Does Lymphatic Drainage Massage Really Work?

More than 15 years ago, Julie Brown Price was treated for breast cancer, and 25 of her lymph nodes were removed during mastectomy surgery.

“I was lucky not to experience post-treatment lymphedema, which is a blockage in the lymphatic system that can cause swelling and pain,” the Eden Prairie, Minnesota, resident said. “But on some intuitive level, I knew I needed to detox my body from chemotherapy and radiation treatments, so I started receiving regular manual lymphatic drainage (MLD), a massage technique that lightly stretches skin to encourage the flow of lymphatic fluid.”

Price continues to receive the massages regularly, but she’s also aware that many perfectly healthy people are flocking to make appointments with certified lymphedema therapists. News stories, Instagram reels and TikTok all have examples of the latest celebrities who are seeking out these specialized massages, including supermodel Elle Macpherson and actress Selena Gomez. They’re loyal clients for renowned masseurs like Flávia Lanini and Camila Perez.

When asked how she feels about A-listers queuing up for a treatment that has been helpful for those recovering from cancer treatment, Price is sanguine: “I’m OK with that, since I think we can all benefit from having our plumbing cleaned out occasionally,” she said.

As a treatment for lymphedema and other complications of cancer treatment, MLD has been a lifesaver for many people. “It’s a dreaded condition, and it’s almost endemic,” said Wei Chen, a Cleveland Clinic professor of plastic surgery and head of the clinic’s regional microsurgery and supermicrosurgery. He sees many lymphedema patients in his practice, including women who have survived breast cancer or reproductive cancers, who benefit from the treatment. “The efficacy of MLD treatment for lymphedema is well-established,” he said. “It’s a large patient population that’s often desperate and helpless, and MLD can offer some relief.”

But that’s not why so many people are seeking out MLD these days, as it moves from therapeutic treatment to another “must have” pampering moment as stars get ready for the Met Gala and the Oscars, or as non-celebrities seek out ways to look their best for weddings and class reunions.

From Post-Cancer Treatment To Post-Face-Lift Pampering

Recently, Chen began to notice that the massages were expanding from post-cancer treatment care to treatment for post-operative patients who had received cosmetic plastic surgery. And, in the past few years, he’s seen otherwise healthy people seek out lymphedema therapists for lymphatic drainage massages, often with a stated goal of reducing bloat, giving skin a glow or aiding in digestion.

“While promising as a therapeutic modality, the science and the efficacy of this specific treatment remain to be proven,” he said.

Even without hard evidence, a growing number of influencers, celebrities and just plain folks are becoming interested in a technique that was first introduced by Danish doctor Emil Vodder in the 1930s. Most of them don’t care if randomized controlled trials have proven the benefits of the treatment — they’ve read about a famous person getting one of the massages, and they want one for themselves, too.

“Most of my clients come to me through word of mouth from others who are excited about the effects they’ve experienced,” said Lisa Levitt Gainsley, a certified lymphedema therapist and author of “The Book of Lymph: Self-Care Practices to Enhance Immunity, Health, and Beauty.” “When friends tell them that their skin clears up or their pants feel looser afterwards, they want to know more and try it for themselves.” Gainsley said she hears reports back from patients who say their post-massage selves feel lighter, more energized and less fatigued. Fine lines in the face might relax, sleep can improve and digestion can get a boost. “I get a lot of day-after poop emojis,” she said.

What about all those weight loss claims? Alison Merrick, a Vodder-qualified advanced MLD therapist, said: “It will help with fluid balance and decongestion of tissues, which can help with the appearance of cellulite, but it’s not a weight loss cure. Many people will include it as a part of a ‘cleansing’ regimen or change in diet, but as a stand-alone treatment, it will only result in weight loss due to fluid loss.”

What Happens During Lymphatic Drainage Massage

First, it helps to know what lymph is and what it does. The lymph system plays a key role in the body’s immune system. Many lymphatic vessels, which contain lymphatic fluid that circulates through the body, lie right under the skin. There are lymph node clusters in the armpits, groin, neck and abdomen. “Lymphatic fluid moves through our channels naturally when we exercise, but by encouraging that flow manually, we can speed the process,” said Tammy Fender, esthetician and the owner of spas in West Palm Beach and Delray Beach, Florida.

“When most people think of ‘massage,’ they’re thinking of Swedish massage, which focuses more on muscles and blood vessels,” said Femi Akinnagbe, resident physician, alternative medicine physiologist and massage therapist at the Harbor-UCLA Family Medicine Residency program. “That type of massage can be very good for stimulating the cardiovascular system, but not as effective at stimulating the lymphatic and immune system. In my general opinion, Swedish massage can be better at improving mood, and lymphatic massage can be better at increasing energy levels.”

Fender explained what to expect: “Using a very light, rhythmic pumping technique, the practitioner concentrates on the layer between the skin and muscle.” The practice may not be as intense as what you’re used to. “It’s like seaweed undulating in the ocean,” Gainsley said.

“The massage starts around the area of the neck,” Merrick explained. “From there, it works out to the area of concern. For example, if I were treating swollen ankles, I would work from the neck slowly to the ankles with the direction of the massage always being back towards the neck. Repetition, rhythm, direction, varying skin stretch and release of pressure provide a light stimulation.”

“As with any massage, you should leave feeling restored and serene, although you may feel slightly fatigued if the body is processing a larger-then-usual toxic load,” Fender said. “To optimize the benefits, drink lots of water afterward and avoid alcohol, extreme heat and exercise.”

How often should you be getting these massages? If you’re interested in general health maintenance, Akinnagbe suggested receiving a couple within a short time, like once a week for two to four weeks. “After that, space them out and move to maintenance, like once every three to six months,” he said.

Choosing A Therapist

First things first: Consult with your physician before booking an appointment or trying any at-home massage. MLD is not a good idea for those with active bleeding, blood clots, acute congestive heart failure, acute infection, acute renal failure cellulitis, deep-vein thrombosis, embolisms, untreated cancer and other illnesses. “If you’re a cancer or lymphedema patient or have another medical condition, be sure to ask your insurance about coverage,” Akinnagbe suggested.

You’ll want to make sure your massage therapist knows what they’re doing and understands proper technique. Merrick suggested asking about the therapist’s membership in professional associations and how many hours they’ve spent in training. Akinnagbe added: “Ask about success stories they’ve had with other clients or what benefits their clients have shared with them.”

DIY Techniques To Try At Home

You might want to try doing your own three- to five-minute self-massage sequences daily. “Lymphatic self-massage utilizes the same massage techniques as a practitioner would, but allows you to begin healing using your own two hands,” Gainsley said. Akinnagbe agreed: “You can achieve most of the benefits through self-massage.”

Gainsley teaches an online master class in these techniques, and they’re outlined in greater detail in her book. Here’s a quick example.

The “Spock” sequence calls for a finger separation between the middle and ring fingers, just like the Vulcan salute from “Star Trek.” “Place your middle finger, index finger and thumb behind your ear and your ring and pinky fingers in front of your ears,” Gainsley said. “Gently massage in front of and then behind your ear at the same time. Aim toward the back of your head and down your neck, toward the lymphatic nodes at the base of your neck. This helps release the fluid that builds up around your ears. This stroke is very powerful for colds, ear congestion, sinus pressure and hangovers.”