Home / What's going on? / Gender-affirming surgery recovery
Post-operative lymphatic care · South Berkeley
You are welcome here, and you were before you asked.
I provide Vodder-certified Manual Lymph Drainage after gender-affirming surgery: top surgery, bottom surgery, facial procedures, and body contouring. Less swelling, more range of motion, less pain, and a recovery where you are not managing anyone else's discomfort about your body.
- Method
- Dr. Vodder MLD, certified since 2009
- Procedures
- Chest, facial, genital, contouring
- Timing
- Guided by your surgeon
- Setting
- Private, one to one, by appointment
First, the thing you are actually wondering
Whether it is safe to book with me.
When you are looking up a bodyworker before surgery like this, you are not only assessing technique. You are trying to work out, from a website, who this person is and how they are going to feel about you. That is an exhausting thing to have to do while you are also preparing for an operation.
So let me save you the guesswork. You are welcome in my office. Your pronouns and your name are the ones you give me. I have done this work for people through these surgeries already, and I intend to do a great deal more of it.
Appointments are private and one to one, in a quiet treatment room in South Berkeley. What you tell me stays with me.
I just want to help everyone in the same way. Removing swelling, increasing range of motion, reducing pain, and helping everyone feel supported during this time.
What I work with
Procedures I support recovery from.
Gender-affirming surgery covers procedures that help align your physical body with your gender identity, tailored to what you actually want. Lymphatically, these are procedures I already know well.
Top surgery
Chest reconstruction, whether double incision, keyhole, periareolar, or breast augmentation. Drainage around the chest, axilla, and upper arm, then attention to the incision lines once they have closed.
Bottom surgery
Vaginoplasty, phalloplasty, metoidioplasty, orchiectomy, and hysterectomy. Swelling in this region is stubborn and uncomfortable, and lymphatic work is well suited to it once your surgeon clears you.
Facial surgery
Facial feminisation or masculinisation, jaw and brow reshaping, rhinoplasty, tracheal shave. Facial swelling is dramatic early on and drains beautifully with the right hands.
Body contouring
Liposuction and fat transfer to reshape hips, waist, and buttocks. This is the same post-lipo drainage work I have done for years, and there is a great deal of it in my practice.
Before your surgery
Coming in beforehand is genuinely useful. We get your lymphatic system moving, calm your nervous system, and plan when to start afterwards, which is far easier than arranging it while you are sore.
Scars, later on
Once everything is fully closed, I work scars with Dolphin microcurrent and hand technique. Chest scars in particular can bind and restrict how your arms move.
Why lymphatic work, specifically
Your body does not know this was your idea.
Your brain has been planning this, possibly for years. Your body has not. As far as your nervous system is concerned it has just sustained a significant injury, and it responds accordingly: it clamps down, it swells, and it goes into fight-or-flight.
That matters, because a body stuck in fight-or-flight cannot heal efficiently or even digest properly. So before anything else happens, we shift you out of it. Once you are there, the lymphatic work has something to work with.
- Swelling and fluid move out rather than sitting in tissue that has nowhere to drain it, because the surgery cut through lymphatic vessels.
- Bruising clears faster and tissue comfort improves as damaged cells are carried away.
- Range of motion returns sooner, which matters enormously after chest surgery.
- Pain eases. MLD has a genuine analgesic effect, quite separate from the relaxation.
- Hardness and fibrosis are less likely to set in when fluid keeps moving through the early weeks.
How this goes
From the first call to the last session.
- Before
A free phone call
You tell me what procedure you are having or have had, when, and what your surgeon has said. I tell you honestly whether I can help and when we should start. Call before surgery if you can.
- Early
Drainage, away from the incisions
In the first weeks I work above and around the surgical area, opening the pathways that fluid needs to travel through. Nothing goes near a closed incision until it is ready.
- Middle
Closer in, as you heal
As the tissue tolerates it, the work moves nearer the site. This is usually where people notice the biggest change in how their chest or face feels day to day.
- Later
Scar and fascia work
Once everything is fully closed, we can address the scars themselves and the fascia underneath, so nothing is left quietly restricting your movement.
- Ongoing
Or not, and that is fine
Some people finish recovery and I never see them again, which is a good outcome. Others stay because they like how this feels. Both are welcome.
Timing
When to start.
Your surgeon sets the schedule and I work inside it. That is not me being cautious for form's sake. Different procedures have genuinely different timelines, and some have specific restrictions on positioning, pressure, and dilation schedules that I need to know about.
In practice, drainage away from the surgical site often begins earlier than people expect, sometimes within the first week or two, while work closer in and on the incisions themselves waits until everything is closed. If you are travelling for surgery, tell me and we will plan around your flight home.
Bring me whatever your surgeon gave you in writing. Post-operative instructions, compression requirements, activity restrictions. I would far rather read them than guess.
If your surgeon says wait, we wait. If they have not said anything about lymphatic drainage, ask them, and I will tell you on the call exactly what to ask.
Worth saying plainly
Where my role stops.
I am not a medical provider
I do not diagnose, and I am not a substitute for your surgical team. I am one supportive part of a recovery that belongs to them and to you.
Anything sudden goes to your surgeon
New or rapidly worsening swelling, redness, warmth, fever, unusual pain, or anything about a wound that worries you. Lymphatic drainage is never the right answer to a possible complication. Make that call first.
Wound care is not mine
Anything open, weeping, or not yet closed belongs with your surgeon or a wound care specialist.
Sometimes I am the wrong person
If the timing is wrong, or you need someone closer to home, I will say so and then help. I have relationships with practitioners across the Bay Area and beyond, and nobody leaves that call empty-handed.
One more thing
This is an emotional time, and that is not a complication.
Recovery from any surgery is vulnerable. Recovery from this one can be all of that plus grief, elation, impatience, and a strange period of not yet looking like the thing you have been waiting for. Swelling in particular can be demoralising, because early on it hides the result.
I mention it because it is worth knowing that the swelling is temporary and the timeline is longer than most people are told. Also because you may find yourself unexpectedly emotional on my table, and I want you to know in advance that this is common, that it is fine, and that it does not make the appointment awkward for either of us.
You do not have to explain your body to me, justify your surgery, or perform being fine. You can just lie down and let someone competent take care of the swelling for an hour.
Before you call
Questions I get asked.
Have you worked with trans and non-binary clients before?
Yes. I have provided post-surgical lymphatic care through these procedures, and I want to do more of it. The Bay Area has some of the best surgeons in the country for this work, and their patients deserve recovery care that is just as easy to find.
How soon after top surgery can I start?
It depends on your surgeon's instructions, your drains, and how you are healing. Drainage away from the surgical site often begins earlier than people expect. Work closer in, and on the incisions themselves, waits until everything is fully closed. Book the free call and we will map it to your actual dates.
I am travelling to the Bay Area for surgery. Can you help?
Often yes. Tell me your dates and where you are staying. If you are only here briefly we can work out how many sessions are realistic, and if you would be better served by someone Vodder-certified near home, I will help you find them.
Will lymphatic drainage change my surgical result?
It does not alter what your surgeon built. What it does is help fluid clear, which means less swelling, less hardness, better range of motion, and often a clearer view of your actual result sooner.
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The next step
Ask Ida.
Fifteen free minutes on the phone with me. Tell me what is scheduled or what you have just been through, and I will tell you honestly when to start, what to expect, and whether I am the right person. No forms to fill in first, and the call comes straight to me.