Lymphatic drainage: a solution against cellulite?

The essential point to remember.

Lymphatic drainage stimulates lymph flow, facilitating the elimination of accumulated fluids and toxins.
Aqueous cellulite, associated with fluid retention, is the form that responds most effectively to lymphatic drainage.
Clinical studies show that lymphatic drainage contributes to reducing the severity of cellulite after liposuction, although this method should not be considered a miracle solution.
Because lymphatic drainage has contraindications, it is important to seek medical advice beforehand.

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What is the relationship between cellulite and the lymphatic system?

The cellulite corresponds to an alteration of the structure of subcutaneous adipose tissue which leads to a dimpled appearance of the skin, often called "orange peel skin." More common in women, it results from an imbalance between fat storage and elimination, associated with microcirculatory changes and connective tissue alterations.

Among the different types of cellulite, it is above all the aqueous cellulite that is associated with poor blood and lymphatic circulation. Indeed, the lymphatic system, whose role is to drain fluids and waste from the body, can become sluggish: this promotes water retention and contributes to sensations of swelling in certain areas of the body, such as the thighs or buttocks. Conversely, the other forms of cellulite – adipose and fibrous – are less directly related to a lymphatic circulation problem. Adipose cellulite results from excess fat storage in adipocytes, whereas fibrous cellulite involves a hardening of the connective tissue, making the skin more tender to the touch and the dimpled appearance more pronounced.

Type of cellulite	Causes
Aqueous cellulite	Water retention, impaired blood and lymphatic circulation
Adipose cellulite	Excess fat stored in adipocytes, often associated with rapid weight gain
Fibrous cellulite	Hardening of the connective tissue, which can be painful and is often longstanding and well-established

The different types of cellulite.

Does lymphatic drainage eliminate cellulite?

Lymphatic drainage is a massage technique developed in the 1930s by Dr. Emil Vodder, with the objective of reactivating lymph flow, in order to facilitate the elimination of fluids and toxins accumulated in the tissues. This mechanism is particularly relevant in cases of aqueous cellulite, which is primarily the result of water retention and poor circulation. By promoting decongestion of the tissues, drainage can reduce swelling, improve the sensation of heaviness, and visibly decrease the volume associated with this form of cellulite.

In the case of adipose cellulite, the role of lymphatic drainage is more indirect. This type of cellulite is caused by an accumulation of hypertrophied adipocytes that compress blood and lymphatic vessels, thus intensifying fluid stagnation. By stimulating lymphatic circulation, draining massage does not reduce fat mass but can limit water retention which accompanies it, improving tissue suppleness and slightly smoothing the dimpled appearance. However, lymphatic drainage has no effect on fibrous, hard, and entrenched cellulite.

The efficacy of lymphatic drainage for cellulite has been investigated in several studies, although these studies did not specify the type of cellulite affecting the participants.

A clinical study compared the efficacy of manual lymphatic drainage with that of shockwave therapy in managing cellulite after liposuction. Thirty women with grade 3 cellulite (on a four-point scale) were assigned to two groups: Group A received shockwave sessions, while Group B underwent manual lymphatic drainage, both administered twice weekly for four weeks. The results demonstrate a significant reduction in subcutaneous adipose tissue thickness measured by skinfold thickness, of 24.4% in Group A and 15.38% in Group B. Furthermore, dermatological evaluation revealed a marked decrease in cellulite severity in both groups, although shockwave therapy proved more effective than lymphatic drainage.

Grade moyen de la cellulite dans les groupes A et B avant et après traitement. — Mean cellulite grade in groups A and B before and after treatment.
Source: ELADL H. L. & al. Comparison of extracorporeal shock wave therapy versus manual lymphatic drainage on cellulite after liposuction: A randomized clinical trial. Evidence-Based Complementary and Alternative Medicine (2021).

These results confirm that lymphatic drainage can improve the appearance of cellulite, although other techniques may demonstrate superior efficacy. Another study compared manual lymphatic drainage with the use of a pneumatic compression pump in women presenting with grade 3 out of 4 cellulite following thigh liposuction. Thirty patients were equally divided into two groups: the first (Group A) underwent manual lymphatic drainage sessions combined with treadmill walking three times per week for eight weeks, while the second (Group B) received pneumatic compression sessions alongside the same physical activity. Assessment of cellulite severity using a clinical scale showed a significant improvement in both groups, more pronounced in the women who received the drainage massage.

Lymphatic drainage appears to be a relevant approach for improving the appearance of cellulite, especially when it is related to water retention. Although it is not a miracle cure for eliminating cellulite, it can be considered an interesting complementary option.

Important information: contraindications to lymphatic drainage.

Lymphatic drainage is not suited for all individuals. It is particularly contraindicated in cases of acute infections, fever, or inflammatory diseases, as stimulating lymphatic circulation could worsen health status. Individuals with heart failure, uncontrolled hypertension, phlebitis, or a history of thrombosis should also avoid this form of massage. Finally, cancers may also represent a contraindication, since drainage can interfere with disease progression. Therefore, it is always essential to obtain medical advice before undertaking lymphatic drainage sessions.