Longitudinal evaluation of manual lymphatic drainage for
               the treatment of gynoid lipodystrophy

Schonvvetter, Bianca; Soares, Juliana Laudicéia Marques; Bagatin, Ediléia

doi:10.1590/abd1806-4841.20143130

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Investigation • An. bras. dermatol. 89 (5) • Sep-Oct 2014 • https://doi.org/10.1590/abd1806-4841.20143130 copy

Longitudinal evaluation of manual lymphatic drainage for the treatment of gynoid lipodystrophy^* * Work conducted at the Cosmetology Unit, Department of Dermatology, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM-UNIFESP) - São Paulo (SP), Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

BACKGROUND:

The gynoidlypodystrophy, known as cellulitis or cellulite, refers to a condition that gives the skin an undulating and uneven appearance, affecting 80-90% of women after puberty.

OBJECTIVES:

to investigate the efficacy and safety of manual lymphatic drainage for cellulite management.

METHODS:

this was an open, prospective, intervention study including 20 women aged from 20 to 40 years. Fourteen sessions of manual lymphatic drainage were performed once a week on lower limbs and buttocks.

RESULTS:

Fifteen women completed the study. A significant improvement on quality of life was observed (p=0.018). A significant reduction (p=0.023), estimated at 0.3±0.8 cm, in hip circumference was found, but no difference was found in thighs circumference (p>0.05). A significant reduction elastic recuperation of skin on buttocks, which means skin elasticity worsening, was observed. All measures obtained by ultrasound images showed no changes (p>0.05).

CONCLUSION:

manual lymphatic drainage was safe but not effective as an isolated approach for cellulite management. Further randomized, controlled or comparative studies about manual lymphatic drainage for cellulite control, as unique or combined therapeutic modality, are necessary.

Cellulitis; Drainage; Massage

	Opinion
	Patients	Examiner 1	Examiner 2
Total	15 (100.0%)	15 (100.0%)	15 (100.0%)
Worsening	-	1 (6.7%)	2 (13.3%)
No change	7 (46.7%)	8 (53.3%)	9 (60.0%)
Improvement	8 (53.3%)	6 (40.0%)	4 (26.7%)

Opinion Examiner 1	Opinion Examiner 2			Total
Opinion Examiner 1	Worsening	No change	Improvement	Total
Total	2 (13.4%)	9 (60.0%)	4 (26.6%)	15 (100.0%)
Worsening	1 (6.7%)	-	-	1 (6.7%)
No change	1 (6.7%)	5 (33.3%)	2 (13.3%)	8 (53.3%)
Improvement	-	4 (26.7%)	2 (13.3%)	6 (40.0%)

	Before treatment	After treatment	p-value^# # paired t-test
Hip biometric measures (cm)	106.0±12.0	105.7±12.4	0.023
Right thigh biometric measures ^a a for data on thighs n=11 (cm)	59.2±8.7	59.7±8.0	0.527
Left thigh biometric measures ^a a for data on thighs n=11 (cm)	58.2±8.5	58.9±8.8	0.310

	Before treatment	After treatment	p-value^# # paired t-test
BMI	26.4±5.6	25.7±5.3	0.475
BF%	22.3±9.6	20.4±11.6	0.125

	Before treatment	After treatment	p-value^# # paired t-test
R7 of the right buttock (mm/sec)	0.773±0.104	0.671±0.135	0.027
R7 of the left buttock (mm/sec)	0.753±0.090	0.606±0.116	0.004

	Before treatment	After treatment	p-value^# # paired t-test
Dermal-hypodermal line in the right buttock or hip (pixels)	13.329±0.859	13.252±0.634	0.728
Dermal-hypodermal line in the left buttock or hip (pixels)	13.244±0.736	13.533±1.011	0.403
Thickness of the dermis in the right buttock or hip (pixels)	1.670±0.371	1.639±0.383	0.614
Thicknesses of the dermis in the left buttock or hip (pixels)	1.683±0.274	1.650±0.315	0.658
Collagen density of echogenicity of the right buttock or hip (pixels)	0.275±0.121	0.278±0.125	0.918
Collagen density of echogenicity of the left buttock or hip (pixels)	0.306±0.153	0.267±0.094	0.295
Dermal-hypodermal line in the right thigh ^a a for data on right thigh n=15 (pixels)	12.939±0.464	12.994±0.814	0.745
Dermal-hypodermal line in the left thigh ^b b for data on left thigh n=13 (pixels)	13.113±1.139	12.676±0.289	0.161
Thickness of the dermis in the right thigh ^b b for data on left thigh n=13 (pixels)	1.243±0.318	1.187±0.227	0.424
Thickness of the dermis in the left thigh ^b b for data on left thigh n=13 (pixels)	1.150±0.254	1.212±0.321	0.389
Collagen density of echogenicity of the right thigh ^b a for data on right thigh n=15 (pixels)	0.632±0.127	0.667±0.127	0.194
Collagen density of echogenicity of the left thigh ^b b for data on left thigh n=13 (pixels)	0.675±0.135	0.688±0.151	0.613

Sociedade Brasileira de Dermatologia Av. Rio Branco, 39 18. and., 20090-003 Rio de Janeiro RJ, Tel./Fax: +55 21 2253-6747 - Rio de Janeiro - RJ - Brazil
E-mail: revista@sbd.org.br

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[1] MAILING ADDRESS: Bianca Schonvvetter, Rua Estado de Israel,192, Vila Clementino, 04022-000 - São Paulo - SP, Brazil. E-mail: biavvetter@hotmail.com

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Longitudinal evaluation of manual lymphatic drainage for the treatment of gynoid lipodystrophy* * Work conducted at the Cosmetology Unit, Department of Dermatology, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM-UNIFESP) - São Paulo (SP), Brazil.

BACKGROUND:

OBJECTIVES:

METHODS:

RESULTS:

CONCLUSION:

Longitudinal evaluation of manual lymphatic drainage for the treatment of gynoid lipodystrophy^* * Work conducted at the Cosmetology Unit, Department of Dermatology, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM-UNIFESP) - São Paulo (SP), Brazil.