Manual Lymphatic Drainage

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Jessica Johnson

Owner, Practitioner, Educator, Advocate

LMT

CLT

CMLDT

LDT

MTI

LMT

CLT

CMLDT

LDT

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Jess – Passionate Educator and Advocate for Lymphatic Therapy
It’s funny how life happens to you. No matter how much we plan (or don’t plan), we always seem to end up exactly where we’re supposed to be. Over a decade ago, I was introduced to lymphatic massage by my brilliant pathology professor—a nurse turned massage therapist who completely changed how I saw the human body. At the time, I was managing a holistic health clinic, yet somehow, I had never learned about the lymphatic system. The moment I took my first lymphatic drainage course, everything clicked. I was hooked.
The more I learned, the more I realized: this wasn’t just another massage technique—this was a missing piece in modern healthcare, a crucial tool for recovery, resilience, and overall well-being. I wanted something profoundly effective yet deeply nurturing. Lymphatic therapy offered exactly that. It worked with the body, not against it. And as I refined my skills, I saw firsthand how life-changing this approach could be—especially for people dealing with autoimmune disorders, post-surgical recovery, cancer recovery, chronic inflammation, and other complex health issues.

Personal Mission
I’ve always been drawn to a gentler approach to healing, but that instinct was deeply personal. My mom has a highly sensitive nervous system. Both traditional and alternative medicine never worked for her—they overwhelmed her body instead of helping, leaving her in worse pain than before. I knew she couldn’t be the only one. If she struggled to find bodywork that truly supported her, there had to be thousands of others who needed effective, yet non-invasive care.

That realization fueled my passion. I dove into the rabbit hole by doing advanced trainings, studying Vodder and Chikly Lymphatic Drainage Techniques, Abdominal Visceral Massage, Ashiatsu Barefoot Bar Therapy, Cupping, Post-Surgical Massage, Facial Cupping, Breast Reconstruction Techniques, Oncology Massage, Lymphatic Taping, and Complete Decongestive Therapy (CDT) for Lymphedema. Each technique gave me new tools to better serve my clients, allowing me to create a practice where people—especially those who felt like their bodies couldn’t tolerate traditional massage—could finally find relief.

When I started out, plastic surgeons were among the only doctors who understood the benefits of lymphatic massage, and their patients became the bulk of my clientele. Post-surgical recovery became a cornerstone of my practice, but I knew how much more this work could do. The need for specialized lymphatic therapy stretched far beyond aesthetics, and I was determined to bridge that gap.

From Hands-On Therapist to Industry Leader & Educator
As my practice grew, I reached a point where I physically couldn’t keep up with the demand. I was booked out for months, and I hated telling people in pain that they had to wait. I realized that if I wanted to help more people, I had to stop doing everything myself and start training others to carry this work forward.
I got my teaching certification, created my own continuing education course—Integrative Lymphatic Therapy®—and developed a structured system for training highly specialized lymphatic practitioners. Last year alone, I had the privilege of teaching nearly 100 students, equipping them with the skills and knowledge to bring high-quality lymphatic care to more communities. And I’m not stopping there. I’m constantly refining protocols and creating new techniques to standardize care for conditions like Lipedema, manual body sculpting, and post-surgical recovery.

My goal isn’t just to train more therapists—it’s to elevate the entire industry. Lymphatic massage isn’t just a trendy beauty treatment; it’s an essential, medical-grade therapy that deserves recognition for its true healing potential. Through my courses, mentorship, and continued research, I’m working to ensure that lymphatic therapy is taken seriously in both the medical and wellness communities.

The Unexpected Gift: Deep Human Connection
This work has given me so much more than a career—it has given me a life filled with connection, adventure, and purpose. Some of my dearest friends started as clients on my table—people I never would have met otherwise. There’s something about this work that fosters trust, vulnerability, and genuine human connection in a way I never expected when I first started.

And it hasn’t just changed my world—it’s taken me around the world! I’ve had the opportunity to study bodywork in Thailand, Colombia, Mexico, and across the U.S. Every trip, every training, and every conversation has reinforced the profound impact this work can have on people’s lives.

A Life of Unrelenting Gratitude
This path has given me more than I ever could have imagined. It’s allowed me to build a career doing something I truly love, surround myself with an incredible team, change lives in a tangible way, and be part of a movement that is only growing.

I am endlessly grateful—for the clients who trust us with their healing, for the team that makes Houston Lymphatic what it is today, and for every single opportunity this work has brought into my life. Lymphatic therapy isn’t just my profession—it’s my purpose. And I’m honored to be on this journey, helping people feel better in their bodies every single day.

Tai Hughes

LMT

CMLDT

Clinic Manager

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CMLDT

Clinic Manager

Bringing Tai onboard was a no-brainer. With over 20 years of experience as a licensed massage therapist, she’s honed her skills in medical, chiropractic, and spa settings, building an impressive and versatile “toolbox” of techniques.

But discovering lymphatic massage was a turning point for Tai. The intricacies of the lymphatic system and its role in healing captivated her, and it quickly became her true passion. Over the years, she’s developed a deep expertise in lymphatic work, with a special focus on pre- and post-operative care, TMJ pain, headaches, and general wellness. Her work is both effective and transformative- just read her google reviews.

Tai’s style is truly one-of-a-kind. Her hands move in a wave-like flow that’s impossible to mimic but remarkably effective. Beyond her technical skills, Tai’s kindness and southern hospitality has a way of making everyone feel cared for and supported, creating a safe and comfortable environment for her clients to heal and thrive.

Tai has found her home here at Houston Lymphatic. Tai has become an integral part of our family and I feel so fortunate to have her on our team.

Tai, you make this place better in every way, and I’m endlessly grateful for your unwavering dedication, your incredible talent, and the profound impact you have on everyone you touch.

What exactly is this service and how is it different from a regular massage or a lymphatic drainage massage?

A lot of people are curious about lymphatic work, or know they want it, but they don’t love the light touch associated with it — even if that light, superficial pressure is exactly what lymphatic vessels respond to. The lymphatic system lives just beneath the surface of the skin, so true MLD will always feel slow, rhythmic, and gentle. There’s no way around that if the goal is to actually move lymph.

At the same time, we’re very aware that for some bodies, that light touch alone just doesn’t feel therapeutic — especially when you’re also tired, tight, swollen, stressed, or sore. We created this service for exactly those clients: the ones who want the benefits of lymphatic support, but also want a relaxation experience that includes targeted, intentional massage work where it truly makes sense.

These sessions blend true MLD with selective, point-focused deeper massage techniques, myofascial release, and tissue decompression, so the experience feels more complete without turning into an all-over deep tissue treatment. Our philosophy is simple: almost no one actually needs head-to-toe deep pressure. Deep tissue massage has a time and place, but it should be reserved for specific areas of pain, injury, or restriction that are clearly asking for it. The rest of the body deserves to be spared, listened to, and met where it’s at — not forced into the same pressure profile for the sake of calling it “deep tissue.”

So the real difference is this: unlike a regular massage, we don’t default to uniform pressure across the entire body. We tailor the approach—light and lymph-focused where the lymph lives, deeper and fascial-focused only where your tissues are actually calling for it. And unlike a stand-alone lymphatic drainage massage, we offer a hybrid experience for those who want both lymphatic support and localized therapeutic massage work in one thoughtfully-paced session.
To be clear, this is not a full deep tissue massage. It’s not a one-size-fits-all MLD session either. It’s designed for the client who wants lymphatic flow and intentional massage mixed together, without pushing the whole body into intensity it simply doesn’t need.

And if you walk out feeling noticeably different, calmer, and less compressed in all the right places, then we did our job.

When is this NOT appropriate?

 This service is not appropriate when you’re expecting a full, all-over, high-pressure deep tissue massage. If that’s what you’re looking for, that’s totally fine! We just want to make sure you land in the session that actually matches your goals and your tissues.

In our clinic, full-on deep pressure is best delivered through Ashiatsu barefoot back-walking massage, where the practitioner can apply focused, grounded pressure using their feet while keeping the rest of the body supported, aligned, and non-provoked. If you book this hybrid massage/MLD session hoping for head-to-toe intensity, you’ll leave feeling like the pressure wasn’t “enough,” when really, it was simply never designed to go there in the first place. So if deep tissue everywhere is the expectation, we’ll always steer you toward Ashiatsu instead. It’s the better tool for that job, and your body will genuinely be glad you chose it.

What should I do before and after my session?

 Before your session, drink water earlier in the day so your tissues are well hydrated. We will be able to get more out of the session this way. Try to avoid eating a heavy meal right before… We do a lot of abdominal work during these sessions so it’s more comfortable if you don’t have a full belly. And finally,wear whatever you are comfortable in for the day. We work skin-to-skin so we will have you undress like a regular massage and keep you covered on the table. That said, you will get more out of this session if you wear loose fitting clothing…tight clothes can dig into the skin not allowing fluid to continue flowing after the session is over.

After your session, drink plenty of water again. A short, easy walk later in the day helps your lymph keep moving. You don’t need to avoid your life. Just give your body a little motion and hydration so it can finish the process we started together.

These targeted sessions can move a lot of fluid under gentle direction, so if you feel extra relaxed, tired, or notice more urination afterward, that’s common. Listen to your body and take it relatively easy.. try to keep your nervous system in this sweet spot as long as you can.

If you plan to work out/cardio, take a sauna, or do ice baths, just do it before your session or the next day.

I have autoimmune inflammation — can my body tolerate Integrated Deeper Tissue?

 At our clinic, Integrated Deeper Tissue is usually not the best place to start for autoimmune inflammation. Many conditions can benefit from integrated manual therapies, but autoimmune cases require a different order of operations. We generally recommend beginning with a generalized, gentle MLD session first, and evaluating how your body responds before layering in any deeper mechanical stimulus.

Autoimmune inflammation means the immune system is already over-activated in the tissue environment. In these cases, our priority is never to introduce additional inflammatory signaling into tissues that are already struggling with immune regulation. Increasing mechanical stimulus in this moment can escalate immune response rather than support recovery, which is the opposite of what these bodies need most. The goal here is not to activate inflammation, but to help the system drain, decompress, and settle so the immune environment can downshift.

The smarter therapy choice to start—the one that supports fluid movement and inflammation recovery without escalation—is gentle Manual Lymphatic Drainage instead. MLD helps reduce tissue pressure, improve fluid return, and support immune calm by aiding clearance rather than adding stimulus. Once your body has shown it tolerates MLD well, we can gradually and selectively revisit whether deeper, localized manual work makes sense for you, based on presentation and response, not pressure preference.

The goal is to dial it in and calibrate these session to your body and your specific need.

Do you take my insurance or provide superbills for reimbursement?  

Right now, we don’t accept insurance. Our sessions are private pay and charged by time: $140 for 60 minutes. Some cases require 90 minutes, which is $210.

 We can provide a superbill for you to submit to your insurance company if you plan to seek reimbursement. Most insurance companies require a clinical diagnosis from a medical doctor to be included when you submit it. We recommend checking your coverage ahead of time because reimbursement rules are all over the place. Some companies will cover treatment if it’s done by an Occupational Therapist, but not if it’s done by a Physical Therapist or a Massage Therapist — and the reverse is true for other plans. There’s no one standard, so getting the details up front means we can guide you to the right practitioner based on what your plan actually allows.

If you’re still working on getting a diagnosis and need help figuring out what kind of doctor to see or what to ask for, it’s okay to call the office. We talk through that with people every week. We can’t diagnose you ourselves, but we can help you understand the path so you can get the care you need without unnecessary delays or confusion.

I have autoimmune inflammation — can my body tolerate FasciaFit?  

At our clinic, FasciaFit Body Sculpting is not considered an appropriate therapy method for autoimmune inflammation management. FasciaFit uses deeper mechanical stimulation designed to influence collagen behavior and fascial tension in bodies that specifically present with connective tissue dysfunction, post-surgical fibrosis, or chronic structural barriers to drainage. Autoimmune inflammation means the immune system is already over-activated in the tissue environment, and our priority in these cases is never to introduce additional inflammatory signaling to tissues that are already struggling with immune regulation. Adding more stimulus in this scenario can escalate immune response rather than calm it, which is the opposite of what these bodies need most.

Many people with autoimmune conditions also experience swelling, especially in regions like the abdomen due to overlapping symptoms from IBS, endometriosis, or other inflammatory drivers. It’s common for these clients to think they want tissue-focused sculpting work because their swelling is visible and frustrating. But in the context of autoimmune inflammation, the safest and most effective approach is almost always Manual Lymphatic Drainage (MLD) alone, delivered gently, rhythmically, and directed through the correct lymphatic pathways to support fluid return without amplifying immune threat response. MLD helps reduce interstitial pressure, supports inflammatory cleanup, and gives the body a clearer path to regulate fluid burdens without adding more mechanical load to the fascia itself.

The only times we consider fascia-focused tissue work in swelling cases like these is when the client has a confirmed connective tissue disorder, where fascial organization — not immune flare — is the primary barrier limiting drainage. Outside of that scenario, we don’t recommend FasciaFit for autoimmune clients. Safe lymphatic care is always about helping the system, not challenging it when inflammation is chronically present.

So the most accurate answer is this: your body can tolerate FasciaFit mechanically, but it likely won’t benefit your autoimmune inflammation physiologically. And the smarter therapy choice — the one that actually supports fluid movement and inflammation recovery without escalation — is gentle Manual Lymphatic Drainage instead.

Do you use devices like RF, ultrasound, lasers, or cavitation? Why or why not?

  We do not use these devices in our clinic- we don’t feel that the risk is worth the reward in most cases. Tools like Radio Frequency, Ultrasound, Lasers, or Cavitation are powerful, but they are not inherently “tissue-smart.” They create heat, vibration, or mechanical stimulus in broad tissue fields, which can be helpful when the body is stuck in LATER remodeling phases and needs a controlled signal to soften or mobilize fibrosis or densified connective tissue. But they also increase circulation, cellular activity, and inflammation — which means timing, tissue condition, and system safety matter a lot. A device can stimulate change, but it cannot assess texture, pressure, pain patterns, tension direction, or interstitial stagnation the way trained human hands can. So our first question is never, “What machine can we use?” It’s always, “What does the tissue actually need right now”.

Early injury sites are already signaling the body for cleanup, collagen deposition, immune activity, and tissue adaptation. Adding more heat, aggression, or stimulation too early can amplify inflammation, accelerate fibroblast activity before collagen has directional organization, and increase nervous system threat response — the very conditions that can worsen fibrosis, dimpling, stiffness, sensitivity, and restrictive scarring long-term. This is why many bodies that go through aggressive device-heavy cosmetic protocols immediately after surgery often require even more machines later to clean up the tissue aftermath those interventions contributed to.

That said, once the tissue is clearly in the remodeling phase — where collagen has formed its initial matrix and the body is responding to mechanical input instead of injury threat — we may suggest incorporating device support if the tissue demonstrates resistance to manual progress alone… this does not come up often enough in our practice to justify having the machines on hand.

Our clinic is intentionally structured around manual tissue care because machines don’t replace touch-based assessment, and inflammation doesn’t remodel tissue better just because it came from a device. If we do suggest a machine, it means your tissues are in a phase where that signal could help — but it should be paired with manual therapy and an actual plan for collagen behavior and fluid direction afterward.

So the bottom line is this: We are selective about when suggesting these things could be appropriate because aggressively stimulating already-activated tissue is not how you get natural-looking, functional, long-term results. Timing, collagen direction, lymphatic flow, inflammation load, and nervous system safety will always matter more than the tool… in our humble opinion 😉

Please note that if you are receiving these treatments by a medical doctor, we trust that you are in their capable hands and that they fully understand when these tools are and are not appropriate. Always follow your doctor’s protocols!

Will this help with loose skin or only tissue texture?

  When it comes to skin changes after surgery, weight loss, pregnancy, or chronic swelling patterns, we always start with a foundational truth: manual therapy works on the tissues under the skin, which can influence how the skin lies and moves, but it does not replace the role of surgical skin excision, dermatologic intervention, or inherent genetic elasticity. So when someone asks if we “treat loose skin,” the most accurate answer is: we don’t tighten or remove skin itself, but we do work with the connective tissue and fluid dynamics that help the surface behave and feel better. And that can still help a lot.

FasciaFit and the other integrative tissue techniques we use are designed to improve tissue texture, fascial tension patterns, mobility, and fluid exchange in the interstitial space. When that environment becomes healthier and less congested, many bodies experience better collagen adaptation over time, improved skin glide, and a softer, more even drape at the surface. So if your skin feels “loose” because of underlying stagnation, swelling pressure history, or fascial densification pulling unevenly, improving what’s happening beneath it can make a noticeable difference in how the surface looks and moves during the remodeling window. But if skin is objectively excessive after weight loss, for example — that is a conversation for a surgeon, not a massage table.

We can help guide tissue organization, fibrosis, fluid stagnation, fascia behavior, and nervous system down-regulation because those are the layers the body can change with manual input. We do not claim to “snap back” or “tighten” loose skin, we do not promise outcomes like surgery does, and we always prioritize the goal of improving how your body feels in daily life.

Can FasciaFit help with the appearance of cellulite or dimpling tissue?

  This is a really common question. To be clear, it will not get rid of your cellulite but we’ve found that controlled fascia-focused work like FasciaFit can absolutely help with the appearance of cellulite or “dimpling” tissue, under the right conditions. Here’s how we explain it, and what you can expect:

FasciaFit doesn’t melt fat or restructure genetics. But what it can do is help improve tissue texture and mobility in a way that often makes cellulite appear softer, less puckered, and more even. When cellulite shows up, part of what’s going on is that the fibrous connective tissue (fascia) and the bands running under the skin are holding fat and fluid in ways that create dimples, uneven texture and restricted movement. By gently working with fascia — releasing tension, encouraging better alignment of fibers, improving fluid exchange, reducing congestion in the interstitial tissue, and improving skin and fascial glide — FasciaFit supports the tissue environment to reorganize in healthier, more supple patterns.

We’ve seen first hand that combining fascia-focused work with lymphatic support can make a notable difference. Over time, clients often notice less “puffiness,” less skin tightness, softer tissue, and a smoother feel overall.
That said: we don’t guarantee a perfectly smooth outcome. Cellulite is multifactorial (fat, fascia, fluid, genetics, skin thickness, hormone patterns, etc.), and every body responds differently. FasciaFit — and the tissue-focused work we do — simply gives your body the best environment to heal, soften, and reorganize in the direction of healthy, functional tissue.

It should be noted that this is not appropriate for everyone. If you already have loose, thin, or elastic skin, then breaking up underlying adhesions may make the skin more loose which is not a sought after look. We do a thorough evaluation and discussion before applying these techniques to make sure you’re a good candidate.

What’s the difference between FasciaFit and Brazilian lymphatic massages?

  FasciaFit Body Sculpting is a hands-on, fascia-focused tissue therapy method created with intention and clarity. We named it FasciaFit because we wanted to move away from terminology that has become confusing and anatomically inaccurate for the general public. Brazilian “lymphatic massage,” despite the name, does not meaningfully address lymph nodes, nodal basins, or the deeper lymphatic channels responsible for fluid regulation. Most Brazilian methods emphasize fast cosmetic de-puffing at the surface, often working primarily on skin manipulation without engaging the lymphatic anatomy itself. Over time, this created widespread misunderstanding about what lymphatic therapy actually is, what it does, and why it works.

We designed FasciaFit specifically to change that narrative. This method works first with the fascial network — the connective tissue that surrounds, organizes, and influences fluid pressure, tissue mobility, and lymphatic glide under the skin. When dimpling, tissue stiffness, or fibrosis forms — whether from surgery, inflammation history, weight fluctuation, or chronic tissue disorders like lipedema — it often restricts how fluid is able to move and drain, not just cosmetically, but mechanically. The primary goal of FasciaFit is not to force fluid out — it is to restore tissue mobility, tension patterns, fascial glide, and interstitial space behavior so the lymphatic system has less resistance when doing its job. We do incorporate true Manual Lymphatic Drainage (MLD) into these sessions, but always secondarily and intentionally, because lymphatic anatomy still matters for tissue health, inflammation mitigation, and appropriate remodeling support. In FasciaFit sessions, we are treating the barrier to drainage, not just the fluid symptom itself.

So, is it similar to Brazilian lymphatic “massage”? The intention is often the same — helping the body feel less congested and reducing surface-level puffiness when fluid is a barrier. But the approach is very different. FasciaFit Body Sculpting is lymph-node-aware but fascia-led, meaning we work first with the connective tissue network that organizes pressure, collagen fiber direction, and fluid resistance under the skin. Because fascia tension and fibrosis can mechanically limit lymphatic flow, our primary goal is reducing the barrier to drainage, not creating fast, short-lived cosmetic effects. We are not aiming for dramatic before-and-after photos that only last a few hours. We care far more about the long-term health, organization, and adaptability of the tissue, giving your lymphatic system the best chance to move fluid efficiently and supporting collagen to remodel in the direction of supple, functional tissue instead of stiff, disorganized fiber patterns.

And yes — many people seek lymphatic care because they’ve seen intense transformations online. Understandable! Those results can happen, but they are not the majority of cases. These tend to be clients that naturally retain a lot of fluid to begin with. When someone experiences a dramatic visual shift from a single hands-on session, the transparent clinical question should be: why is that much fluid sitting in the tissue space in the first place?

For some bodies, the difference is visible and immediate. For others, it may only be felt — lighter, softer, less restricted, and more mobile, without much to see on the surface. I’m a good example of the second category… I’ve gotten these types of sessions all over the world and don’t see those drastic results.. I just don’t retain a lot of fluid, so I won’t necessarily look different after one session.. They usually tell me that it takes a few days to see results.. but those results never come (which is fine…it still felt good!). So the real takeaway here is this: don’t let before-and-after pictures alone pull you in. I guarantee if these companies only post a small percentage of their before and after pics.

We know that the language around the lymphatic industry has gotten confusing. Companies are jumping on it like it’s the buzz word of the year. If you have questions or want clarification on if this work is appropriate for you, please give us a call. We are happy to point you in the right direction… even if it isn’t on one of our tables.

Do you take my insurance or provide superbills for reimbursement?

Right now, we don’t accept insurance. Our sessions are private pay and charged by time: $140 for 60 minutes. Some cases require 90 minutes, which is $210.

We can provide a superbill for you to submit to your insurance company if you plan to seek reimbursement. Most insurance companies require a clinical diagnosis from a medical doctor to be included when you submit it. We recommend checking your coverage ahead of time because reimbursement rules are all over the place. Some companies will cover treatment if it’s done by an Occupational Therapist, but not if it’s done by a Physical Therapist or a Massage Therapist — and the reverse is true for other plans. There’s no one standard, so getting the details up front means we can guide you to the right practitioner based on what your plan actually allows.

If you’re still working on getting a diagnosis and need help figuring out what kind of doctor to see or what to ask for, it’s okay to call the office. We talk through that with people every week. We can’t diagnose you ourselves, but we can help you understand the path so you can get the care you need without unnecessary delays or confusion.

Can I also get a facial with this service?

No. We do not provide esthetician services so this experience is quite different from a typical facial you might get at a spa. This is truly targeting the deeper layers of muscles and tension in the face, scalp, neck and chest…. not the skin surface like a typical facial. It’s more like a Swedish massage for your face. Different tools, different layers, different intentions.

If you’re looking for a true skincare-based facial with cleansing, exfoliation, or extraction, we always send folks to Val at Potion in South Austin. She’s magic, and truly one of our favorites. Enjoy!

Who could benefit the most from this?

 Seriously, everyone. That’s all.

Why did you start offering this service?

Story time: I was in a yoga class one afternoon being gently coached into a deeper and deeper state of relaxation. The instructor kept giving cues like, “Relax your jaw… your brow… your scalp… your teeth.” The problem was, I genuinely couldn’t. Even when I tried, the tension never actually let go. That stuck with me. I started recognizing it everywhere — the constant contraction between my eyebrows, the unconscious jaw clenching, the tightness across the frontalis muscle in my forehead. I began looking at my face not from a skincare perspective, but from a neuromuscular one.

When you study facial anatomy, you realize how many powerful little muscle groups are holding posture just like anywhere else in the body. The face has over 40 individual muscles, many of which directly influence visible aging patterns. For example, the frontalis muscle lifts the brow but also etches horizontal forehead lines when chronically tight. The orbicularis oculi muscle circles the eye — necessary for blinking — but increases the appearance of crow’s feet when it remains hyper-tonic instead of moving dynamically. And the jaw? That’s where some of the strongest facial muscles live: the masseter, temporalis, and medial and lateral pterygoids, all responsible for chewing and stabilizing the mandible. When they over-contract, they don’t just feel tight — they mechanically pull fascial structures downward, contributing to jowl tension, marionette line depth, and compression at the corners of the mouth.

What I found shocking was not the tension itself, but that no dermatologist ever explained this incredibly obvious truth: muscular imbalance drives visible line formation and directional tissue pull. Skin therapies can resurface, relax, or fill — but if the underlying muscle environment stays over-activated, the tension pattern will continue shaping the tissue. Aging signs show up first where habitual contraction lives, and in my case, that was the brow complex, the jaw elevators, the periorbital region around the eyes, and the DAO muscle that depresses the corners of the mouth.

So I started experimenting. I loosened specific muscles using targeted mechanical techniques (MLD principles first, then precise tissue work), and paired it with strengthening exercises for muscles that were not pulling their weight anymore — like the zygomaticus major/minor (your natural smile-lifting muscles), deep cervical stabilizers of the neck that support head posture, and portions of the platysma and orbicularis oris that benefit from active engagement rather than chronic fold-shaping compression. The biggest surprise? I didn’t just see a difference — I saw a dramatic difference in photos.Subtle soft-tissue release combined with specific muscle retraining changed my symmetry, my facial posture, and ultimately the direction those tissues were being influenced every single day. My camera is still in live mode, but for the first time in my life, I can honestly say I look like myself in photos.

That fascination turned into a service. We built a clinic protocol that prioritizes relaxing hyper-tonic facial muscles, encouraging appropriate lymphatic return from superficial face and scalp vessels, and restoring neuromuscular balance without overstimulation. The face has an extensive lymphatic network draining into the submandibular, parotid (pre-auricular), occipital, and deep cervical lymph node chains, all of which eventually return lymph to the venous system. Our work gently supports those pathways first, because fluid movement and nervous system down-regulation always come before cosmetic change.

The real goal isn’t chasing wrinkles — it’s recognizing that facial tissue behaves like every other region of the body: posture, fascia, muscle tone, and lymphatic flow determine what’s possible for healing, symmetry, relaxation, and structural strain. The result of our sessions is a deeply calming, restorative session that supports lymphatic load reduction (depuffing where congestion lives), reduces compressive pull from over-contracted muscle groups, and gives clients simple retraining tools when strengthening can meaningfully improve balance. It brings the face into a more neutral, less strained position, which for many people, just happens to read as more lifted, more even, and more relaxed — but only because we addressed the underlying system instead of just the surface

The more you know 💫

Can MLD help with TMJ, jaw pain or jaw surgical recovery?

Coming from someone who has experienced these benefits firsthand, I can truthfully say, yes, absolutely. In many cases, it’s one of the gentlest, most overlooked ways to bring relief to an area that can stay chronically tight and inflamed.
TMJ dysfunction and jaw pain usually involve a combination of muscular guarding, lymphatic congestion, and irritated neural pathways that sit right along the face and upper neck. When fluid can’t move well through that region, everything feels off.. It’s truly a miserable feeling: pressure builds in the cheeks and jawline, the muscles stay stuck in a protective clench no matter how hard you try to relax, and the nervous system keeps interpreting those signals as pain in a brutal feedback loop.

Manual Lymphatic Drainage can be helpful here because of its targeted anti-inflammatory intention. We’re not digging into tight jaw muscles or trying to “force” anything to release- that can often cause more harm than good in my experience. Instead, we use incredibly gentle, superficial techniques to encourage fluid movement through the lymph nodes that live along the jawline, under the chin, around the ears and down the neck. As that congestion clears, the deeper layers of the face and TMJ complex finally get a chance to decompress. Muscles soften, joint pressure eases, and the irritated nerves in the area can settle down.

This approach is also ideal for jaw-related surgical recovery. Whether someone has had maxillofacial surgery, dental implants, extractions, grafts, or any other procedure involving the jaw, the tissues in this region respond best to light, intentional stimulation that supports healing without disturbing the surgical site. We stay external only — never inside the mouth — and focus on reducing swelling, improving drainage, calming the nervous system, and helping the tissues reorganize in a cleaner, less reactive way.

Clients are often surprised by how much relief they feel after these gentle sessions. And for people dealing with longstanding TMJ patterns, a series of sessions may help to break the cycle of clenching, inflammation, and congestion that keeps everything locked up.

We love working with this patient population cause it can truly make a huge difference in how comfortable some is in their body – it’s a big deal!

Can I get lymphatic drainage if I still have stitches in my mouth?

Yes! Intraoral massage is all the rage right now but it’s not at all appropriate after oral surgery. We do external facial lymphatic drainage which is very safe, even when you still have stitches inside your mouth. In many cases, this can be incredibly relieving during that early recovery window. We never work inside the mouth, and we never use techniques that would stretch, pull, or disturb the surgical area. Everything we do stays on the outside of the face and neck using extremely gentle, superficial skin stretch to stimulate lymphatic movement and absorption. The stitches, grafts, or implants inside the mouth remain completely untouched.

What matters most is how the work is done. Post-dental surgery requires a very specific approach: slow, intentional, soothing movements with zero friction over the tissues that are still trying to seal and organize.

Clients are often surprised by how much relief they feel even with such light work. The pressure that builds in the cheeks, jawline, and under the eyes can start to soften, and the tissues around the surgical site may finally get a chance to “decompress.” So while we always respect your surgeon’s guidance, from a lymphatic standpoint, external MLD during the stitched phase and beyond can make the healing process feel calmer, less reactive, and far more comfortable.

How soon after a dental procedure can I start lymphatic drainage?

You can typically begin lymphatic drainage very soon after a dental procedure—often within 24 to 48 hours—as long as your surgeon confirms there are no complications such as active bleeding or infection. Because MLD is extremely gentle, external, and non-invasive, it doesn’t interfere with stitches, grafts, implant posts, or surgical adhesives. In fact, the earliest phase of healing is when your lymphatic system is working the hardest to clear anesthesia fluid, inflammatory agents, and the natural swelling that comes from tissue trauma. Supporting that process early can make the entire recovery period more comfortable. Many clients notice that starting within the first couple of days significantly reduces the “puffy” look and feeling in the cheeks, jaw, and under-eye area, and helps minimize the progression of swelling before it peaks.

That said, the exact timing can depend on the type of dental work you’ve had. Procedures like wisdom teeth removal, gum grafts, or implant placement often create predictable inflammatory patterns that respond beautifully to early lymphatic support. If your surgery involved bone grafting, significant infection, or more complex reconstruction, we may coordinate directly with your dentist or oral surgeon to ensure the timing is right for your case. Once cleared to begin, the sessions remain entirely external and use only light, rhythmic skin traction—no pressure in the mouth, no stretching of sutures, and no manipulation of the surgical field. Starting early isn’t just safe; it can often be the smartest way to prevent excessive swelling, reduce pressure-related pain, and help your body move through recovery with far less discomfort.

Can Manual Lymphatic Drainage help reduce swelling after dental surgery or tooth extraction?

Yes! In fact, dental surgery is one of the situations where Manual Lymphatic Drainage can be very helpful. Any time a tooth is pulled, a graft is placed, or the tissues are scraped, drilled or manipulated, your body responds with a big wave of fluid and immune activity to protect and repair the area. That’s normal — but it also creates that tight, puffy, “chimpmunk” sensation that so many people dread after oral surgery.

The lymphatic system is the only system responsible for clearing out all that excess fluid and the inflammatory byproducts that come with healing. When it gets overwhelmed, swelling hangs around longer than it needs to, and that pressure builds under the jaw, along the cheeks, and even up into the eyes and temples. This is where MLD can make a meaningful difference.

Lymphatic techniques are incredibly gentle and are designed to encourage fluid movement and reabsorption through the lymphatic pathways that drain the face — especially the submandibular nodes under the jaw and the cervical nodes along the sides of the neck. When you stimulate those areas correctly, the pressure can start to shift. Clients often report feeling the “fullness” soften. These techniques are incredibly gentle and we never work over the surgical site, so they are safe to use very early in recovery when swelling is at its peak.

Do you take my insurance or provide superbills for reimbursement?

  Right now, we don’t accept insurance. Our sessions are private pay and charged by time: $140 for 60 minutes. Some cases require 90 minutes, which is $210.

We can provide a superbill for you to submit to your insurance company if you plan to seek reimbursement. Most insurance companies require a clinical diagnosis from a medical doctor to be included when you submit it. We recommend checking your coverage ahead of time because reimbursement rules are all over the place. Some companies will cover treatment if it’s done by an Occupational Therapist, but not if it’s done by a Physical Therapist or a Massage Therapist — and the reverse is true for other plans. There’s no one standard, so getting the details up front means we can guide you to the right practitioner based on what your plan actually allows.

If you’re still working on getting a diagnosis and need help figuring out what kind of doctor to see or what to ask for, it’s okay to call the office. We talk through that with people every week. We can’t diagnose you ourselves, but we can help you understand the path so you can get the care you need without unnecessary delays or confusion.

What should I do before and after my session?  

Before your session, drink water earlier in the day so your tissues are well hydrated. We will be able to get more out of the session this way. Try to avoid eating a heavy meal right before… We do a lot of abdominal work during these sessions so it’s more comfortable if you don’t have a full belly. And finally,wear whatever you are comfortable in for the day. We work skin-to-skin so we will have you undress like a regular massage and keep you covered on the table. That said, you will get more out of this session if you wear loose fitting clothing…tight clothes can dig into the skin not allowing fluid to continue flowing after the session is over.

After your session, drink plenty of water again. A short, easy walk later in the day helps your lymph keep moving. You don’t need to avoid your life. Just give your body a little motion and hydration so it can finish the process we started together.

MLD moves a lot of fluid under gentle direction, so if you feel extra relaxed, tired, or notice more urination afterward, that’s common. Listen to your body and take it relatively easy.. try to keep your nervous system in this sweet spot as long as you can.

If you plan to work out/cardio, take a sauna, or do ice baths, just do it before your session or the next day.

Who is MLD good for and when is it NOT okay?  

In all honesty, Lymphatic Drainage is good for practically everyone. These days, it’s so difficult to avoid the everyday build up of toxins and inflammatory agents we are exposed to. Most people’s systems could benefit from a little extra support.

It’s also great for you if you want immune system support but you’re not trying to “treat” an illness. If you’re someone who gets knocked off your feet by allergies, colds, random inflammation flares, travel swelling, or just wants to support your body so it can do its job better, MLD is a strong, safe, gentle tool. People who sit a lot for work, fly frequently, feel puffy in the mornings, or want a service that helps the fluid system without any deep pressure usually respond really well.

We also highly recommend this service for those with autoimmune conditions. Consistent support of the lymphatic system can help clear inflammatory agents in the tissue space, leading to fewer, less severe flare ups. Many of our clients report feeling “normal” after these sessions or “getting a break”. .. we recognize what a huge deal for those dealing with crippling chronic pain or autoimmune conditions.

Now — who is it not good for? MLD moves fluid at a high rate, so we avoid it if there’s anything going on that your body doesn’t need circulating faster. Active infections, untreated heart conditions, kidney failure, deep vein thrombosis, blood clots, or any recent stroke or pulmonary embolism risk are the big ones. Basically, if your body is in acute crisis mode, or there’s something dangerous sitting in your system that shouldn’t be encouraged to move, MLD is a no-go.

Cancer is its own category too. If you are under oncology care, MLD may still be possible or even encouraged, but it has to be cleared by your doctor first, and the approach is adjusted based on your entire medical picture. Many oncologists and surgeons are on-board with their patients receiving MLD during cancer treatment but we like to make sure it’s timed appropriately and that everyone is on the same page. We recommend calling the office to make arrangements and finding the practitioner that is best suited for your case.

At our clinic, we don’t work on pregnancies during the first trimester. This isn’t because MLD is dangerous — it can be done safely with modifications when appropriate. But we choose to start care in the second trimester out of an overabundance of caution. Many people find MLD incredibly helpful for pregnancy-related swelling, joint discomfort, pelvic pressure, sleep disruption, and sinus or digestive changes. These sessions are gentle on the body and can feel like a real reset when everything feels inflamed or shifting fast.

So the simplest way to put it is this: MLD is appropriate for you if your body needs help moving fluid out of the tissues safely, calmly, and intentionally. It is not appropriate for you if moving fluid around could put stress on a system that’s already medically compromised or in an unsafe state. When in doubt, give us a call and ask! I love talking about this stuff and want to make sure we are a good fit and can meet your body where you’re at. We will always take your history into account before doing any work on you. It’s part of what keeps this kind of therapy safe and actually effective for the people who need it most.

How many sessions should I book if I want to see real results?

  One session of MLD is like straightening up your house: making the bed, fluffing the pillows, throwing the socks in the hamper. It can make things feel a little better. You might walk away thinking, “okay, that helped a bit.” And it does. But it isn’t going to make a radical shift.

Most people feel noticeable changes when they return a few times closer together. A second session is like digging out the drawers, wiping down the surfaces you don’t see every day. A third is when you hit the baseboards, clean the oven, and deal with the corners you forgot existed. That’s where the difference becomes obvious – you just need enough sessions at the start to actually do a deep clean of the system.

And here’s the truth: lymph buildup is slow. The puffiness, inflammation, heaviness, aches, fog, and sluggishness you feel? That didn’t happen in a day, and it won’t come undone in one visit. It takes weeks or months for your lymphatic system to get overloaded in the first place. So a short series of 3–5 sessions gives your body enough repetition to move real volume, evacuate inflammatory material from the tissues, and reset circulation. After that first little series, most people can switch to spacing sessions out for maintenance based on how their body feels in daily life.

If your goal is swelling reduction, inflammation support, stress downregulation, or clearing that “heavy, stuck” feeling, coming back a few times early on means you’re actually giving your body a fair chance to respond. After that, you don’t have to keep coming at that pace forever. It just needed enough repetition to make the shift.

What are possible side effects?

  The short answer? Most of the time, you don’t get side effects. You get relief. But lymphatic work is still physiological movement, and when you move fluid that’s been sitting in the tissue space holding cellular waste, immune debris, proteins, fats, and inflammatory agents, your body has to actually process what got mobilized. That’s where some people can get surprised and experience possible side-effects.

The overwhelming majority of people feel good after their sessions. “Relieved”. They may experience an increase of urination and in general feel “better”. But especially after those first few sessions, if the tissues you drained had a lot of inflammatory buildup or stagnant material, your body may respond for a short time while it clears the load. Some people may notice headaches, a tired or achy body, or a temporary uptick in fatigue. It can be as severe as “flu-like”. Others feel like their sinuses open and then drain later, or like their joints are releasing pressure but feel a little sensitive that evening. Basically, it’s your body saying, “thank you, but also, hold on while I process with all this.” Once the fluid gets back into circulation, the liver and kidneys take over from there, which is why hydration and gentle movement after your session can help your body keep the momentum going.

These side effects are considered normal. It usually passes within 24 hours, sometimes faster. We expect it to be short-lived. If it does continue on, please PLEASE let us know. This is an indication that 1) your body probably desperately needs this work and 2) we need to take it easier and augment our sessions so your system doesn’t have to clear out as much next time.

What is Manual Lymphatic Drainage, and why would I need it?

  Let’s start with what the lymphatic system does in the first place. Your lymphatic system is responsible for recirculating fluid that has accumulated cellular waste and debris in tissue space. When this system gets over burdened, more and more inflammatory agents are able to build up in the body and that’s when we experience a cascading inflammatory response that can lead to a number of symptoms many of us experience on a daily basis and think of as “normal”. Headaches, brain fog, fatigue, poor digestion, frequent illness, allergies, puffy and stiff joints, feeling heavy or sluggish are all early signs of a poor circulating lymphatic system.

Manual Lymphatic Drainage (MLD) is a slow, rhythmic, gentle technique that mimics the body’s own mechanical process of fluid reabsorption…we are just helping this happen at a much faster rate that it does on its own. This can help evacuate this fluid from the tissue space so you have less inflammatory agents lingering and irritating the body. Your lymphatic system generally filters about 3-5 liters of fluid a day but with MLD it’s possible to filter up to 20 liters!!!

The result? After the first session you may feel lighter, you may have noticeably less swelling in your joints, hands and legs and your digestion may be better. It’s also deeply relaxing so most people leave the office feeling a little “out of it”.

But as you can imagine, moving that much fluid can make some people feel a little off. If your body has a lot of buildup to process after these sessions, some people may experience headaches, body aches, or fatigue after their first few sessions. This is normal, should not last more than a day or so, and is a good indication that you desperately need this work! After several sessions is where the magic really happens. Many people report having less brain fog, having more energy, less allergies, better digestion, easier menstrual cycles, more joint mobility etc etc etc.

It is hard to overstate how important mitigating inflammation is – and that’s why MLD is such a powerful tool for MOST everyone.

Do you take my insurance or provide superbills for reimbursement?

 Right now, we don’t accept insurance. Our sessions are private pay and charged by time: $140 for 60 minutes. Some cases require 90 minutes, which is $210.

 We can provide a superbill for you to submit to your insurance company if you plan to seek reimbursement. Most insurance companies require a clinical diagnosis from a medical doctor to be included when you submit it. We recommend checking your coverage ahead of time because reimbursement rules are all over the place. Some companies will cover treatment if it’s done by an Occupational Therapist, but not if it’s done by a Physical Therapist or a Massage Therapist — and the reverse is true for other plans. There’s no one standard, so getting the details up front means we can guide you to the right practitioner based on what your plan actually allows.

 If you’re still working on getting a diagnosis and need help figuring out what kind of doctor to see or what to ask for, it’s okay to call the office. We talk through that with people every week. We can’t diagnose you ourselves, but we can help you understand the path so you can get the care you need without unnecessary delays or confusion.

If my autoimmunity is caused by chemical toxicity, will lymphatic massage help me detox?

This is such an important question, and one that rarely gets answered clearly. The word “toxins” gets thrown around constantly — often with very little accuracy — so before we can talk about whether lymphatic massage helps, we need to talk about what an actual toxin is, how the body deals with it, and where the lymphatic system fits into that picture. When we talk about true chemical toxicity, we’re referring to substances that create measurable, biological harm and require specific detoxification pathways to remove. This can include things like heavy metals (lead, mercury), environmental chemicals (pesticides, VOCs from paint or cleaning products), mycotoxins from mold, silicone or implant-related compounds, industrial pollutants, solvent exposure, etc.

 These substances don’t leave the body through lymphatic massage alone, but they can be flushed out of the tissues and brought back to the bloodstream… that’s not necessarily a good thing when the true detoxification systems and pathways are not being supported. These substances must then be processed through phase 1 and phase 2 detoxification in the liver, rendered water-soluble, and finally eliminated through the kidneys, bile, sweat, or stool. Some toxins require very particular medical interventions to actually clear them — for example, chelation for heavy metals, glutathione or NAC support for a great number of chemical toxins, or binding agents for mycotoxins and numerous other toxic insults.

 The reality is, some bodies move through this process efficiently, and others (myself included) need significantly more support. Genetics, immune health, gut integrity, stress levels, and exposure levels all play a role. But for true chemical toxicity, the primary intervention needs to be medical or biochemical supported — meaning supplements, medications, binders, lifestyle changes, and physician-guided detox protocols designed for the specific toxin involved. Manual Lymphatic Drainage can’t eliminate toxins from the system. It can’t chelate heavy metals, clear mold from your system, detox silicone, although it may help draw chemical particles out of your tissues.

However — and this is the part that is often overlooked — while MLD can’t remove the toxin itself, it can support the body in crucial ways while those toxins are still present.

 Toxic exposures create inflammation, immune dysregulation, and a kind of “static” in the tissue environment. The body becomes overwhelmed by the constant cleanup work, and this is often where autoimmune patterns begin to take hold. Your lymphatic system doesn’t detox the chemical, but it handles all the inflammatory by-products and cellular debris created by the damage that toxin is causing. When that material backs up, it increases inflammatory symptoms and the likelihood of your immune system tagging some of these tissue fragments as foreign invaders and kicking off an unwanted autoimmune reaction. Lymphatic work can help keep that system moving so the body isn’t drowning in the secondary inflammation of the exposure.

So if you’re experiencing something like mold toxicity, breast implant illness, or autoimmune activation due to chemical or environmental exposure, no amount of MLD alone will “fix” the problem. The toxin must be removed and detoxified through the correct pathways. In these cases, I’m always going to tell you to prioritize your medical treatment first. That is the real lever you need to pull to preserve or restore your wellness.

But in cases like this, MLD can be genuinely meaningful. While it can’t remove the toxin itself, it can reduce the inflammatory load your body is carrying during detox, explant, or whatever primary intervention your doctor has you working through. Many people dealing with chemical toxicity feel a deep sense of pressure or heaviness in their tissues — a sign that the system is overwhelmed and struggling to move waste efficiently. Lymphatic work can help ease that congestion so the body isn’t constantly operating at its limit. It also supports the nervous system, which is almost always overstimulated and exhausted in toxin-induced autoimmunity. By calming some of that underlying reactivity, MLD can soften the intensity of symptoms and make the medical detox process more tolerable while the real root cause is being addressed.  

Still, if your toxin is still in the environment (active mold in your home) or still in your body (removal hasn’t occurred yet), I generally encourage clients to put more of their time, energy, and money toward eliminating that cause before investing heavily in lymphatic sessions. There is no point trying to quiet inflammation when something is still pouring gasoline on the fire.

Once the toxin is actually out — whether that’s explant surgery, successful chelation, or environmental cleanup — this is where MLD shines. After the threat is gone, the immune system often stays dysregulated, stuck in a reactive, hyper-vigilant pattern. Lymphatic work can help restore balance, support the clearing of leftover inflammatory debris, and help downshift a system that has been in fight-or-flight for far too long.

 So: 
No, MLD cannot remove a true toxin.
 Yes, it can support your body while you’re clearing it. 
And yes, it can be incredibly helpful once the toxin is gone and your system is ready to re-regulate.

I hope this is helpful. There is so much misinformation out there about this stuff. This is a rough situation – you feel it everyday. Don’t let people take advantage and sell you stuff that’s not going to yield true results. A sauna is not going to rid your body of true toxins – neither is a rebounder or a shake plate, or a series of lymphatic massages.

 In case you can’t already tell, I genuinely have a soft spot for this particular patient population and I’m super passionate about finding people appropriate care. Give us a call and we can help you make a plan for your specific needs… even if that’s not starting out on our table.

How often should I come in if I have a chronic autoimmune condition?

This needs to be done very intentionally. There is no “one size fits all” protocol for autoimmune cases, and we work closely with you to dial in the cadence that your body can actually tolerate. The goal is never to keep you coming in endlessly. The goal is to create noticeable, meaningful change in the first few months, stabilize your system into a new baseline, and then transition you to maintenance, home care, or as-needed sessions. You will never be asked to come in more than what is clinically appropriate, and if you don’t notice any shift after 6–8 sessions, we’ll be honest with you — it may mean this isn’t the right modality at this time, and we’re always happy to point you in the right direction as best we can… we are here to support you!

Our general approach is to be a little more “aggressive” upfront depending on your tolerance. Most autoimmune clients benefit from a short, focused period of consecutive sessions to help clear congestion, calm the inflammatory load, and shift the tissue environment out of that chronically irritated state. A solid starting protocol is three sessions within a 10-day period, followed by once a week until we’ve made meaningful, consistent changes in how your body is responding. After that, we can gradually space appointments out as your system stabilizes.

We do need to calibrate this carefully. Many people with autoimmunity have a significant buildup of inflammatory waste in their tissue, and the first few sessions can sometimes stir things up. Mild headaches, fatigue, and body aches can happen; they’re not unusual. But if you feel truly flu-ish or overwhelmed, that tells us we pushed your system too quickly. In those cases, we simply slow the pace, adjust how much fluid we’re mobilizing in each session, and spread visits out until your body can process the work more comfortably. This also tells us that you very likely need and could greatly benefit from consistently receiving this work.

We also recognize that coming in frequently is not financially feasible for everyone. If weekly care isn’t realistic, we can absolutely build a plan that fits your budget. That often means spacing sessions out a bit more and leaning more heavily on high-value home-care tools between visits — things like lymphatic stretching, gentle movement protocols, hydration strategies, dry brushing, castor oil packs, and nervous-system downregulation practices that extend the benefits of each appointment. When used consistently, these tools help maintain drainage, calm baseline inflammation, and reduce the need for very frequent in-clinic sessions.

Our end goal is to help you reach a steadier, less reactive baseline and give you the tools to maintain that stability long-term so you can feel better in your body!

What happens if I’m in a flare — should I reschedule or come in?

In most cases, we recommend rescheduling until your immune system has calmed down. A lymphatic session moves fluid, proteins, and inflammatory by-products through the system more efficiently. Under normal conditions, that’s exactly what we want. But if you’re already in a flare — meaning your immune system is activated, symptoms are heightened, and your tissues are reactive — adding more movement through the lymphatic system can feel like asking your body to process too much at once.

 Basically, because you are already not feeling great, we would never want to risk making things any worse buy stirring up the system. A flare is your body saying, “I’m over capacity.” Our job is to respect that capacity, not push through it. Once things settle, lymphatic work can be far more effective and supportive.

With that said, we do have a very strict 24-hour cancellation policy. Late cancellations are charged regardless of the reason. So if you feel a flare coming on, call the office as soon as possible so we can adjust your appointment before you enter that 24-hour window and avoid the fee.

That being said, we are highly sensitive and understanding about how touchy these things can be. If you’re someone who flares frequently or unpredictably, please don’t let that stop you from getting care. Just call us before scheduling and let us know what your body tends to do. When we understand the pattern, we can flag your account, build more flexibility around your appointments, and use extra discretion. We will always do our best to find a balance that protects your body and respects our therapists’ time and commitment.

If Lymphatic Massage helps to stimulate the immune system and my system is already overactive, wouldn’t this be a problem?

 This is such a valid question, especially when your body is already on high alert. The truth is, Manual Lymphatic Drainage does not “stimulate” your immune system in the sense of activating it or pushing it to work harder. This is a common misconception. What it actually does is help remove the leftover cellular waste, debris, and inflammatory molecules that your immune system is already reacting to. We’re essentially creating a cleaner cellular environment with fewer irritants so your immune system can be less reactive overall.

 Think of your immune system like a team of firefighters. Their job is to respond when something genuinely needs attention. But if the landscape is covered in dry brush—old inflammation, leftover debris, cellular waste, toxic byproducts—those firefighters are constantly being called out for every tiny spark. Not because there’s a true wildfire, but because the environment is primed for one. Living with autoimmunity often feels exactly like that: everything ignites too easily, escalates too quickly, and becomes harder to “put out.”

MLD acts like clearing that brush. You’re not giving the firefighters more work—you’re giving them less unnecessary work. By helping clear out the inflammatory buildup that keeps triggering reactions, your immune system can finally stop jumping at every signal and respond more appropriately when there is an actual event. It supports regulation, not stimulation.

 This is also why flare patterns shift. With less “fuel” in the tissue, the body doesn’t spiral into full-fledged flare-ups as easily or as frequently. With consistent care, clients often notice that flares happen less often, feel less explosive, and resolve more quickly because their body isn’t starting from an inflamed baseline every single day. So no — lymphatic work doesn’t stimulate an already overactive immune system. It helps clear the environment so the system can settle, regulate, and respond from a calmer, less reactive place.

How can Lymphatic Massage help with autoimmunity?

Manual Lymphatic Drainage can be especially supportive for autoimmune conditions because it helps the body clear out the lingering inflammatory by-products that accumulate in the tissue space. When cellular waste, proteins, and debris sit in the interstitial fluid for too long, they act as constant irritants. For someone whose immune system is already on high alert, that extra “background noise” can contribute to more frequent or more intense flare-ups.

Lymphatic Massage works by gently accelerating the movement of lymph — the system responsible for carrying away that waste so the body can resolve inflammation more efficiently. It doesn’t change the autoimmune condition itself, but it improves the environment your tissues are operating in. For many people, that translates into fewer inflammatory spikes, less heaviness or swelling, and a body that doesn’t feel like it’s fighting so hard all the time. When done consistently, this can create a meaningful shift in how stable and manageable day-to-day symptoms feel.

Do you take my insurance or provide superbills for reimbursement?

  Right now, we don’t accept insurance. Our sessions are private pay and charged by time: $140 for 60 minutes. Some cases require 90 minutes, which is $210.

We can provide a superbill for you to submit to your insurance company if you plan to seek reimbursement. Most insurance companies require a clinical diagnosis from a medical doctor to be included when you submit it. We recommend checking your coverage ahead of time because reimbursement rules are all over the place. Some companies will cover treatment if it’s done by an Occupational Therapist, but not if it’s done by a Physical Therapist or a Massage Therapist — and the reverse is true for other plans. There’s no one standard, so getting the details up front means we can guide you to the right practitioner based on what your plan actually allows.

If you’re still working on getting a diagnosis and need help figuring out what kind of doctor to see or what to ask for, it’s okay to call the office. We talk through that with people every week. We can’t diagnose you ourselves, but we can help you understand the path so you can get the care you need without unnecessary delays or confusion.

What should I do before and after my session?  

Before your session, drink water earlier in the day so your tissues are well hydrated. We will be able to get more out of the session this way. Try to avoid eating a heavy meal right before… We do a lot of abdominal work during these sessions so it’s more comfortable if you don’t have a full belly. And finally,wear whatever you are comfortable in for the day. We work skin-to-skin so we will have you undress like a regular massage and keep you covered on the table. That said, you will get more out of this session if you wear loose fitting clothing…tight clothes can dig into the skin not allowing fluid to continue flowing after the session is over.

After your session, drink plenty of water again. A short, easy walk later in the day helps your lymph keep moving. You don’t need to avoid your life. Just give your body a little motion and hydration so it can finish the process we started together.

MLD moves a lot of fluid under gentle direction, so if you feel extra relaxed, tired, or notice more urination afterward, that’s common. Listen to your body and take it relatively easy.. try to keep your nervous system in this sweet spot as long as you can.

If you plan to work out/cardio, take a sauna, or do ice baths, just do it before your session or the next day.

Who is MLD good for and when is it NOT okay?  

In all honesty, Lymphatic Drainage is good for practically everyone. These days, it’s so difficult to avoid the everyday build up of toxins and inflammatory agents we are exposed to. Most people’s systems could benefit from a little extra support.

It’s also great for you if you want immune system support but you’re not trying to “treat” an illness. If you’re someone who gets knocked off your feet by allergies, colds, random inflammation flares, travel swelling, or just wants to support your body so it can do its job better, MLD is a strong, safe, gentle tool. People who sit a lot for work, fly frequently, feel puffy in the mornings, or want a service that helps the fluid system without any deep pressure usually respond really well.

We also highly recommend this service for those with autoimmune conditions. Consistent support of the lymphatic system can help clear inflammatory agents in the tissue space, leading to fewer, less severe flare ups. Many of our clients report feeling “normal” after these sessions or “getting a break”. .. we recognize what a huge deal for those dealing with crippling chronic pain or autoimmune conditions.

Now — who is it not good for? MLD moves fluid at a high rate, so we avoid it if there’s anything going on that your body doesn’t need circulating faster. Active infections, untreated heart conditions, kidney failure, deep vein thrombosis, blood clots, or any recent stroke or pulmonary embolism risk are the big ones. Basically, if your body is in acute crisis mode, or there’s something dangerous sitting in your system that shouldn’t be encouraged to move, MLD is a no-go.

Cancer is its own category too. If you are under oncology care, MLD may still be possible or even encouraged, but it has to be cleared by your doctor first, and the approach is adjusted based on your entire medical picture. Many oncologists and surgeons are on-board with their patients receiving MLD during cancer treatment but we like to make sure it’s timed appropriately and that everyone is on the same page. We recommend calling the office to make arrangements and finding the practitioner that is best suited for your case.

At our clinic, we don’t work on pregnancies during the first trimester. This isn’t because MLD is dangerous — it can be done safely with modifications when appropriate. But we choose to start care in the second trimester out of an overabundance of caution. Many people find MLD incredibly helpful for pregnancy-related swelling, joint discomfort, pelvic pressure, sleep disruption, and sinus or digestive changes. These sessions are gentle on the body and can feel like a real reset when everything feels inflamed or shifting fast.

So the simplest way to put it is this: MLD is appropriate for you if your body needs help moving fluid out of the tissues safely, calmly, and intentionally. It is not appropriate for you if moving fluid around could put stress on a system that’s already medically compromised or in an unsafe state. When in doubt, give us a call and ask! I love talking about this stuff and want to make sure we are a good fit and can meet your body where you’re at. We will always take your history into account before doing any work on you. It’s part of what keeps this kind of therapy safe and actually effective for the people who need it most.

How many sessions should I book if I want to see real results?

  One session of MLD is like straightening up your house: making the bed, fluffing the pillows, throwing the socks in the hamper. It can make things feel a little better. You might walk away thinking, “okay, that helped a bit.” And it does. But it isn’t going to make a radical shift.

Most people feel noticeable changes when they return a few times closer together. A second session is like digging out the drawers, wiping down the surfaces you don’t see every day. A third is when you hit the baseboards, clean the oven, and deal with the corners you forgot existed. That’s where the difference becomes obvious – you just need enough sessions at the start to actually do a deep clean of the system.

And here’s the truth: lymph buildup is slow. The puffiness, inflammation, heaviness, aches, fog, and sluggishness you feel? That didn’t happen in a day, and it won’t come undone in one visit. It takes weeks or months for your lymphatic system to get overloaded in the first place. So a short series of 3–5 sessions gives your body enough repetition to move real volume, evacuate inflammatory material from the tissues, and reset circulation. After that first little series, most people can switch to spacing sessions out for maintenance based on how their body feels in daily life.

If your goal is swelling reduction, inflammation support, stress downregulation, or clearing that “heavy, stuck” feeling, coming back a few times early on means you’re actually giving your body a fair chance to respond. After that, you don’t have to keep coming at that pace forever. It just needed enough repetition to make the shift.

What are possible side effects?

  The short answer? Most of the time, you don’t get side effects. You get relief. But lymphatic work is still physiological movement, and when you move fluid that’s been sitting in the tissue space holding cellular waste, immune debris, proteins, fats, and inflammatory agents, your body has to actually process what got mobilized. That’s where some people can get surprised and experience possible side-effects.

The overwhelming majority of people feel good after their sessions. “Relieved”. They may experience an increase of urination and in general feel “better”. But especially after those first few sessions, if the tissues you drained had a lot of inflammatory buildup or stagnant material, your body may respond for a short time while it clears the load. Some people may notice headaches, a tired or achy body, or a temporary uptick in fatigue. It can be as severe as “flu-like”. Others feel like their sinuses open and then drain later, or like their joints are releasing pressure but feel a little sensitive that evening. Basically, it’s your body saying, “thank you, but also, hold on while I process with all this.” Once the fluid gets back into circulation, the liver and kidneys take over from there, which is why hydration and gentle movement after your session can help your body keep the momentum going.

These side effects are considered normal. It usually passes within 24 hours, sometimes faster. We expect it to be short-lived. If it does continue on, please PLEASE let us know. This is an indication that 1) your body probably desperately needs this work and 2) we need to take it easier and augment our sessions so your system doesn’t have to clear out as much next time.

What is Manual Lymphatic Drainage, and why would I need it?

  Let’s start with what the lymphatic system does in the first place. Your lymphatic system is responsible for recirculating fluid that has accumulated cellular waste and debris in tissue space. When this system gets over burdened, more and more inflammatory agents are able to build up in the body and that’s when we experience a cascading inflammatory response that can lead to a number of symptoms many of us experience on a daily basis and think of as “normal”. Headaches, brain fog, fatigue, poor digestion, frequent illness, allergies, puffy and stiff joints, feeling heavy or sluggish are all early signs of a poor circulating lymphatic system.

Manual Lymphatic Drainage (MLD) is a slow, rhythmic, gentle technique that mimics the body’s own mechanical process of fluid reabsorption…we are just helping this happen at a much faster rate that it does on its own. This can help evacuate this fluid from the tissue space so you have less inflammatory agents lingering and irritating the body. Your lymphatic system generally filters about 3-5 liters of fluid a day but with MLD it’s possible to filter up to 20 liters!!!

The result? After the first session you may feel lighter, you may have noticeably less swelling in your joints, hands and legs and your digestion may be better. It’s also deeply relaxing so most people leave the office feeling a little “out of it”.

But as you can imagine, moving that much fluid can make some people feel a little off. If your body has a lot of buildup to process after these sessions, some people may experience headaches, body aches, or fatigue after their first few sessions. This is normal, should not last more than a day or so, and is a good indication that you desperately need this work! After several sessions is where the magic really happens. Many people report having less brain fog, having more energy, less allergies, better digestion, easier menstrual cycles, more joint mobility etc etc etc.

It is hard to overstate how important mitigating inflammation is – and that’s why MLD is such a powerful tool for MOST everyone.

Can you help even if I had surgery a long time ago?

Yes! We can still help, it’s just a very different approach than early post-op care. Once you’re months or years past a procedure, we’re working less with swelling and more with how the tissues ultimately healed and organized themselves. Scar tissue is not a fixed, unchangeable thing — collagen fibers continue adapting for 12–24 months (and sometimes longer) based on movement, tension direction, hydration, and shear forces from surrounding fascia. When scars mature without enough mobility or guidance, collagen can densify in a disorganized, stiff pattern. This can limit skin glide, contribute to tissue stiffness, and add external pressure to the tiny lymphatic pumping units (lymphangions), making it harder for fluid to exchange and clear efficiently between tissue layers.

When we work with scar tissue long after surgery, we apply controlled mechanical stimulus, not uncontrolled force. This signals the body to continue remodeling collagen without creating additional trauma. The result we’re aiming for is improved skin and fascial mobility, softer tissue texture, better lymphatic glide, and a healthier interstitial environment for ongoing adaptation — which can mean less long-term stiffness, reduced discomfort, and a smoother, more natural feel to the tissues. It’s normal to feel a little soreness for 24–48 hours afterward, very similar to the temporary soreness you get when you resume exercise after a long break. It’s expected, short-lived, and part of how tissues adapt.

How we approach scars is always intentional and progressive. We start with restoring skin mobility and glide, then introduce manual fascial shear, scar mobilization, decompression techniques (like cupping or gua-sha when appropriate), and MLD to support fluid exchange between tissue planes. We may even use vibration or microcurrent to help soften the tissue so we can help remold it in a more appropriate fashion.

Because collagen adapts slowly, we typically space these sessions weekly, giving the tissue time to reorganize between visits, while supporting progress at home with simple daily habits like movement you tolerate, hydration, and scar mobility techniques when indicated. This spacing allows remodeling to be more effective with fewer invasive tools needed later.

Even long after surgery, tissue can learn to move better, soften, and exchange fluid more efficiently. We just guide the process slow, smart, and specific to your tissues.

How many sessions should I book after surgery?

This is a great question that comes with a frustrating answer. The truth is, there isn’t a one-size-fits-all plan. There are so many factors that influence what your healing will look like and how much support your specific tissues will need. This is honestly one of the reasons we don’t sell packages anymore. If I sell you 10 sessions and you only need 8, that’s annoying. If I sell you 10 and you actually need 12+ to feel your best, you’re less likely to book those last few visits — the ones that could make a real difference — because the package already told you you were “done.”

What I can say confidently is this: the closer you are to surgery, the more beneficial gentle Manual Lymphatic Drainage (MLD) tends to be — as long as your doctor has cleared you. We try see clients as soon as their physician allows, and we’ll always meet the tissue where it’s at. Nothing we do will ever interfere with incision sites, sutures, drains or early healing devices – we know how to work with and around this stuff. Post-op MLD starts incredibly gentle, with slow, intentional strokes, and progresses naturally as your body heals, swelling reduces, and tissues become more resilient. For most surgical cases — including liposuction — the lymphatic system benefits from early, consistent support to manage post-op swelling, fluid pressure discomfort, and early fibrosis formation. By helping move that fluid burden and reducing tissue congestion from the start, we often see a smoother recovery curve overall.

General cadence (for many post-op cases):

2–3 sessions per week for the first 2–3 weeks (once cleared for touch)
Then easing into once-a-week support + homecare until swelling has fully resolved
Along the way, we provide homework (movement, lymphatic habits, compression guidance, etc.) so you stay supported between visits

And yes — every person is different. The variables matter: surgery type, pre-existing tissue integrity, lifestyle, age, genetics, inflammatory history, strength, stress load, movement access… the list goes on. Anyone who promises you’ll only need “X” number of sessions is selling something – I wish it were that easy!

In short: 
We recommend early, consistent, gentle MLD once cleared — then we adapt week by week based on your real tissues, your real healing, and your real results.

What kinds of surgical cases are appropriate for the type of lymphatic care you offer?

Truly, most ANY type of surgical case can benefit from Manual Lymphatic Drainage both before and after surgery. The reason MLD is so important after surgery is because it helps with appropriate tissue regeneration. Our clients report experiencing less pain, swelling, bruising, tightness, more mobility, and better sleep.

We see a ton of plastic surgery cases because those are the doctors who refer out for it. We LOVE working on these cases! Plastic surgeons know that their patients are motivated to see their results as quickly as possible and that lymphatic drainage helps you get there faster with less chance of unsightly (or restrictive) scaring. When it really matters how the body heals (and it always matters) doctors tend to send their patients our way. High-level athletes are also commonly referred for MLD after surgery so they can get back in the game quicker with higher function, less restriction and more range of motion.

I’m hopeful that one day Knee Replacements, Hip Replacements, Shoulder Replacements and especially any type of Abdominal Surgeries: C-sections, appendectomy, even laparoscopic surgeries for things like endometriosis or gallbladder removal) will be standard to have MLD incorporated with recovery.

In orthopedic cases, MLD is most helpful when range of motion is a priority and swelling is the biggest barrier standing in the way. A lot of times, the swelling is literally what keeps a knee or shoulder feeling tight, stuck, or limited. If PT sessions keep getting paused or are not progressing because swelling isn’t resolving, MLD can help get the fluid layer moving so rehab can focus on the deeper work of motion and strength instead of waiting on pressure and puffiness to stand down.  

So basically, if you want your swelling to go down more quickly and your scars to heal up flatter with more mobility Manual Lymphatic drainage might be able to make a real difference in your recovery!

Do you do incisional “lymphatic” drainage?

NO! Let’s start with what this is and why we don’t do this even if your doctor is telling you you have to get this done after your surgery: 
You may have seen videos online of people going in after their BBL, Liposuction or even Mommy Makeover surgeries to have their incisions re-opened and have fluid squeezed out of the body (and all over the floor). This is a common practice in some Latin American countries and places like Miami or even Houston. This is a brutally painful medical procedure that would need to be done in a sterile environment under doctor supervision. Our office is incredibly clean, but it ain’t sterile.

This one is frustrating because it has nothing to do with actual lymphatic fluid, yet it is commonly referred to as lymphatic drainage which is the manual technique we offer in our clinic so we often get calls about this.

The truth is, I get it – there is a LOT of fluid building up in the tissue space after these surgeries and it seems like a shortcut to juice it out of the body rather than waiting for the lymphatic system to slowly clean this up. But as we mentioned earlier whenever you are causing more pain, you are causing more inflammation signaling to the body that it needs to heal at the cellular level creating more fibroblast that can turn hard and dense. This is why things like cavitation and ultrasound therapies are commonly needed in addition to these types of aggressive procedures – because the tissue turns hard and dense which is what we are trying to avoid! We want your results to look natural and soft so we find it is best to let it heal in the natural way.. even if it takes longer – we find the results to be better with less invasive therapies needed.

One more note about incision and drainage: It is actually not legal in the state of Texas for us to do this under our license. Houston Lymphatic consists of Physical Therapists, Occupational Therapists and Massage Therapists. None of us are allowed to work with fluid that leaves the body. This requires appropriately regulated sanitation practices and ways of discarding bio-hazardous materials. Please, don’t let someone do this to you who is not a registered nurse or an actual medical doctor. …. I’ve heard of people getting these types of procedures done in someone’s garage.I’ve had people call asking if it’s normal to pee blood after these procedures (it’s not = go to the ER now). Please be safe and use common sense!

Bottom line, when done properly, Lymphatic Drainage is never about squeezing fluid out of the body. It’s about helping the body clear fluid better on its own, without creating more injury in the process. That’s what we do, and that’s why we do it the way we do.

Can you see me before surgery to prep my tissues?

Absolutely!! In fact, we highly recommend a few sessions of Manual Lymphatic Drainage (MLD) before most surgeries. The healthier your tissue is going in, the less inflammation and tissue congestion you’ll likely deal with on the back end.

Here’s how it helps: 
It’s true — the stronger you go into surgery, the stronger you tend to come out. Pre-care is gaining traction for good reason. Let’s take something like a knee replacement. The tissue around that joint has probably been irritated, inflamed, and congested for months (sometimes years) leading up to the procedure. That means old cellular waste, debris, and inflammatory build-up sitting in the tissue space — kind of like grimy, stagnant water in a flower vase. If we can clear and refresh that tissue environment with MLD before surgery, it can make a huge difference in how the body heals. It’s basically like swapping out the old water and giving your tissues a cleaner, healthier place to regenerate from.

This is especially beneficial for liposuction cases, too. Even when lipo is elective and the tissue seems “healthy,” reducing baseline congestion, improving micro-circulation, and mitigating lymphatic preload before the procedure helps the body manage post-op swelling, inflammation, and early fibrosis formation more effectively. Think of it as prepping the system so fluid build-up has a faster and easier escape route afterward, which can also mean less pressure discomfort and a smoother transition into visible results.

Timing-wise: 
We usually suggest beginning about one week before surgery, then coming back again ~2 days before your procedure. We avoid seeing clients within 48 hours of surgery, and we do not recommend coming in during a 48-hour window before anesthesia. MLD done a few days beforehand gives the body enough time to process the session so you walk in feeling clear, calm, and hopefully “tip-top” on procedure day. 

In short: 
We recommend MLD before nearly any surgical case — including joint replacements, abdominal procedures, and liposuction — whenever a healthier tissue environment and reduced inflammation can support better recovery … and honestly, that’s almost always.

I just had surgery. Will this be painful?

NO! Post surgical massage should NEVER be painful. I know there are some horrific videos online of aggressive postsurgical massage and I’m here to say that that is not our approach – here’s why: It has to do with the way appropriate scar tissue forms and the way your body keeps it in check. Fibrosis occurs when there is an over abundance of cellular waste and debris in the tissue space. Your lymphatic system is responsible for cleaning this up and when there is so much tissue disruption at once, it has a hard time keeping up with the clean up. This is why we never want to add more inflammation to a fresh surgical site.

Instead, what your body needs is gentle support to allow your lymphatic system to work at a more rapid pace so we can help to evacuate cellular waste and debris out of the tissue space and allow fresh, nutrient-rich, oxygenated fluid to flow in, allow healing, and repeat!

Healing occurs on the cellular level. Our post surgical massages should match that level of delicate support at first. Once your body has healed enough to be in the remodeling phase, we can offer deeper interventions to soften any hard, dense areas that have developed.

Let me just say that adding inflammation to already inflamed tissue is never the answer. Adding pain to an already traumatized nervous system is never the answer either. Your body needs to be bet where it’s at with gentle support after any surgical procedure.

Do you offer anything beyond MLD for lipedema tissue care?

Yes. We offer integrative tissue-focused care that goes beyond MLD when it is appropriate for your body. This may include gentle or more intense fascia focused work, lymphatic cupping, taping support for fluid and comfort, scar and adhesion work if you’ve already had surgery, and hands-on guidance for tissue texture changes like fibrosis, tenderness, or restricted areas that don’t need deep pressure but do need intentional direction. We are basically trying to smooth out the uneven tissue and create space in the tissue so your nerves are not as compacted and inflamed. The first goal is to decrease pain, improve mobility and quality of life and the secondary goal is to improve the appearance and texture of the skin. This care plan may change depending on your personal goals and what would make you feel most comfortable in your body.

Do you take my insurance or provide superbills for reimbursement? 

Right now, we don’t accept insurance. Our sessions are private pay and charged by time: $140 for 60 minutes. Some cases require 90 minutes, which is $210.

 We can provide a superbill for you to submit to your insurance company if you plan to seek reimbursement. Most insurance companies require a clinical diagnosis from a medical doctor to be included when you submit it. We recommend checking your coverage ahead of time because reimbursement rules are all over the place. Some companies will cover treatment if it’s done by an Occupational Therapist, but not if it’s done by a Physical Therapist or a Massage Therapist — and the reverse is true for other plans. There’s no one standard, so getting the details up front means we can guide you to the right practitioner based on what your plan actually allows.

If you’re still working on getting a diagnosis and need help figuring out what kind of doctor to see or what to ask for, it’s okay to call the office. We talk through that with people every week. We can’t diagnose you ourselves, but we can help you understand the path so you can get the care you need without unnecessary delays or confusion.

Can MLD actually help lipedema fat or just the swelling around it?

MLD does not eliminate lipedema fat. It works on the swelling and inflammation that lives around and between the fat cells in your tissue space. That fluid layer carries the inflammatory agents that contribute to tenderness, skin tightness, pressure pain, and heaviness. When that fluid gets help moving, your tissue can feel noticeably less irritated or tender. So MLD can be of some benefit. That being said, the swelling is a byproduct of a deeper issue when it comes to Lipedema and we have found MLD alone can be helpful but not life-changing. With that in mind, we started approaching things more “aggressively”. In addition to MLD, we also incorporate deeper interventions to address the diseased fatty tissue that is bound up like cement under the skin surface. By adding in, cupping, vibration, scraping, skin rolling, and pinching into these sessions, we have found that our clients get greater relief from the continuous pain and that we are able to move more fluid out of the tissue space with our lymphatic techniques. These sessions can be painful at first but we try to always work within your tolerance. Most of our clients experience pain during the first several sessions as we break up stubborn tissue and then it gets much more tolerable over time.

What makes lipedema swelling different from lymphedema swelling?

Lipedema and lymphedema get mixed up a lot. They are very different diseases that just happen to share the symptom of swelling. What causes that swelling — and how the tissue and body respond — is not the same.

Lymphedema swelling comes from excess lymph fluid collecting in the tissue space because lymph nodes are missing, damaged, or the lymphatic system is moving too slowly to keep up. The fluid is protein-rich, often creates visible pitting in the skin, and usually affects one side more than the other. Pain isn’t always present in the earlier stages, so many people don’t realize how limited or congested the system is until swelling becomes more consistent. The current clinical standard for managing lymphedema is Complete Decongestive Therapy (CDT), which combines MLD, compression, movement, skin care, and long-term self-management. That model works well because it’s designed to reroute and contain fluid safely when the lymphatic system needs ongoing support.

Lipedema swelling isn’t just a fluid issue. It’s a tissue disease. The fat cells themselves are inflamed and unhealthy, which slows lymph flow and creates pressure pain, tenderness, bruising, nodules, and a sense of heaviness that can be intense to live in. The swelling is typically bilateral (both sides of the body) and often painful, sometimes to a debilitating degree. Regular MLD and compression can help manage the fluid piece, but liposuction or lymph-sparing surgical approaches are often recommended because the root of the problem is in the tissue, not just the fluid.

Post-lipedema surgery swelling is also its own category. Recovery can involve high volumes of fluid shifting out of tissues that have been congested for years, so clients often need more MLD sessions spaced specifically around their procedure timeline. This is exactly why many surgeons refer their patients to lymphatic specialists for aftercare. We’ve worked with many clients in this window, and the feedback we hear most often is that the treatments made recovery feel more manageable, more comfortable, and more efficient. The surgeries can be life-changing. The aftercare is what helps you get through the recovery phase in a way that feels supportive to your body instead of overwhelming it.

We recommend calling the office so we can do a quick verbal assessment to get you set up with the best practitioner for your case.

Have your therapists worked with clients before or after lipedema surgery?

 Yes. Many of our therapists have worked with clients both before and after lipedema reduction surgery. Most of this care is private pay, so clients choose us because they want practitioners who already understand the tissue, the pain patterns, the swelling cycles, and the recovery window. Before surgery, the goal is to reduce pressure and fluid in the tissues so the body goes into the procedure less irritated. After surgery, the benefit is supporting swelling reduction and tissue recovery while following your surgeon’s timing and safety guidelines. Many doctors recommend bandaging after lipedema surgery and that is also something we can help with. With these types of cases, it’s important for us to plan ahead so there’s no delay in the services we provide. Please give us a call so we can make an appropriate care plan with the best therapist for your specific need.

Will someone be able to answer my questions on the phone before I book?

Absolutely! You can speak to someone who understands your case before you book. Liz and I both handle phone messages and are CLD/CDT therapists. Liz practiced hands-on for years before moving into a remote clinical support role, so she brings a huge depth of experience when answering case-specific questions.

We can’t diagnose you but we can help you understand what might be going on, what kind of care may fit best, and whether our clinic is a good next step for your body and your schedule. And if not, where the best spot for you might be.

You’ll leave a message when you call. One of us will get back to you soon. We both love supporting people and giving guidance as best we can. We will often wait to call back when we have a moment to answer all your questions so please be patient. We look forward to connecting!

What is included in a lymphedema MLD session? Is anything extra charged? 

Our sessions are all inclusive so there should be no additional cost for your time with us.
Depending on your case, your therapist may suggest you get a custom compression garment or a compression pump machine. You may also need to order bandaging or some other type of compression to help decrease initial limb volume. But all these things would be discussed with your practitioner and are not purchased through our clinic directly. In many cases, your insurance can also cover these things so you don’t have to pay out of pocket.

Do you treat medically complex lymphedema cases?

Generally not. We do have Certified Lymphedema Therapists on staff, however, because these more complex cases often take a significant amount of intervention, we find that for most, it’s better if they can instead, go through the insurance model because coming to see us as frequently as needed can be costly. We find it’s better if you can have your insurance pay for your acute care and then you come see us as-needed when you are in your maintenance stage.
However, if you don’t have insurance and think we might be a better fit, give us a call, we are happy to chat and see if one of our providers is appropriate for your case.

Do you treat patients who are in maintenance instead of “intensive phase” therapy?

Yes. Most of the people we see for lymphedema are in maintenance or prevention. It’s actually the core of what we do here.

Hospitals and large outpatient clinics are set up to handle the most advanced or medically complex cases. We fill a different but important role — supporting people who need regular MLD to help manage their swelling long-term, stay comfortable in daily life, and avoid needing the intensive model if possible.

For maintenance clients, the biggest difference is time. We don’t break your hour into small billable segments like many insurance-based clinics do. If your body benefits from hands-on lymphatic work, having the full session focused on fluid movement instead of switching between exercises, intake, and multiple providers can feel like a much more efficient use of your time and your energy.

If your lymphedema care plan is mostly MLD, compression, and self-management — and you want steady, personalized support when you need it — those are the cases that fit very well here.

How do I know which practitioner is the best fit for my body and my case?

Give us a call! Most of our therapists are very capable and experienced working with mild cases of lymphedema or those who have compromised systems and may be at risk for developing it. But if you have a more complicated or advanced case, you may be better suited with one of our therapists who has more in-depth training. Give us a call so we can discuss your case and get you set up with an appropriate practitioner.

Will someone be able to answer my questions on the phone before I book?

Absolutely! You can speak to someone who knows the work before you book. Liz and I both handle phone messages and are Certified Lymphedema Therapists. Liz practiced hands-on for years before moving into a remote clinical support role, so she brings a huge depth of experience when answering case-specific questions.

We can’t diagnose you but we can help you understand what might be going on, what kind of care may fit best, and whether our clinic is a good next step for your body and your schedule. And if not, where the best spot for you might be.

You’ll leave a message when you call. One of us will get back to you soon. We both love supporting people and giving guidance as best we can. We will often wait to call back when we have a moment to answer all your questions so please be patient. We look forward to connecting!

What’s the actual difference in what I can expect from treatment here versus hospital-based protocols that would accept my insurance? Basically, why should I come see you instead of going to a more traditional clinic?

In all honesty, some cases will be better suited for a hospital or insurance-based outpatient clinic. If you currently need wound care, infection management, or have medical complications layered into your swelling, a traditional medical practice that takes your insurance is the safest place for you to start.

But most people with lymphedema live in the early to moderate stages, where daily discomfort is real, but complex medical intervention isn’t required. This is the space we built our clinic for. And the biggest difference is simple: we don’t follow the insurance model, so we don’t split your care into short, billable segments.

In an insurance-based outpatient clinic, your hour is typically divided. You may speak with a provider (OT or PT) for about 10–15 minutes, spend another 10–15 minutes doing supervised exercises, receive about 30 minutes of MLD, and round out the rest of the hour talking through compression protocols, bandaging, and next steps. There’s nothing inherently wrong with that model — it’s just the only model insurance allows. And for people who need frequent fluid movement for maintenance (instead of provider conversation), it can feel slow, repetitive, and frustrating.

Here, your session is structured differently because we’re allowed to dedicate the full hour to MLD without pausing or shifting gears. For general maintenance, people feel and notice the difference. Many therapists who left the hospital and outpatient settings to work with us did so for this exact reason — they wanted more time to actually do the hands-on work their patients needed, not more time spent fitting insurance billing requirements.

The other difference is access. Insurance-based clinics are often booked months out, and once you finally get a spot, follow-up availability can also be spaced far apart. For someone whose body shifts week to week, that can feel like being on a waitlist for your own care plan. A lot of people come see us while waiting to get in with an insurance-based clinic because they didn’t want to pause their progress or comfort for that long.

And since it gets asked a lot, here’s the clear answer for why we don’t take insurance: the labor of collecting it is not sustainable for a small business. The paperwork hours, billing hours, phone hours, follow-ups, denials, resubmissions — it’s not that we don’t want to support you. We just can’t run a clinic that way and still deliver consistent care.

That said — if your body is using MLD well and you want regular fluid-focused support without interruptions or resets, this is a great fit. If your case eventually needs provider coordination, compression onboarding, or intensive-stage care, we’ll tell you. We will always guide you to the safest next step for your body.

And finally, if you’re in a true financial hardship, it’s okay to call and ask. We don’t promise outcomes, but we do talk through options when we can. We want care to feel accessible, straightforward, and safe. That’s been the mission from day one.

HEALTH & WELLNESS

HEALTH & WELLNESS

Manual Lymphatic Drainage

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Flow Is Foundational

Flow better & Feel better.

Flow Is Foundational