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Heal Faster, Heal Better with Lymphatic Therapy & Ultrasound

Research Articles

The use of ultrasound in cosmetic surgery

June 14, 2012 by James Romano, MD Board Certified Plastic Surgeon , Education articles (http://jromano.com/category.education

There are numerous exciting new applications of ultrasound therapy in cosmetic surgery.  Ultrasound has been used for cosmetic purposes since around the early 1980s. New and current uses of ultrasound include facial and body skin-rejuvenating treatments, reduction of stretch marks, treatment of contracture and scar tissue such as around breast implants, and the pre- and post-operative treatment of plastic-surgery patients to accelerate healing and recover after procedures such as face lifts, tummy tucks, and liposuction. Ultrasound applied over certain creams contributes to greater effectiveness through deeper and more thorough penetration of the products.

Multiple treatments are usually required, and the treatment is safe for all skin colors and types.  the number and frequency of your treatments depends on your skin type and response to therapy.  Improvements are usually seen by the fourth treatment.

Scar tissue and contracture is improved tremendously with ultrasound. This has demonstrated great effects in speeding the healing and discoloration of firm or bruised areas occasionally seen after facelifts, tummy tucks, or liposuction. Patients with breast implants and some hardening have appreciated softening of the implants and breasts.  Six to twelve treatments provide the best results with improvements usually seen after four sessions. Summary: Ultrasound is routinely used in these patients to promote fast resolution of swelling, quicker healing, less bruising, and better skin molding and shrinking down around the reduced fatty framework.

Combining manual lymph drainage with physical exercise after modified radical mastectomy effectively prevents axillary web syndrome

Journal Phlebol Lymphol. 2017;10(1):15-18

Axillary web syndrome (AWS) is one type of Mondor disease. It is an early post-operative complication of breast cancer secondary to axillary lymph node dissection (ALND) or sentinel lymph node biopsy (SLNB) and it can occur in non-breast cancer patients with axillary node biopsies. Manual Lymph Drainage, MLD has been shown to improve blood circulation, stimulated the movement of lymphatic or other tissue fluids, and promote fluid clearance and tissue softening. Early stimulation of lymphatic drainage can also modulate the pain and inflexibility associated with lymphatic vessel inflammation secondary to surgical injuries. Conclusions: MLD in combination with physical exercise is beneficial for preventing AWS and increasing comfort in breast cancer patients after modified radical mastectomy.

Manual lymphatic drainage and therapeutic ultrasound in liposuction and lipoadbominoplasty post-operative period

Indian Journal of Plastic Surgery; Varanasi 47.1 (Jan-Apr 2014): 70-76

Background: Physiotherapy in the plastic surgery post-operative (PO) is essential to provide means for an adequate and fast recovery as it restores function through the use of physiotherapeutic procedures.  Aim: The aim of the following study is to verify the effects of the association between the manual lymphatic drainage and the therapeutic ultrasound on pain, oedema and the tissue fibrosis in liposuction and lipoabdominoplasty PO . A total of twelve sessions of therapeutic ultrasound followed by the manual lymphatic drainage were performed. Results: There was a statistically significant reduction of pain, swelling and tissue fibrosis in both groups. Conclusion: the association between manual lymphatic drainage and the therapeutic ultrasound reduced the swelling and the tissue fibrosis and made pain disappear in liposuction and lipoabdominoplasty PO period.

Research Articles

FYI

(Repeated Heat Stress, RMHS)

Hormetic prevention of molecular damage during cellular aging of human skin fibroblasts and keratinocytes

Annals of the New York Academy of  Sciences 2007 April;1100:424-30

Progressive accumulation of molecular damage is a hallmark of cellular aging, which is amenable to intervention and prevention by hormesis through mild stress. Our studies have shown that repeated mild heat stress (RMHS) has antiaging effects on growth and various other cellular and biochemical characteristics of normal human skin fibroblasts undergoing aging in vitro. RMHS at 41 degrees C, for 1 h twice a week, increased the basal levels of various chaperones, reduced the accumulation of oxidatively and glycoxidatively damaged proteins, stimulated proteasomal activities for the degradation of abnormal proteins, improved cellular resistance to ethanol, hydrogen peroxide, and UV-B rays, enhanced the levels of various antioxidant enzymes, and increased the phosphorylation-mediated activities of various stress kinases. RMHS-exposed human fibroblasts are also better protected against glucose- and glyoxal-induced growth inhibition and apoptosis. We have also observed various hormetic effects of RMHS on normal human epidermal keratinocytes, which include increased replicative life span, increased proteasomal activity, and enhanced levels of Na/K-ATPase pump. We are also testing the above effects of RMHS in combination with potential hormetic molecules, such as curcumin, on aging, longevity, and differentiation of human cells in culture.

Ultrasound as a treatment for chronic rhinosinusitis

Med Hypotheses. 2009 Jul;73(1): 15-7. doi: 10.1016/j.mehy.2008. 12.049

Bacteria are now recognized as existing in two forms-free floating (planktonic) or in sophisticated communities called biofilms. Bacteria within biofilms are difficult to culture and highly refractory to antibiotic treatment.  Biofilms could explain some of the paradoxes associated with chronic rhinosinusitis. The successful application of ultrasound to sinus disease could mean the development of a new paradigm in our treatment of chronic rhinosinusitis, a reduction in antibiotic resistance and improved medical management with a subsequent reduction in surgical intervention.

Effects of a physical therapy program combined with manual lymphatic drainage on shoulder function, quality of life, lymphedema incidence, and pain in breast cancer patients with axillary web syndrome following axillary dissection.

Support Care Cancer 2016 May;24(5):2047-2057.doi: 10.1007/s00520-015-3005-1

Purpose: The aim of this study was to evaluate the effects of physical therapy(PT combined with manual lymphatic drainage (MLD) on shoulder function, pain, lymphedema, visible cords, and quality of life (QOL) in breast cancer patients with axillary web syndrome (AWS). Conclusions: PT improves shoulder function, pain, and QOL in breast cancer patients with AWS and combined with MLD decreases arm lympedema (after 4 weeks of treatment).

Research Studies

FYI

A Clinical Trial on the Treatment of Chronic Rhinosinusitis with Continuous Ultrasound

J Phys. Ther. Sci. 20: 233-238, 2008

Chronic rhinosinusitis (CRS), a common and long-term condition, is a significant health problem.  Sinusitis represents a significant health and socioeconomic problem, with 29.2 million adult patients in the United States.  CRS is a prolonged or recurrent infection and/or inflammation of the mucous membranes of the sinuses and mucous lining of the nose.  The etiology of  RS is multifactorial (e.g.viral, bacterial, or fungal infection), allergy, and environmental factors and no effective treatment has been established.  Symptoms of inflammation of the paranasal sinuses persisting more than 8-12 weeks or more than 3 or 4 acute episodes per year, each lasting for at least 10 days. The major symptoms are facial pain/pressure, nasal obstruction, discharge, discolored post nasal drip, smell disturbances, and fever. Headaches, halitosis, fatigue, dental pain, cough, and ear pain as minor symptoms. Patients were treated three days per week, every other day for 10 treatments. Following treatment, the mean percent of improvement was 74.7% (good); 43.3% had an excellent improvement; 20% had poor-fair improvement; 3.3% had no improvement, and no reports of negative effects from the treatment.

What is hyperthermia?


Hyperthermia (also called thermal therapy or thermotherapy) is a type of cancer treatment in which body tissue is exposed to high temperatures (up to 113°F). Research has shown that high temperatures can damage and kill cancer cells, usually with minimal injury to normal tissues (1). By killing cancer cells and damaging proteins and structures within cells (2), hyperthermia may shrink tumors.

Hyperthermia is under study in clinical trials (research studies with people) and is not widely available.

Combining manual lymph drainage with physical exercise after modified radical mastectomy effectively prevents axillary web syndrome

 J Phlebol Lymphol. 2017;10(1):15-18.

Axillary Web Syndrome (AWS) – is an early post-operative complication after axillary lymph node dissection or sentinel lymph biopsy and can occur in non-breast cancer patients with axillary node biopsy. AWS is characterized as sudden upper arm pain, aggravated by elevating the shoulder exhibiting tightness and limited range of motion (ROM). Subcutaneous tissue draws in, presenting cording under in the armpit, breast, chest wall, upper, or lower arm. Post-operative exercises combined with Manual Lymphatic Drainage reduces the incidence of AWS. One study of 400 women with breast cancer were randomly selected into two groups of 200 and compared the incidence of AWS between physical exercises, PE vs. manual lymphatic drainage, MLD & PE. The number of patients with AWS in the MLD & PE group were significantly fewer. At month one: PE 20 vs 7 PE & MLD; month two: PE 29 vs 5 PE & MLD; month three: 22 vs 3. Conclusion: considering earlier studies regarding the prevention of lymphedema, MLD in combination with PE can be an effective strategy for preventing AWS and is a treatment needed for postoperative breast cancer survivors. 

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