Manual lymphatic drainage leg massage - Innovative Vascular Center

Briefly about the treatment method

Manual lymphatic drainage is a special type of massage that is designed to enhance the natural flow of lymph and help remove excess tissue fluid from limb segments affected by lymphedema.
The therapeutic effect of lymphatic drainage massage is realized through the preserved connections between the lymphatic vessels and veins in the limb segment, so it is possible to eliminate lymphatic edema even with the removal of regional lymph nodes. The main point of lymphatic drainage massage is the gradual movement of tissue fluid from segments with poor lymphatic drainage to segments with normal drainage, where it is absorbed and goes into the bloodstream. By combining manual lymphatic drainage with banding, it is possible to eliminate lymphedema in most patients.

Manual lymphatic drainage not only reduces the volume of the limb, but also stimulates the formation of new lymphatic vessels and accelerates lymphatic drainage through existing ones. After the massage course, special compression jersey is used. Massage is also used in stage III lymphedema to prepare for surgical treatment.

Operating principles of LPG devices –

The LPG® trademark belongs to (Valence, France), which was founded by the Frenchman Louis Paul Guitey. Only devices from this company can use the LPG® abbreviation, although there are also a large number of devices on the market from other manufacturers that are similar in functionality, but do not have the right to use this abbreviation. Abroad, the LPG massage technique bears the original name – LPG® Endermologie.

Currently it produces several variants (of which the most popular is the “Integral” modification) -

"LPG® Cellu M6 Integral",
"LPG® Cellu M6 Alliance"
"LPG® Cellu M6 Endermolab".

Of course, it must be said that LPG body massage actually has FDA recommendations - both for the correction of cellulite and for working with local fat deposits. However, it is worth noting that these recommendations were received so many decades ago - when effective methods for correcting fat deposits had not yet been developed in principle, and they did not even know how to approach cellulite. Therefore, at the moment, it is only a stretch to say that LPG is recommended by the FDA for these indications (immediately looking at more modern methods).

How LPG massage works –

As we said above, the device has a working attachment, which the cosmetologist presses against the patient’s body and moves it over the area of the problem area of the skin. In this case, the patient’s body must be wearing a tight-fitting, lightweight, breathable suit (for example, LPG-Endermowear), which will need to be purchased additionally and worn during each procedure. The vacuum pulls the skin folds inside the working nozzle, and the rollers begin to knead and massage the skin folds.

One of the options for the working nozzle of the LPG device for working on the body, as well as the main types of folds that are created by the independent motorized rollers of the working nozzle -

What does this massage give us? After a single procedure, the following occurs: 1) venous outflow improves by 2-3 times, but only for 6 hours after the procedure, 2) lymphatic drainage improves by 3 times, but this effect lasts a little more than three hours, 3) approximately 4-5 times blood microcirculation in the skin and subcutaneous fat improves (this effect lasts about 6 hours). Thus, the main thing that LPG can do is improve blood circulation and lymphatic drainage. And here lies the main secret of reducing the external manifestations of cellulite and the volume of fat deposits.

The fact is that cellulite occurs against the background of impaired venous outflow, deterioration of microcirculation and lymphatic drainage. All this leads to an increase in the permeability of the vascular wall, and as a result, to the development of interstitial edema of the fatty tissue (i.e. there will be swelling of the fatty tissue). The same thing happens in the presence of local fat deposits, because adipose tissue absorbs water like a sponge. For example, when you visit a massage therapist, in the first few procedures you can immediately lose from 4 to 8 kg of weight. But you're not losing fat, you're losing water.

Whether a massage therapist gives you a massage with his own hands or is it a hardware LPG massage, improving venous outflow and lymphatic drainage leads to a reduction in interstitial edema of fatty tissue, i.e. Water is removed from it (and further through the kidneys). By reducing swelling, the total volume of fatty tissue decreases, and the patient thinks that he has lost a lot of fat, but as you now understand, this is not so. By the way, we in no way want to say that LPG massage as a method of treatment does not deserve the right to exist. This is wrong. This is a good method, but it solves only narrow problems.

LPG body massage: video procedure

Optimal indications for LPG massage –

For example, treatment of cellulite or local fat deposits always involves the first stage of normalizing venous outflow, microcirculation and lymphatic drainage. This can be done using injection mesotherapy with vascular and drainage drugs, manual or LPG massage. Those. when working with local fat deposits, LPG will be good only at the 1st stage of treatment, in order to remove interstitial edema of fatty tissue. After this, it will be necessary to switch to either lipolytic injections or hardware methods for lipolysis of fat deposits.

Among hardware methods, this could be, for example, RF lifting or ultrasonic cavitation. Or more radical invasive fat removal methods can be used, such as liporeduction and liposuction. But when it comes to cellulite, everything is more complicated. You probably know that cellulite goes through 4 stages in its development. At the first stage, only a disturbance occurs in the vascular link, and there are no visual changes on the surface of the skin yet (the problem can so far be determined only by a decrease in skin temperature in problem areas).

Stages of cellulite development –

The second stage of cellulite is indicated by the development of interstitial edema of fatty tissue. It is due to this swelling and tissue hypoxia that the appearance of an orange peel occurs (when you gather the skin into a fold). But when you release the fold, then, if this is stage 2, the symptom should disappear immediately. So LPG will work well only at these 1-2 stages of cellulite, when there are no signs of fibrosis and sclerosis of the connective tissue septa. At these stages it can be used as the main treatment method.

But at stages 3-4 of cellulite, this method can only be secondary, because At these stages, fibrous adhesions formed in the tissues, i.e. fibrous connective tissue septa. It is precisely such adhesions that are to a large extent the cause of the appearance of the symptom of orange peel, lumpiness on a permanent basis (even when we do not fold the skin). By using LPG at these stages, you will certainly get a temporary improvement caused by a decrease in the volume of water in the fat lobules, which in this case will bulge less. But at the same time, fibrous adhesions will not disappear anywhere, and when the swelling of the fatty tissue returns, the orange peel symptom will be restored in full.

Therefore, because all improvement in the condition of the skin is not caused by a decrease in the volume of fat (actually lipids contained in fat cells), but by the removal of the excess volume of water contained in the intercellular fluid - then you will gradually return to the original condition of the skin and the volume of fat deposits. After completing the LPG course, venous outflow, lymphatic drainage and microcirculation will gradually begin to deteriorate again, and interstitial edema of the fatty tissue will return. Studies show that the original state usually returns within 3-4 months (on average).

Important: the important point is that LPG has virtually no effect on fibrous adhesions, which contribute to the appearance of orange peel and lumpiness. And therefore, it is impossible to cure 3-4 stages of cellulite with LPG even in 100 procedures. In addition, in the advertisements of some beauty salons you can read not only about significant weight loss and cellulite reduction, but also about an increase in the volume of collagen in the skin by up to 130% after LPG massage. It is simply pointless to comment on such figures, and in one of the following sections we will move on to clinical studies of the effectiveness of LPG, which confirm the main points of this article.

Advantages of treatment at the ISC

Our specialists have successfully mastered the technology of lymphatic drainage massage in the treatment of lymphedema, adopted in the German clinic Lympho-Opt and have been using it since 2008. During this time, the clinic treated more than 1000 patients with severe lymphostasis. We use a rational combination of an instrumental approach (pressotherapy) and manual lymphatic drainage to achieve maximum therapeutic effect.

In our clinic it is used in complex treatment including pneumocompression with manual lymphatic drainage massage and bandaging. Pneumocompression stimulates the outflow of tissue fluid and activates the function of lymph nodes and blood vessels. The combined use of all methods of conservative treatment of lymphostasis can reduce the volume of the affected limb by up to 50%. These methods are especially effective in the treatment of stage I-II lymphedema.

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How the treatment method works

The technology includes manual and hardware massage of the soft tissues of the affected limb. The skin is slightly moisturized. Manual lymphatic drainage massage is performed using the method of light, smooth pressure and sliding along the lymph flow line.

The technique of manual lymphatic drainage massage has several methods:

superficial (stimulates metabolic processes in the body and in the layers of the skin and unblocks capillaries)
deep (impact on the vessels that ensure the outflow of lymphatic fluid from the internal organs directly)
internal (impact on lymph nodes).

Manual lymphatic drainage consists of gentle, rhythmic massage of the skin, deep massage of the lymph nodes. First, the proximal parts of the limb are released, then the distal parts. Session duration is 40 - 60 minutes. Careful massage movements are carried out, during which the pressure on the tissue should not exceed 40 mmHg. Art. Lymphatic drainage massage promotes the movement of high molecular weight proteins into the lumen of the lymphatic capillaries and at the same time stimulates the contraction of the lymphatic vessels. As a result, the flow of lymph through the subcutaneous plexuses and collaterals of the lymphatic vessels of the affected limb increases. During the procedure, the patient is in a horizontal position. The effect is made directly on the skin. In this case, it is necessary to ensure that the folds of the patient’s skin do not fall between the doctor’s fingers. RLD is carried out in the direction of the lymphatic flow. The procedure is performed slowly, with a frequency of 10-12 movements per minute.

Hardware lymphatic drainage massage

Pressotherapy is the effect of compressed air on certain parts of the body. Most often, the technique is used to reduce the volume of the arms, hips and legs. This hardware method requires the use of special equipment. During pressotherapy, the client is dressed in a suit that resembles a giant cuff for measuring blood pressure.

Variable pneumatic compression (APC) is one component of the treatment of lymphedema. Typically, PPC is performed after manual lymphatic drainage. This procedure leads to an increase in pressure in the tissues, promotes the outflow of fluid accumulated in the interstitial space and reduces edema.

Pneumocompression is carried out using a pneumatic device divided into a large number of chambers. Each chamber is filled with air and emptied independently of the other chambers. Thus, the chambers operate in an intermittent mode and are filled sequentially in the direction of lymph flow. The newest PPC devices consist of 10-12 overlapping chambers designed to apply increasing pressure in the direction of lymph flow. When treating lymphedema of the extremities, a pressure of 20-40 mmHg is used. Art., each PPC session lasts from 30 minutes to several hours. Before applying sequential compression, manual lymphatic drainage should be performed to ensure patency of the lymphatic vessels above the compression site. Pneumocompression has long been the standard of care in the treatment of lymphedema. Devices for pneumocompression include inflatable cuffs for the arms and legs and an electric pump. To ensure proper pressure distribution, the pumps operate according to a special program that allows for alternating compression and relaxation of areas of the swollen arm or leg.

When is lymphatic drainage massage needed?

This extremely pleasant and most beneficial procedure is used for any part of the body. A patient who has undergone a full course of lymphatic drainage massage can without a doubt expect to receive the following effect:

The functioning of all cells of the body is stimulated, and toxic substances are intensively removed from it.
Lymph flow improves and excess intercellular fluid is removed.
Cellulite disappears.
Metabolic processes are activated, resulting in a person losing weight.
Bags under the eyes disappear.
If you regularly use lymphatic drainage massage sessions, swelling throughout the body is eliminated and blood vessels are strengthened.
A person gets rid of the feeling of heaviness in his legs and arms, and his calves stop hurting. This massage is especially suitable for those women who like to wear high heels.
Lymphatic drainage massage has a beneficial effect on varicose veins. The likelihood that spider veins will appear is reduced.
The skin becomes more elastic.
The immune system improves.

It is important to remember that performing lymphatic drainage massage at home cannot be compared with the procedures provided by professionals in this field. They use special techniques and devices, so the client is guaranteed to receive the most effective result.

Observation program after treatment method

Manual lymphatic drainage massage should be performed by a specially trained massage therapist. If the skin is exposed to excess, it can lead to increased blood flow and increased swelling, which is not necessary for patients with lymphedema. It is important to properly direct the lymphatic fluid without increasing arterial inflow. Manual lymphatic drainage massage can be used in combination with hardware massage. After the massage session, a special bandage is used to consolidate the result.

The effectiveness of treatment is monitored daily by measuring the circumference of the limb. In stages I-II of lymphedema, it is possible to achieve a reduction in the volume of the limb by 8-15 cm only by using massage and bandaging.

LPG facial massage: reviews

Imagine that you have your own company that has developed and sells some pharmaceutical drug or medical device. If the instructions for your drug contain only 1 indication for use (for example, it will be indicated only for hyperacid gastritis), will you earn a lot of money? What if there is a large list of indications for various diseases? This is why any company strives to get its product in front of more people.

A new original LPG® device costs about 3,000,000 rubles (although there are also Chinese analogues for 500,000 rubles). But all this somehow needs to be repaid, and you need to start making a profit quickly. If the device is very expensive and has a slow payback, simply no one will buy it. Therefore, increasing the number of indications for use of the device allows you to increase the number of potential patients and, thus, speed up the payback period. And in this case, hardware LPG facial massage is a way to speed up the payback of expensive equipment.

That is, we consider such a massage to be purely a marketing ploy. We have patients over 40 years old who regularly go for a regular manual facial massage once a week, and at this age they have practically no wrinkles. Manual facial massage, in our opinion, is much better; it allows you to work individually with each face, each muscle, and no working attachment of an electrical device (as applied to the face) can replace the hands of a truly good massage therapist.

LPG facial massage: video procedure

Important: but in any case, LPG facial massage (the manufacturer calls this massage the term endermolift) will be useful to you to some extent. It is done using a special working attachment - a specially designed manipulator for use on the face, which creates a wave-like vibration of the soft tissues of the face. Of course, this should improve lymphatic drainage and blood circulation. But there is one thing that may not allow this to be done. The fact is that almost all of our patients have problems with the cervical part of the spine (24stoma.ru).

Spasmed neck muscles impede venous outflow and lymph flow from the face and scalp. Therefore, any work on the face without working on the neck-collar area is essentially useless and will only give a short-term effect. Therefore, if you decide to do an LPG facial massage, reviews say that before starting it, it is better to first undergo a course of capillary mesotherapy from a mesotherapist (4-6 procedures), which will improve venous outflow and lymphatic drainage from the face and neck.

Photos before and after a course of LPG facial massage treatments –

Is it worth it or not to do LPG: conclusions

Therefore, it is worth summarizing which patients should be prescribed LPG.
Firstly, in patients with local fat deposits - as the first stage of therapy, and then move on to methods that provide active lipolysis. Secondly, with 1-2 stages of cellulite, especially if it occurs against the background of a large volume of fat deposits, and then here you also need to move on to active lipolysis by connecting hardware or injection lipolysis. Moreover, LPG will work very well for the atonic form of cellulite, when the patient has flabby muscles and loose, flabby skin. At stages 3-4 of cellulite, LPG can only be perceived as an additional, and not the main method of treatment. At these stages, the symptom of “orange peel” on the skin will be visible all the time, and not just when we gather the skin into a fold. And without destroying the fibrous adhesions, it is impossible to get rid of the orange peel and tuberosity. LPG does not significantly affect fibrous adhesions, and therefore, after a few months, your cellulite will return to its original state. To summarize what has been said, LPG will work well at a maximum of stage 2 of cellulite - when the orange peel becomes visible on the skin only when you gather it into a fold.

We also recommend paying attention to what kind of attachment (handle) you will use for LPG massage. The most effective attachment at the moment is the Energodrive manipulator, which allows you to work deeper and with greater efficiency. And returning to the 3-4 stages of cellulite, I would like to say that the main methods of treatment will be those aimed at destroying fibrous adhesions, which give rise to the orange peel symptom. We wrote about such methods in the next article -

→ Hardware methods for cellulite correction

Conclusions: Thus, we consider the LPG massage method to be useful, but in the later stages of cellulite, it does not allow for significant changes to be achieved over a long period of time. In such situations, this is a good method only as part of complex therapy (allowing for a certain time to normalize venous outflow, microcirculation and lymphatic drainage). LPG will also be a good choice in situations - when the patient comes specifically for the prevention of cellulite development and, in our opinion, in this case it is better to really prefer LPG rather than manual massage.

In any case, we draw the same conclusion: the effectiveness of LPG in terms of reducing body circumference will be directly proportional to the severity of interstitial edema of subcutaneous fat. The more impaired your lymphatic drainage and venous outflow are, the stronger the interstitial swelling of the fatty tissue will be and, accordingly, the more noticeable the effect of using a course of LPG procedures will be (optimally 8-10 procedures).

LPG massage: price for 1 procedure

As we said above, the procedures are carried out while the patient is wearing a special tight-fitting suit. It is reusable and will cost you approximately from 500 to 2300 rubles (depending on the manufacturer). For 1 LPG massage procedure, the price can range from 800 to 2000 rubles, which will depend on the brand of equipment. The cost will also be affected by the number of procedures, for example, when purchasing a course of treatment of 10 procedures, a discount of 10 to 20% is usually given.

Most often, clinics present the original LPG Cellu m6 Integral device. One procedure lasting 35 minutes on such a device costs on average about 1,700 rubles (once again, please note that the Energodrive handpiece will work more effectively on the body). In turn, the cost of LPG massage on Chinese and Belarusian devices should not be more than 600-800 rubles per procedure. But the price of 1 procedure lasting 30 minutes on “VelaShape 3” will be about 7,000 rubles, but this is real lipolysis and stimulation of collagen synthesis, and not just lymphatic drainage and improved blood supply.

Clinical studies on the effectiveness of LPG –

Below we will demonstrate several independent clinical studies on the subject - 1) does LPG massage affect the loss of fat deposits and cellulite, 2) does it lead to true lipolysis of adipose tissue, which should be accompanied by the release of the contents of fat cells into the intercellular space and further - transportation and processing in the liver to metabolites.

Clinical study Gulec AT "Treatment of cellulite with LPG® Endermologie", published in the scientific journal "Dermatol" in 2009.
Conclusion: “Improvement in the appearance of cellulite was observed in only 15% of women, but all patients showed significant loss of circumference in every area of the body treated. Based on this, it can be concluded that the LPG method is a well-tolerated and effective method for reducing body circumference, but it is weakly effective in reducing cellulite (improving the appearance of an orange peel).” Comment: thus, we undoubtedly agree that there is indeed a reduction in body volume (this effect will be especially pronounced in patients with a large volume of fatty tissue, as well as in cases of edematous cellulite). Studies show that on average the reduction in body volume after 7-10 procedures ranges from 1.3 to 2.5 cm in circumference. The fact that patients practically did not notice any improvement in the condition of the skin with cellulite indicates that LPG does not significantly affect fibrous adhesions and does not cause true fat lipolysis, removing only water from the fatty tissue.
Clinical study Adcock D., Paulsen S., Davis S. et al. "Analysis of the cutaneous and systemic effects of Endermologie in the porcine model", published in the scientific journal Aesth Surg. This is a very interesting clinical study in which not only the loss of fat tissue was measured, but also the blood and urine were examined for the presence of lipid breakdown products. After all, if we assume the fact that LPG provides real lipolysis of adipose tissue, and not just water loss, in this case the breakdown products of triglycerides (the contents of fat cells) should be determined in the blood and urine.
Research results: tests revealed that after using the LPG massage technique, the membranes of only a very small number of adipocytes (fat cells) are destroyed. However, the researchers did not find any evidence of remodeling of adipose tissue, and also did not detect lipid breakdown products and their metabolites in urine or blood samples.
Comment: we would like to add that this means that true lipolysis does not occur in fat cells, but that interstitial edema of adipose tissue simply goes away. The fact is that lipolysis always occurs with the breakdown of triglycerides contained in fat cells into monoglycerides and their subsequent release into the intercellular space. Monoglycerides are then transported through the circulatory and lymphatic systems to the liver, where they are processed. Therefore, the absence of lipid breakdown products in the blood, as well as metabolites after their processing by liver enzymes, confirms the absence of a statistically significant lipolysis process.

Analysis of LPG massage devices –

As we said above, only (Valence, France) produces branded devices, and only its devices can legally use the LPG® trademark. The devices of this company are truly of high quality and contain a number of patented technologies that distinguish them from cheaper analogues. For example, we are talking about motorized rollers that can move independently of each other, which, simultaneously with the effect of vacuum, allows you to create several different types of skin folds under the working attachment.

Different forms of folds are aimed at solving different problems - affecting atonic sagging skin, lymphatic drainage and reducing body volume, or working with cellulite. produces several types of devices, which have the general name “LPG® Cellu m6”. Depending on the modification of the device, the terms “Integral”, “Endermolab” or “Mobilift” are further added to this name. Most often in clinics you can find the LPG Cellu m6 Integral device, the cost of which is about 3,000,000 rubles.

Similar devices –

However, there are many analogues, most of which are made in China. For example, there is a device “Body integral V-9” (China), which costs only about 450,000 rubles. But this device does not have such high-quality independent motorized rollers as the original LPG devices. There is also a Chinese device “Perfect-1000”, which costs about 350,000 rubles. This device is somewhat similar to the previous one, but it additionally has a thermal effect function.

There is a Belarusian-made device “Wirtex-slim”, which in terms of functionality does not reach the Chinese, and costs from 250,000 rubles. A slightly more advanced Belarusian-made device is the “B-Flexy CelluStop”, however, its handpieces (working attachments) do not even closely resemble the handpieces of the original LPG devices. There is also a Korean device “Resolady”, which only from a distance resembles LPG. This device does not have massage rollers at all, but works through a combination of vacuum suction, RF lifting and ultrasonic influence. Such a device costs about 600,000 rubles.

Of course, all these devices are far from the original devices (for example, LPG Cellu m6, especially with the Energodrive handpiece). However, these devices also have advantages - a low price, which will quickly pay for itself and make a profit. Moreover, the price of 1 session of LPG massage on such inexpensive devices should not be more than 600-800 rubles. However, so that we are not accused of being biased (that we criticize “wonderful” cheap Chinese devices in favor of the original manufacturer), there is another good device that we consider, in many respects, even more effective than the original LPG devices.

VelaShape 3 device (Syneron) –

This is an expensive device from the famous Israeli company Syneron (also sold under the brand of the American company Candela), which produces cutting-edge laser and ultrasound equipment, including for the correction of local fat deposits and cellulite. In this line. In this device, the handpiece also combines the effects of massage rollers and vacuum, but at the same time, sources of infrared light and pulsed electromagnetic fields are additionally built into the handpiece.

Infrared light acts at a depth of up to 3 mm, promoting the remodeling of fibrous connective tissue. Electromagnetic fields penetrate the upper layers of fatty tissue, heat them, thereby ensuring true lipolysis. Massage rollers and vacuum improve blood circulation and lymphatic drainage. This device is recommended by the FDA for the correction of local fat deposits. This device does not have FDA recommendations for cellulite, because... over the past decades, even more effective methods of treating cellulite have appeared, but if we compare “LPG Cellu m6” and “VelaShape 3”, we still incline our choice in favor of the latter, especially if you have a large amount of fatty tissue, cellulite and loose atonic flabby leather.

The cost of “VelaShape 3” is close to 3,000,000 rubles, but now in clinics you can also find Chinese counterfeits of this device (with the same name). In the Chinese version, it costs a little more than 300,000 rubles.