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Trauma Remodeling Chart Explained
The concept of client trauma remodeling operates on the principle that the human body responds to trauma by undergoing a process of adaptation and remodeling. When the body experiences trauma, whether physical or psychological, it initiates a series of biological responses aimed at repair and recovery. This remodeling process involves the restructuring of tissues, cells, and physiological functions to adapt to the new conditions imposed by the trauma. Through the trauma, the body reshapes. If trauma isn’t introduced, the body doesn’t change.
As the body undergoes trauma remodeling, the extent and nature of changes depend on several factors, including the severity and duration of the trauma, individual physiological characteristics, and the body’s innate healing capacity.
Importantly, the trajectory of remodeling is not linear; instead, it follows a continuum where the intensity and rate of remodeling vary over time.
One key aspect of trauma remodeling is that as the body moves further away from the onset of the trauma, the degree of remodeling tends to diminish. Initially, following trauma, the body exhibits more pronounced changes as it mobilizes resources to repair damaged tissues and restore homeostasis. However, as time progresses and the healing process advances, the body’s remodeling responses become less prominent, eventually stabilizing at a new equilibrium.
To induce additional changes in the remodeling process, new trauma needs to be introduced. This concept is reflected in the idea of trauma tiers, where different levels of trauma elicit varying degrees of remodeling responses. For instance, surgical interventions represent a high level of trauma, involving significant tissue disruption and physiological stress. In contrast, nonsurgical body contouring (NSBC) techniques involve lower levels of controlled trauma, such as targeted energy delivery or mechanical manipulation of tissues.
Faja Explanation
A “faja” is a post trauma compressive garment clients wear to amplify the effects of the lymphatic system. They can be worn for surgical and nonsurgical clients; however, for them to be effective (same with waist trainers), trauma has to be introduced. This is called “bioengineering”. If there hasn’t been a source of trauma, compression garments are mores shapewear instead of reconstructive compression tools; they will only have a temporary impact.
When it comes to post surgical wear, fajas follow a client’s trauma remodeling continuum moving from Stage 1 to Stage 3 respectively.
Stage 1: the lowest stage of compression. This garment has the most amount of “give” to it, affording for tissue expansion and swelling fluctuations the first week of surgery
Stage 2: this is a moderate stage of compression. Clients will stay in this garment around 8 before reassessing their results with their body goals. If clients would like to maintain results achieved, they will stay in this stage of compression for 6 months until 1 year before weening off of compression; after reassessing, clients can typically ditch their faja accessories during this stage of compression.
Stage 3: this is the highest stage of compression. After 8 weeks, clients may move into this aggressive level of compression to amplify their results further. This stage can also be used during the nonsurgical body contouring phase.
Massage Explanation
Types of Massages during a cosmetic self love journey
PreOp Lymphatic Massage
Lymphatic massage, also known as lymphatic drainage massage, is a therapeutic technique designed to stimulate the lymphatic system to remove excess fluid and toxins from the body.
During a lymphatic massage, a trained therapist uses gentle, rhythmic movements to encourage the flow of lymph fluid throughout the body. The massage typically begins with light pressure on the neck and collarbone area, where many lymph nodes are located. The therapist then progresses to other areas of the body, using gentle strokes and pumping motions to stimulate lymphatic circulation.
The primary goal of lymphatic massage is to reduce natural swelling and promote detoxification. Lymphatic massage can help boost the immune system, improve circulation, and promote relaxation.
These types of treatments were invented in 1931 by Emil Vodder and his wife. This is only appropriate for nonsurgical applications OR for medically necessary post surgical applications; it was never intended to be used for plastic surgery clients. You will see tons of confusion about people using the words “lymphatic massage” when describing their treatments for post surgery– that is NOT what you need or should be looking for. Lymphatic massage is not intended for large volume inflammation. This style of treatment should be reserved for either PreOp massages OR for when you are 3-6 months postOp. These sessions are typically 60min-90min long. They are conducted using hands-only techniques and applications.
The therapist you use for your PreOp massages may not be the same person you need for your Incisional Drainage Treatments, PostOp-Indur Treatments, or your Body Contouring treatments.
Incisional Drainage Treatments
These types of treatments will be delivered by a professional that specializes in Incisional Sciences & Technology applications and treatments. They are delivered from Day 1 until Day 7 after plastic surgery. The pressure of these treatments ranges on a pressure gradient from a scale of 1-10 from a 1 to a 4. The strokes are superficial, light, and are meant to help your body expel fluid through the car-air-bag atmosphere around your cells and vessels. If you have a drain tube or open incisions, fluid may be expelled through your incisional sites* and towards your internal lymph nodes– small, bean-shaped structures located throughout the body along the lymphatic vessels; they play a role in immune function & fluid balance in the immune system by filtering lymph fluid and trapping bacteria, viruses, and other harmful substances.
These sessions are done predominantly with hand techniques and applications; a few devices can be used that include ultrasound, pressotherapy sessions, and jade scrapers. These sessions are typically 30min-60min long. After Day 7 postOp, the style of treatment you receive should switch to PostOp-Indur treatments.
The therapist you use for your Incisional Drainage Treatments may not be the same person you need for your PostOp-Indur Treatments or your Body Contouring treatments.
* Not everyone will drain externally. If you don’t have drains, your incisions do not HAVE to be reopened. If they are, it does typically help the final results as a lot of surgeons tend to use too much tumescent fluid during the procedure. The healthier you are before surgery, the less this aspect of the treatment needs to be performed but we want you to feel empowered to do what you think is best for your body. Note: incisions are not to be reopened past day 7. If you develop a seroma or localized fluid build up, these fluid pockets can be aspirated with a small needle and a syringe. Look for a nurse or someone that is Seroma Network certified to perform this treatment.
PostOp-Indur Treatments
These post surgical palpation treatments are the types of sessions you will receive for the bulk duration of your post plastic surgery healing journey. They are applied from Day 8 until around week 8 after a plastic surgery procedure. The purpose of these sessions are to manually move water based cells towards your lymph nodes; stroke direction changes and should be going upwards towards your underarms and clavicle. While PostOp-Indur (POI) treatments will have some MLD and lymphatic massage techniques added in, these sessions should not be lymphatic massage only. They combine hands, tools, equipment, and machines that make up your treatment protocols during a 60min-90min session duration; initially these treatments will be mainly hands but will slowly start to add more devices into your treatment as your body continues to heal.
POI treatments follow a client’s trauma remodeling continuum and are customized based on how your body is presenting that day. The pressure ranges from a 2 to a 7, with pressure increasing as your body starts to heal; this is to address the uneven skin integrity that WILL begin to present somewhere between week 3-6. They should be done by a provider that is well versed in post plastic surgery applications. Your provider should have a thorough robust knowledge of faja and compression therapy training, post plastic surgery client nutrition, and plastic surgery edema management. These sessions will vary every time you come; you should see your therapist 1-2 times a week for 8 weeks.
The therapist you use for your Incisional Drainage Treatments may not be the same person you need for your PostOp-Indur Treatments or your Body Contouring treatments.
Body Contouring Treatments (POBC + NSBC)
These treatments are heavily dominated by machines, using techniques and treatments that aim to reshape and sculpt the body. Body Contouring sessions will help to enhance your surgeon’s work, and give you more permanently defined aesthetics and curves. It helps you to perfect your body goals, tighten skin, reduce cellulite, and continues to manually rescind fluid build up. These sessions are intended to target fat cells. Non Surgical body contouring treatments are typically non-invasive or minimally invasive, meaning they do not require incisions or anesthesia. Instead, they work by delivering energy or cooling to the targeted areas, causing fat cells to break down and be naturally eliminated by the body over time. Body contouring sessions can range in intensity, depending on the goals for the session from a pressure of 2 to a pressure of 10. They can be used to enhance surgical results, achieve body goals for those who have never had surgery, or help you simply maintain the results you received. These sessions begin around week 8, although some treatments may start being added into your POI sessions as your body starts to display a need for them. If you desire more enhanced results from your surgery, the sessions will be intense and goal driven. If you desire to simply maintain results achieved after the swelling has mostly subsided, then the sessions will be less intense following a lower pressure gradient. Body Contouring [Maintenance] sessions are what you will continue to get months after having your procedure– usually 1 a month or once every 3 months.
Client Massage/Treatment
[Massage] Treatments are applied based on the needs of the client, their overall body goals, and how their body is presenting that day. These treatments and services fall outside the definition of massage, wound care, cosmetology, and even nursing. They are services that blend together styles and techniques to meet the current needs and demands of today’s client in the Body Altering Aesthetic industry. Each session ranges from 60-90min, and should vary in what is actually done to the tissue at every session. Treatments may be a little uncomfortable, but should never be painful. They should include every part of the body, even if the goal and focus is only on one part of the body.
Transition periods
A client will transition from one treatment style to the next as their body moves along the client care continuum. Once a client reaches 8 weeks [pending they are free of complications and had a fairly normal healing journey], the client can decide with their certified therapist if they would like to maintain their results, or move into Body Contouring. This is also seen in the gradual compression shift from stage 1 to a stage 3 garment. As the client moves from having “active incisions” to the “reabsorption” phase, their tissue will begin to present with uneven dimples and pitting; this is not fibrosis– it is a presentation called “reabsorption”, and also a sign that the client should be in a well fitting stage 2 faja. As the client enters the remodeling phase around 8 weeks postOp, their compression selection may increase or they can opt to stay in their stage 1 garment for another 3-4 months before weening off. NOTE; unless a client gets more surgery, their body will remain in a maintenance remodeling phase.
