing meditation music, eating healthy, taking supplements/medications ordered by my doctor, drinking lots of water, plenty of rest, and lymphatic drainage massage. At each follow up appointment, my surgeon was impressed with my healing, so I guess it was paying off.

6. I started lymphatic drainage massage as soon as I could and maybe I was a bit premature in scheduling my first appointment because I still had areas that were healing. I could only afford 4 massages so I continued to do as much massage as I could on my own.

7. I had a deep plane facelift, neck lift, and blepharoplasty (upper eyelids).

8. As I mentioned, I took advantage of the 4-session discount and did them as close together as recommended. (Basically, 2x per week.) I was in a hurry to get the swelling down as quickly as possible. Interestingly, my surgeon had prescribed a steroid to help with the swelling but I felt it had the opposite effect on me so that was not an option for me to continue. In my mind, Lymphatic massage helped as a replacement for the steroid.

In conclusion

As the field guide closes on this subject, lets laser this down to the fine points.

· Get in touch with yourself and decide what is the most important change to bring you back into focus?

· Research multiple techniques and surgeons to find your best match.

· Manage your expectations and be real with yourself, allow the process to unfold and the new you to appear gradually.

· Partner with a qualified MLD therapist, add this amazing support treatment into your plan.

About the author

Paula Irwin cmt#1985, clt

Owner of Body Being in Balance Massage in Del Mar, California. Paula is an accomplished Certified Sports Therapist Since 1992. She has created her own technique, a blending of trainings in neuromuscular and trigger point therapy expanded with 30 years of assisting clients to move and feel their best. Structural Balancing Sports Massage realigns the body into balance, flexibility, and fluidity. Paula Trained in 1998 with the Learner Lymphedema Academy in Boston, Ma. She has assisted many with lymphedema, lipedema, and post cosmetic, cancer and orthopedic surgery recovery. Paula lives in the Del Mar-San Diego area with her 2 Maltese dogs. She is a natural healer, intuitive and dreamer. Loving the costal life and always creating new adventures.


Featured Posts
Recent Posts
Search By Tags
Follow Us
  • Facebook Basic Square
  • Twitter Basic Square
  • Google+ Basic Square
bottom of page