I did not have much instruction in how--or why--to massage. But I figured it out on my own. I didn't know enough to worry about lymphatic massage. I still have occasional mild puffiness on that side, but otherwise it takes care of itself in time. The massage I did was focused on the scar itself and on the skin of the neck flap.

The scar tissue on the scar itself ....on the surface of the neck...and in several deeper layers.....doesn't stretch. No scar tissue does. So, when it has healed enough, you need to massage it in any way you can.....circular, and along the line of the scar itself...with some sort of lubricant...some nice cream or oil....to keep that scar-line from healing into a tight strip of tissue that will always cause a feeling of pulling if left to heal without massage.

Also....the flap itself must heal. It must re-attatch itself to the underlying layers. You do want your dr.'s go-ahead before you do this, since you don't want to interrupt the early healing. I think of the healing of this sort of flap as beginning with tiny fibers that begin to knit together. If you don't move that tissue around, they will grow short, creating constriction and the feeling of having something tight around your neck. I worked hard to move that skin around, thinking about gently affecting its connection to the underlying tissues. I was leery at first, but I soon found that it was a good thing to do. It increased circulation, and it kept that skin free to move. I worked it over my jawbone too......I had no set routine. I rubbed the scar, to stretch it linearly, and I rubbed the skin of my neck in a circular motion, to free it from the underlying layers. I also did neck stretches, by stretching and pointing my chin to the sky, and I did jaw stretches, by opening and closing my jaw with my neck stretched high.

I did not do any deep massage. There is very little tissue left inside the neck, it seems, and the structures that I feel are the carotid and jugular vessels and the big tendons inside there. Of course, your neck has been "dissected," just like poking around in a frog in biology lab, and there is healing going on that is deep also, I suppose. I did not do anything that caused pain. Before you do that, I think that you need your doctor's go-ahead and some professional guidance about how to do it.

The goal of the massage as I see it is to stretch the surface scar, and to free the surface skin from the underlying layers so that it heals in a pliable fashion.

Perhaps the lymphatic massage requires more deep massage, and perhaps it causes some pain in the tender surgical area, but I would NOT think that ANYthing that causes pain would be recommended. Just MHO. Ask the dr. or the cancer therapist about this. ....Be sure it is someone who knows about neck dissections, and not just a routine therapist.

So....get some nice cream, and rub firmly along the scar....and rub the skin in a circular motion, visualizing gently refusing to allow it to get stuck down to the underlying tissue, and extending that rubbing and stretching over the jaw and even into the cheek area..why stop?? and then do chin stretches and neck turns to both sides.....do it whenever you think about it.