It has been said that manual lymphatic drainage massage was originally invented in the 1930s by Danish citizens Dr. Emil Vodder and his wife, Estrid. It was used for such things as to help speed up the results of healing after surgery or injury and to help treat lymphedema. It is based on the principal that when lymph moves efficiently, homeostasis and well being of the body will pursue. Today, many beauty and health practitioners find it beneficial to incorporate lymphatic drainage into the list of services they offer as the results produced when administered correctly are incredibly beneficial. Lymphatic drainage, when performed either with a handheld lymph drainage machine or by direct hand application using rhythmical, pumping-like gentle pressure in the direction of the heart, can help aid in detoxification of the body and in the removal of toxins, which collect in cellulite and adipose tissue. Lymphatic drainage can be used as an adjunct while performing other forms of facial and body massage, implemented prior to the application of body wraps to intensify its results, or simply used alone.

The lymphatic system is the system of the body that filters toxins, bacteria, viruses, and other impurities from the issues. The lymph also helps to bathe the cells and transport fats in the body. It is a byproduct (leakage) from the circulatory system and is mainly comprised of plasma, a clear fluid primarily made up of water and lymphocytes (white blood cells, e.g., T-cells and B-cells), which help to destroy pathogens. The lymphatic system basically encompasses a network of lymph capillaries, lymph vessels, lymph organs, e.g., the thymus, spleen, bone marrow, and lymph nodes (which are distributed throughout a great portion of the body). Unlike the circulatory system, the lymphatic system does not have a pump. Lymph only moves in one direction: the direction of the heart. Therefore, within its complex arrangement of capillaries and vessels there are many valves to prevent back flow. Lymph flow is made possible by the movement of skeletal muscles and respiration, and may slow down due to disease or injury or by sedentary tendencies of an individual, which can result in edema. Lymphatic capillaries are the absorbing part of this complex system; they are tiny blind ended tubes which collect the fluid from the tissue. The capillaries go through a network of plexuses, which become larger vessels that continue in the same direction that the vein portion of the circulatory system does. All lymph must pass through at least one lymph node for filtration and purification prior to making its way back to the heart, where it originally began. However, most lymph passes through many nodes before it has completed its journey. T-cells mature in the thymus and B-cells mature in the bone marrow while the spleen is a filter of blood. Lymph nodes are small bean-like structures that house many lymphocytes needed for the filtration process. They are attached to vessels throughout the body; however, they are in abundance in certain areas. For lymphatic drainage purposes, we are concerned mainly with the following superficial nodes and their location:

• behind the knee (popliteal)
• groin (inguinal)
• abdominal region (cisterna chyli)
• underarm (axillary)
• crook of the arm (supra trochlear)
• front of the neck (superficial cervical)
• in front of the ear (pre auricular)
• behind the ear (post auricular)
• base of the skull (occipital)
• under the jaw (sub mandibular)
• beneath the chin (sub mental)

Today there are many methods of lymphatic drainage taught. A therapist should be thoroughly educated in the process prior to implementing the procedure, although the basic ideologies are the same. First, lymphatic drainage should never be performed on anyone who has the following contraindications: cancer, a cold or flu, hyperthyroid, HIV or AIDS, other active viruses, inflamed acne, high blood pressure, blood clots, or is pregnant. Doing so can cause an adverse reaction or exacerbate a negative condition. Second, the drainage should always be applied in the direction of the heart and each movement should be done three or four times to insure that the channels have been properly drained. Lymph moves upwards and eventually passes through the right lymphatic duct and left thoracic duct located just below the collar bone, parallel to the sides of the neck. The entire left side of the body and a portion of the right side of the body, from the center of the thoracic cavity down to the feet, drain into the thoracic duct. The remainder of the right side of the body drains into the right lymphatic duct. It is at this point that the lymph joins the blood back in the circulatory system and soon makes its way back to the heart. Lastly, the practice of moving the flow of lymph rapidly helps in transporting toxins to the nodes where they are destroyed more quickly by lymphocytes. It also moves swelling out of the tissue, speeds up the process by which capillaries remove debris from cellulite, making it appear less dimpled and smoother and helps to contribute to the balance of the body. It is highly recommended that prior to offering a lymphatic drainage treatment in any facility that therapists receive training both in the hands-on approach as well as the basic theory of the lymphatic system.

Although not a new therapy, lymphatic drainage is an extremely beneficial therapy. When performed by a well trained therapist the benefits are numerous. Since stimulating the flow of lymph assists the body in the healing process, it makes lymphatic drainage a great service to offer a client after a medical procedure such as liposuction or a face lift as it improves post-operative recovery time. It may also help to minimize edema, bruising, scar tissue, and loss of mobility. It is however important to check with the client's physician prior to administering the procedure to make sure that you do not interfere with an alternative plan the doctor already may have scheduled. For the aesthetician who works in a medical office or medical spa, receiving advanced training in lymphatic drainage is essential.

For improved circulation of the lymphatic system and to help minimize edema in the tissues, the following tips may be helpful to your clients:

• Seek an experienced therapist to provide lymphatic drainage treatments.
• Perform a light massage at home several a times a week in the direction of the heart.
• Use support stockings for swollen feet or ankles.
• Light exercise (such as walking) encourages the flow of lymph, especially if a support garment is also worn.
• Keep body mass index (BMI) within a normal range; extra weight can slow the rate by which lymph moves.
• Drink an adequate amount of water daily to help move impurities out of tissues.
• For painful, swollen glands or lymph edema seek the advice of a medical doctor.