An image of a massage therapist gently massaging a woman's abdomen is used to illustrate the concept of manual lymphatic drainage, a type of massage therapy.

Manual Lymphatic Drainage (MLD) is in high demand by the public, especially by people undergoing cosmetic surgery. Esthetic body procedures, such as abdominoplasty, buttock augmentation and liposuction, increased by 63% between 2020 and 2022, making MLD a potentially lucrative specialty.

The Path Toward Physician Referrals

In 2017, I was contacted by a potential client who stated she was going to have surgery and wanted to find an MLD therapist prior to her procedure.

Of course, I knew what MLD was—but I was not trained in it to offer it to any clients at that moment in time. In the past, I would get inquiries from regular clients about a specific modality and I would pursue training. (It is important to be trained specifically in MLD before offering it, just as with any other specialty modality you offer.)

In this instance, MLD wasn’t necessarily on my radar of modalities, but this client was persistent in staying in contact to see if I had taken the training. All of a sudden, I began to receive multiple inquires about MLD, with people telling me their surgeon recommended MLD post- surgery. I began to think to myself, “If their surgeons are recommending they find a therapist, then this is a plus for our industry.”

I began to wonder if I could do the same with cosmetic surgeons as I had done with chiropractors the year before: In 2016 I went my first chiropractic appointment and then built a relationship with my chiropractor and his staff. My chiropractor began referring clients to me and vice versa.

I began to research MLD training, and I completed my 96-hour training in 2019. Becoming MLD certified was one of the best decisions I have made in my career.

Since completing my MLD training, I have been able to help over 200 clients with their post-operative care.

MLD Therapists are in Demand

The need for MLD therapists is growing at great rates. Studies have shown there are more than 15 million cosmetic procedures done in the U.S. alone. I have clients traveling outside of the U.S. for surgery as well. The most common post-surgical procedure I’ve seen in the last three years is lipo 360, a liposuction procedure that encompasses all areas of the midsection, covering 360 degrees all the way around.

At this rate, no matter if there are three to six therapists in a 10-mile radius, there is enough work to go around for everyone.

MLD is very specific work done to the client—and treatment depends, of course, on what type of surgery that specific client has undergone. In my experience, seeing a client as quickly as possible means the client sees quicker and faster results after their surgery—however, it is important to follow each physician’s specific aftercare instructions for each client.

Some physicians offer MLD as an additional service to their patients. When a client is offered MLD inside the physician’s office, the client wound might be open or might re-open after being closed; however, it is out of our scope of practice to work on clients when their wound is open. Once the client is wound is closed and they begin to see me, we proceed with MLD and drain the lymph to the correct lymph nodes.

It always amazes me to see the client’s state in the beginning and then at the end of six or more sessions, seeing each client’s body return to normal and the client walking again and being able to really be mobile.

“I was initially nervous that it was going to hurt, but it didn’t,” stated one client, Ruby, in a testimonial. “You actually made me feel better after the first session. You made me feel comfortable after my surgery … you were honest with me in reference to what your professional opinion was about how many sessions I should do and what results I should see. I don’t know what I would have done if I didn’t find you.”

Getting Started with Physician Referrals

The client of mine mentioned above, Ruby, had just had an abdominoplasty and lipo on her back. Her daughter had heard of me and recommended her to me. Ruby was one- to two-weeks post-op when she began working with me.

Normally the physician gives the client about six months to recover, and then they release the client. So, every so often the patient would go back for follow-up.

Ruby completed her recommended six treatments with me and decided to keep going and do a second round of treatment sessions with me. She had reached four months and she returned to her physician for a normal follow-up. Ruby had healed very well and the physician asked what she was doing. She stated, “I have been seeing my massage therapist for MLD” and the physician then stated, “You have healed faster than normal and I am going to release you due to your speedy recovery.”

When Ruby returned for her next session with me, she told me what her physician had said. I was ecstatic to hear how pleased he was with my work and how it really helped Ruby heal much faster. The physician released Ruby two months early. Ruby gave the physician my brochure.

Two weeks later, I got a call in which the potential client stated that their physician had referred her to me. Now, at this moment my mind is blown. I’m holding the phone speechless because I knew that to get a physician to refer their patients directly to me would be huge for my business. Following that day, he sent me approximately 15 clients, even though my practice is two hours from his.

From just those 15 clients, I brought in close to $20,000.

As you know, with anything new you have to advertise, which should be included in your monthly budget. But at this point I no longer have to pay for advertising, as my MLD clients find me from physician referrals.

Building Relationships for Physician Referrals

Another direction you could take for physician referrals is to provide massage therapy to the physician while building a professional relationship with them.

My second referral from a physician came from word-of-mouth as well as my reputation. The client came in after having abdominoplasty. Once the patient’s course of treatment was done, her physician began sending clients my way.

Another MLD client of mine shared this testimonial: “I just had plastic surgery eight weeks ago today. I had skin removed from my back, my belly and my arms. One of the most important things to do after plastic surgery is to have lymphatic massage. I had five lymphatic massages right after my surgery that my … massage therapist provided. Once I returned home, I couldn’t find anyone, but thankfully I found Terrance. So, over the last four weeks I’ve had 10 lymphatic massages … It has helped so much. When I first came to Terrance, I was swollen all over and I had places that were hard from fluid buildup. [The buildup is] now all gone. Everything is soft now.”

As you can see, MLD is very much in demand—and with the rate of cosmetic surgeries growing, we can assume this demand for MLD will grow as well.

I recommend getting acquainted with local physicians in your area to begin building that professional relationship. Continue to grow in MLD to deepen and develop your skills and knowledge to increase your value.

By developing professional relationships with medical professionals and earning physician referrals, you too can build a successful practice focusing on post-cosmetic-surgery MLD.

Terrance Bonner

About the Author

Terrance Bonner, LMT, LE, has worked in the beauty and wellness industry for 12 years. He is massage therapy and esthetic instructor, as well as a spa and wellness expert. He is the author of “Determination + Core Values = SUCCESS.” Bonner has won multiple awards in his field. He currently sits on the Mississippi State Board of Massage Therapy, as vice-chairman. He owns and operates The Bonner Institute in Columbus, Mississippi.