Lipo-abdominoplasty patients are not straightforward.
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By the time they arrive in your treatment room, their body has already been through significant trauma. Tissues have been cut, lifted, and repositioned. Superficial lymphatic vessels may have been damaged or removed. The incision is still healing. The patient may be swollen, anxious, and uncertain about what is normal.
A general MLD routine is not enough for this patient group. And good intentions, however genuine, do not replace clinical understanding.
Before you place your hands on a postoperative patient, you need to know what you are looking at. You need to know what questions to ask, what to observe, what the red flags are, and when treatment should wait.
That is what this guide is designed to help you do.
What this guide gives you...
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Before Treatment Begins covers five clinical areas that affect safer early decision-making when working with lipo-abdominoplasty patients.
- How to assess postoperative swelling more effectively, considering where it appears, how it is changing, and whether it fits the stage of recovery.
- How healing stage and tissue readiness influence what treatment is appropriate and when it may be safer to wait.
- How to respond safely to tissue thickening and congestion in the early postoperative stage, without making assumptions about fibrosis.
- How the location of incisions may affect lymph drainage and the drainage pathways you choose to use.
- How to recognise red flags and make clear decisions about when to refer back to the surgeon or clinical team.
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The guide also includes a pre-treatment screening question set, a red flag checklist, a week 1 to 3 treatment considerations framework, a compression observation guide, a simple treatment note template, a pre-treatment decision checklist, and a case reflection based on a patient at day 6 after surgery.
About Petra Erving
Petra Erving is a Certified Lymphoedema Therapist, MLD therapist, Scar Tissue Therapist, and founder of The Aftercare Academy.
With over 20 years in clinical practice, Petra has worked with postoperative, lymphoedema, lipoedema, and complex patients across NHS, hospice care, private practice, and plastic surgery clinics. Her work in postoperative care has developed through direct clinical experience, specialist training, and working alongside experienced clinicians in lymphoedema, lipoedema, plastic and reconstructive surgery, venous care, dermatology, and oncology.
The Aftercare Academy was created to raise standards in postoperative care by helping therapists develop the knowledge, practical skills, and professional boundaries needed to work more safely with this patient group.
This guide reflects that aim.
What Therapists Say About Petra's Training
Robert
“I’ve worked with post-op patients for a while and thought I knew enough to be safe. During Petra’s teaching, I realised how much more there was to understand.”
Olivia
“The information shared was incredible. It changed how I think about treating post-op patients and helped me see why this work needs a much deeper clinical approach.”
Laine
“Petra explains complex postoperative care in a way that feels clear, structured, and grounded in real clinical experience. It helped me see the bigger picture.”