The importance of Manual Lymphatic Drainage (MLD) for Lipedema: Conservative and Post-Surgical Management

What is lipoedema?

Lipedema is a chronic progressive condition that causes a painful and abnormal accumulation of fat cells typically in the legs, hips and arms. So often is it misdiagnosed as obesity or lymphedema so can therefore go undetected for many years. It exclusively affects women and the current prevalence is 1 in 8 women.  The most common onset for lipedema is during times of hormonal change such as puberty or menopause.
Lipedema frequently causes pain, tenderness, swelling, and easy bruising, which significantly impacts a woman’s quality of life. While there is no cure for lipedema, there are many effective management strategies that can help reduce symptoms, slow the progression and improve quality of life.
One of the most important therapies for both conservative treatment and post-surgical recovery is Manual Lymphatic Drainage (MLD).

What is Manual Lymphatic Drainage (MLD)?

MLD is a specialised, hands-on therapy designed to encourage the natural drainage of lymph fluid. The lymphatic system is responsible for removing waste, toxins, and excess fluid from the body. In lipedema, the lymphatic system often becomes overwhelmed due to increased fat deposits and inflammation, leading to fluid retention and swelling. MLD uses non-invasive strokes to stimulate the lymphatic vessels, helping excess fluid move away from congested areas and reducing swelling.

MLD for conservative management of lipedema

For those managing lipedema without surgery, MLD is an essential therapy. Since lipedema fat is prone to fluid retention and inflammation, regular MLD sessions can:
- Reduce swelling and fluid retention
- Improve pain and tenderness
- Enhance mobility and function
- Slow disease progression by managing symptoms and preventing additional complications such as secondary lymphoedema

MLD for post-surgical recovery

Many individuals with lipoedema choose to undergo water-assisted liposuction (WAL), or lymph-sparing liposuction, to remove diseased fat tissue. While these procedures can provide relief, proper post-surgical care is critical for achieving the best results. MLD plays a vital role in recovery by:
- Reducing post-surgical swelling and bruising, and accelerating healing
- Minimising fibrosis and scar tissue
- Enhancing comfort and recovery speed

Why a Myotherapist should perform MLD

While many practitioners offer MLD, it is essential to choose an experienced practitioner who is properly trained, especially for managing lipedema. Myotherapists have in-depth knowledge of musculoskeletal function, soft tissue techniques, and lymphatic system mechanics. A skilled Myotherapist can:
- Tailor MLD to the individual’s needs. As lipedema affects everyone differently, an assessment will need to be made before treatment regarding swelling patterns, pain levels and mobility restrictions
- Use additional techniques to compliment MLD such as myofascial release, gentle stretching, cupping, infrared sauna and red-light therapy
- Ensure safe and effective treatment as those who are untrained or inexperienced in lipedema may apply excessive pressure leading to unnecessary bruising or discomfort

Conclusion

MLD is a cornerstone therapy for both conservative management and post-surgical recovery in lipedema. By reducing swelling, improving pain, and enhancing mobility, MLD significantly improves quality of life. However, to get the best results, it is crucial to receive MLD from a qualified therapist who understands the complexities of lipoedema and can provide expert, individualised care. Whether managing lipedema without surgery or recovering from surgery, MLD is a powerful tool for symptom relief and long-term well-being.