What we do, what we decline, and the clearance policy your patient will be held to. Written for your office, not for your patient.
Sous La Face is a lymphatic facial sculpting studio with locations in Toronto and Los Angeles. We are not a spa, a medical spa or a facial studio, and we do not present ourselves as providing medical care. A meaningful proportion of our enquiries come from patients recovering from facial and body procedures, which is why this page exists: so that you can decide, in about four minutes, whether we are a practice you are comfortable sending someone to.
We do not set the date a post-operative patient may begin. You do. We work to your instruction, and we will not begin without it.
Summary
Discipline
Lymphatic facial sculpting. Manual work only.
Clearance
Required in writing before any post-operative appointment.
Claims made to patients
Comfort and the appearance of swelling. Nothing about healing, prevention or surgical outcome.
Referred out
Lymphedema treatment, at-risk limbs after node removal, any unexamined swelling.
Locations
Toronto (Yorkville) and Los Angeles (West Hollywood).
Founded
December 2019, by Amanda Jeppesen.
IClearance Policy
How we handle a post-operative patient
Every post-operative booking follows the same sequence, without exception and without a discretionary override available to the practitioner:
The sequence
Written clearance on file before the first appointment. An email, a note on the discharge sheet or a message from your office is sufficient. A verbal report from the patient is not.
Restrictions recorded specifically. Which regions are off limits and until when, any compression garment schedule, drains, and any limit on positioning or range of motion.
The clearance date governs. If a patient requests an earlier appointment, we decline and hold the booking.
Any change in presentation returns to you. We stop and refer rather than proceed and observe.
If you would prefer a patient wait longer than they would like, tell us and we will hold the position without putting you in the role of the obstacle. We would rather carry that conversation than have you carry it.
IIRestrictions
What we will not do
These are standing restrictions in our protocol, applied whether or not a specific instruction accompanies the referral. They exist because the mechanical risks in early recovery are not lymphatic questions.
Flaps and incision lines
No shear across a facelift flap, no pressure on incision lines or drain sites, and no work that interferes with a prescribed compression garment schedule.
Nasal surgery
No contact with the dorsum, sidewalls or tip. Drainage is directed through periorbital, malar and cervical territories only. This applies with particular strictness after dorsal preservation technique.
Lower lid
No inferior traction under any circumstances. Vectors are lateral or superolateral toward the preauricular chain. No pressure on the globe.
Alloplastic implants and genioplasty
No directional pressure across the implant footprint until you confirm the capsule has matured. Our default is to wait, and we will ask rather than assume.
Intraoral sites
No intraoral technique after buccal fat removal, third molar extraction or orthognathic surgery. Extraoral work only.
Free grafts
No pressure over grafted fat, nipple grafts or skin grafts. Donor sites and proximal clearing only.
Fixation and osteotomies
No pressure that loads fixation, stresses elastics or levers the mandible.
Reduced sensation
Where a patient has neuropraxia, we work by force rather than by patient feedback, because the feedback is not reliable.
IIIEscalation
When we send a patient back to you
We cancel the appointment and direct the patient to your office, same day, on any of the following. We do not attempt to assess, reassure or treat around them.
Same-day return
Unilateral calf swelling with pain or warmth
Fever, or erythema spreading from an incision
Rapidly increasing rather than settling swelling
Worsening wound drainage, or dehiscence
Dyspnea or chest pain
Any change suggesting hematoma or flap compromise
New or unexplained swelling in a patient with an oncologic history
Within six weeks postpartum: new edema with headache, visual change or hypertension
If you would like to be notified when we send a patient back rather than relying on the patient to make contact, tell us and we will call your office directly.
IVClaims
What we tell your patient, and what we refuse to
This section exists because the most common reason a surgeon declines to refer is not the manual work. It is the expectation the patient arrives back with.
What we say
That the operating surgeon decides when they may begin, and that we work to that date.
That lymphatic drainage is consistently well tolerated, with no adverse events reported in the Cochrane review of the field.
That its measured benefits sit in comfort, in the sensation of tightness and heaviness in the tissue, and in how people describe their own recovery.
That it appears to help most where swelling is mild and recent rather than established.
That facelift surgery temporarily interrupts facial lymphatic drainage regardless of technique, with substantial recovery by three months, as demonstrated by lymphoscintigraphy in the Aesthetic Surgery Journal.
What we will not say
That it speeds healing.
That it prevents lymphedema. The APTA clinical practice guideline grades this as unproven, and we cite that position rather than working around it.
That it reduces bruising, improves the surgical result, or shortens recovery by any stated amount.
Any timing figure presented as a clinical standard. Where a window is convention rather than evidence, we say so.
We also tell patients that two studies are widely cited to justify starting within days of surgery, that one began at six weeks and found no significant difference, and that the other began at an average of ten weeks with no comparison group. We would rather correct that in advance than have a patient present it to you as established.
VBoundaries
What we decline
We refer out rather than accommodate in three situations, and we would rather you know this in advance than discover it through a patient.
Lymphedema treatment. Established lymphedema is managed through complete decongestive therapy by a certified lymphedema therapist. We maintain relationships with certified therapists in both markets and refer directly.
The at-risk limb after node removal. Where nodes have been removed, the region they served carries lifelong risk. Work elsewhere on a cleared patient is straightforward. The at-risk limb itself belongs with a certified therapist.
Unexamined swelling. New or unexplained swelling in a patient with an oncologic history goes back to their team before we touch it, because manual work can soften a sign you need to see.
VIWorking Together
If you would like to refer
Three things we can offer your office, all without cost:
A patient-facing recovery reference covering timing by procedure, the questions to ask you at follow-up, and the same escalation list above. Your office can hand it out or link to it.
A named point of contact at each studio, so clearance goes practitioner to practitioner rather than through the patient.
A standing invitation to review our protocol. If you want a restriction added for your patients specifically, we will add it and record it against the referral.