Manual lymphatic drainage: More than massage
While manual lymphatic drainage (MLD) has been used in many iterations in the self-care and medicine of multiple cultures for centuries, it is having something of a resurgence on social media with 425 million views on TikTok.
“Videos of ‘skinfluencers’ incorporating MLD into their facial regimes at home have skyrocketed, and the trend shows no sign of slowing down,” says Lauren Gibson, Hydrafacial UK and Ireland country manager. “The popularity during lockdown made at-home lymphatic drainage and its immediate results more accessible and more known.”
"Thanks to a growing number of A-List celebrities shouting about their amazing body contouring results with MLD on Instagram and TikTok, awareness has grown," agrees Jules Willcocks founder of Body Ballancer. "And so has demand for the treatment."
You have likely seen impressive before and afters that show the inch-and-bloat reducing power of MLD, as well as its ability to sculpt the face. But still, the functions and value of the lymphatic system are perhaps not as well known as they should be.
Aesthetics and beauty practitioners are among the most well-versed when it comes to lymphatics, because as aesthetic doctor Dr Galyna Selezneva, who practises at The Rita Rakus Clinic in London, says, “Lymphatic drainage is one thing guaranteed to improve the outcome of any aesthetic treatment – whether you are doing lasers on the face or body-contouring treatments. A healthy body is impossible without well-functioning and balanced lymphatics… and healthy skin is impossible without a healthy body.”
What is the lymphatic system?
Second only in importance to the circulatory system, the lymphatic system is a vital part of our immune system. It’s often described as the body’s sewage system for its role in removing waste, toxins and fatty proteins from the body. It’s a delicate network of vessels and nodes that transports a translucent fluid called lymph containing the extra interstitial fluid that drains from the body’s cells and tissues.
The average human body contains approximately 12 litres of interstitial fluid and produces eight to 12 litres of lymph daily. Four to eight litres of lymph are reabsorbed by the lymph nodes, with the remainder returned to blood circulation to be removed from the body.
“Lymphatics work in the background, making sure the body can properly cleanse, detoxify and maintain essential fluid levels,” explains Gibson. “By transporting lymph, which also contains white blood cells, it works to fight bacteria and infections, and expels abnormal or old cells.”
However, unlike the circulatory system, the lymphatic system doesn’t have the help of the heart to keep it pumping around the body, instead relying on muscle movement to keep it in motion. Despite this, even very healthy and active individuals can suffer from sluggish lymphatics, says Dr Selezneva, meaning outside intervention is often required to keep them functioning optimally. “It’s like traffic on the M25,” she adds. “If you don’t direct it, you will end up with traffic jams.”
Impact on health and beauty
When the lymphatic system is flowing healthily, it helps give skin a glow and bodies a more chiselled look, as stagnant fluid isn’t sitting around. “Illness, stress, poor diet or lack of sleep can negatively affect our lymphatic system, impacting overall health and beauty,” says Gibson.
When we’re ill, the lymphatic system’s infection-fighting cells work overtime, causing the lymph nodes (located throughout the body with the biggest being in the groin, underarms and neck) to swell as they work to combat these infections. Swelling of lymph nodes may also be seen in those who are run down or overworked.
“A sluggish lymphatic system can lead to acne, bloating, water retention, loss of elasticity, fine lines and wrinkles, redness and puffiness as well as fatigue and mental health issues. When the cells around the body are bathed in fresh nutrients, it can make the appearance of our skin healthier and more radiant,” Gibson continues.
“The lymphatic system is connected to every organ in the body,” explains Jacqueline Kennedy, global head of business at Cidesco and beauty industry veteran. “If it gets overloaded by environmental or lifestyle toxins, then inflammation and toxic load increases, which weakens the immune system, causing an array of health problems.” A badly backed-up system can cause oedema or swelling, which can lead to lymphedema, a chronic condition caused by a build-up of excess lymph fluid in the body.
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Lymphatics and cellulite
Poor lymphatic drainage is also linked to a less serious but more common condition – cellulite. “Often, when clients request cellulite treatments, what you may see is simple fluid retention,” says Selezneva. “In these cases, a complicated cellulite treatment is unnecessary – the treatment should be purely activation of lymphatic drainage.”
Therefore, it’s vital to diagnose your client correctly in order to choose the right treatment. “I can predict who’s going to have a good outcome and who will be less responsive by assessing a client’s lymphatics; those who have better a lymphatic system will have better results,” says Selezneva. ”So, sometimes, when it comes to body contouring, my aesthetic treatments start not by tackling fat, but by activating the lymphatic system.”
Manual techniques
There are many techniques that aid lymphatic drainage by manually helping lymph fluid move around the body.
The Dr Vodder method of MLD is a technique used by many medics and advanced beauty therapists and originated in the 1930s. “It has a powerful calming effect on the parasympathetic nervous system,” explains Kennedy, who has practised this method for many years. “The gentle, rhythmic, pumping massage movements follow the direction of lymph flow and produce rapid results.”
It involves moving the skin over the underlying tissues using repetitive, circular and spiral-shaped movements with alternating increasing and decreasing pressure. This creates a pumping effect, which encourages the flow of lymph fluid and drains excess fluid from connective tissue.
Surgeons often encourage patients to receive the Dr Vodder method with a trained MLD specialist before and after procedures such as liposuction to enhance results and reduce the risk of swelling or complications. Kennedy says therapists can create tailor-made treatments for clients with the correct pressure, flow and technique. This method only requires the hands and, as no oils are typically used, it’s suitable for all skin types.
Don't miss our feature on replicating invasive procedures for the face with non-invasive devices.
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Drainage devices
“There are many excellent machines available to combat lymphatic conditions of oedema such as lymphedema and lipoedema, which affects the fat cells,” says Kennedy. “These devices can offer life-changing treatment options. Also known as lymphatic pumps or pneumatic compression devices, they can help relieve pain, stimulate fluid movement, and improve the immune system.”
Dr Selezneva swears by Endospheres as standalone cellulite or drainage treatment or in combination to enhance the results of many other treatments such as fat freezing or injectables. The technology uses a compressive micro-vibration system and a roller device. Hydrafacial also has a lymphatic drainage step in its facial system, which involves a suction cup. Recently the brand launched Hydrafacial Body (see page 63) which harnesses suction cups in larger sizes.
The practice is also built into CACI’s Hydratone, Eye Revive, Synergy Advanced Non-Surgical Facial Toning and ECM (CACI’s leg, thigh and buttock treatment), among others.
Pressotherapy devices like Body Ballancer involve a compression suit that completely does the MLD for you. It compresses and contracts to move lymph fluid up the body.
"We’ve seen growing interest and popularity in ‘pressotherapy’ (also known as compression therapy) in the past couple of years driven by a number of factors," says Willcocks. "Firstly, the number of formally trained lymphatic massage therapists in the UK is still very low, so systems like ours help clinics and salons offer more holistic treatments that they wouldn’t be able to otherwise provide."
"Secondly, businesses have started to recognise the potential to increase revenue streams using the devices like Body Ballancer. Beyond the initial outlay for the equipment, these devices give practitioners the ability to improve their service by offering increasingly popular combination treatments with only one therapist, thereby increasing their revenue per room," she continues.
"Finally, forward-thinking clinic owners have also recognised that the tech can also help improve client outcomes and aid quicker recovery from both surgical procedures and non-surgical facial treatments by reducing downtime and side effects such as bruising, inflammation and redness.”
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Cupping for drainage
Cupping is the ancient practice of using suction cups directly on the skin (usually the back) to promote circulation and lymphatic flow and relieve muscle tension.
Glass or silicone cups are placed on the body by a therapist exerting an upward pulling force on the skin, tissues and muscles. Blood and lymph fluid is then able to flow more freely throughout the body, assisting in the elimination of extra fluids and toxins from previously obstructed areas. On the body, cupping can lead to bruising and be slightly painful.
Facial cupping has shot up in popularity in recent years for its ability to give a snatched and contoured appearance. This draws on the same principles, but the process is very different. Smaller cups are used to massage the face, creating a slight vacuum, and encouraging better blood flow and drainage.
Home drainage
There are other ways to help the flow of lymph in the body, many of which clients can carry out at home to boost their health or enhance the results of aesthetic treatments.
Dry body brushing is popular for cellulite reduction due to its ability to boost circulation and lymphatic flow. It involves using a natural body brush in small circular motions from the feet upwards in the direction of the heart.
Gua sha is a traditional Chinese healing method that we have seen all over social media in the past few years. It involves using a smooth-edged tool (often made of rose quartz or jade stone) to stroke the skin with light pressure towards the lymph nodes.
Who can benefit?
Your clients may drink three litres of water a day and be regimental with physical exercise, but even then they can have periods in life when the lymphatic system is sluggish, says Selezneva.
For women, the function of the lymphatic system can ebb and flow with their menstrual cycles. “Periods can really affect the function of lymphatics. During these times of the month, clients could need even more lymphatic activation,” adds Selezneva. Pregnant women can benefit hugely from MLD to help reduce swelling and keep the body working healthily. In fact, in Brazil, where MLD is hugely popular, it is often built into pregnancy plans.
Besides this, anyone can benefit from MLD – from those recovering from an injury or receiving cancer treatment to someone looking to feel better, lighter and healthier. “Clinics that are predominantly filler-focused are missing out on both facial and body lymphatic drainage therapy because longevity and recovery from facial fillers are also subject to a well-functioning lymphatic system,” says Selezneva. “I recommend investing in a device and ensuring ongoing training for the team to achieve the best results.”
Kennedy agrees, adding, “More and more people understand that feeling ‘sluggish’ is actually part of a poorly functioning lymphatic system. It’s vital that people recognise that the lymphatic system is one of the most important gifts we have received from Mother Nature and we need to look out for it as it looks out for us.”