After an initial consultation, you will undress, lie down on a massage table in the face-up position, covered modestly with a sheet. The atmosphere is the same as a massage treatment room with dim lighting and soft music. Although you are in a massage setting, it is important to understand that MLD is a specific form of bodywork designed to efficiently move lymph fluid in your body. MLD is completely different from a deep tissue, Swedish or relaxation massage that you may be expecting or have had in the past. Stimulation of the Lymphatic System activates the para-sympathetic nervous system producing an automatic physiological relaxation response. Many clients fall asleep. Only the area being worked on is undraped at any time. Gentle, rotating, pumping motions with the therapist’s hands and fingertips begin at the collarbone area, then focus on areas where there is a concentration of lymph nodes…the underarms, abdomen, groin and back of the knees. Usually the entire session is performed with you lying in the face-up position because all of the areas of lymph nodes that need to be decongested are located on the front of the body, although some surgeries do require the patient to turn side to side or face down for a short time if tolerated. Starting on the back (even for fat injections to the buttocks) would not be indicated because it is necessary to open up the major lymphatic areas on the front of your body before the backside of the body can drain. It is very important to decongest the areas of drainage in the groin, abdomen, underarms and collarbone areas before sending extra lymph fluid to them. Directing lymph fluid to nodal areas without opening the lymph nodes up first increases the discomfort and overwhelms the nodes, leading to increased recovery time. Each session is one hour, although those who have several procedures at the same time might prefer a 90 minute session.