Lipomodeling manual massage: procedure technique

Valery Kalyalin – massage therapist of the Odessa region bodybuilding team, master of sports and champion of Ukraine in bodybuilding (Ukraine, Ilyichevsk);

Denis Demidov is a spa instructor at Janssen Cosmeceutical and GIGI, an instructor at the Ecologique School of Massage Technologies, and a massage instructor at the Kiev Medical University of the Ukrainian Association of Traditional Medicine (Ukraine, Kiev).

Before proceeding directly to the massage technique, you need to understand: firstly, why the technique is called “lipo-modeling manual massage”, and secondly, what cellulite is.

Lipomodeling manual massage. Lipomodeling – that is, affecting the main stages of the formation of “cellulite” and fat hypertrophy and working in three directions:

1) Activation of fat breakdown;

2) Removal of decay products along with stagnant fluid;

3) Restoring the tone and elasticity of weakened tissues of the dermis and hypodermis, as well as the fight against liposclerosis.

Manual massage – from manual lat. “hand”, that is, manual massage. This technique allows you to equally find an approach to each of the main morphological forms of cellulite: edematous (edematous), liposclerotic (fibrotic) and flabby (atonic), as well as change the massage scheme as the tissues adapt to the load and their condition changes from procedure to procedure .

It should be noted that the massage technique is absolutely comfortable for the client and does not exceed the threshold of pain sensitivity (although everything is very individual). Based on the principles of safety and physiology, this massage helps restore the natural biological mechanisms of normal functioning of the body. The technique is a symbiosis of knowledge of anatomy, pathological anatomy, physiology and pathophysiology, morphology and pathomorphology of a disease such as cellulite, as well as various massage techniques, the movements of which have the maximum impact on the humoral environment of the body, on adipose tissue and epithelium. The tactics of working using this method are determined from the position of the functional unity of the structural, emotional and chemical processes of the body, their mutual influence and interaction.

The term "cellulite" was first used in 1920 to describe non-inflammatory changes in adipose tissue. The word “cellulite” appeared in popular use in 1973 at the suggestion of the American women’s magazine Vogue. The publication's marketers decided to use this medical term for a cosmetic phenomenon - the so-called “orange peel”.

Since then, the term “cellulite” has been established, which occupies a special place in the dictionary of beauty and health. By the way, the presence of “orange peel” does not always mean cellulite; it may be related to the structure of the skin. Until 1996, no one in the post-Soviet space had heard of this disease, although in Europe and the United States they have been dealing with cellulite problems since 1957.

Cellulite is a disease of an unbalanced body in which harmony is lost. These are not only fat deposits under the skin, but also a direct reflection of the physiological processes occurring in the body. In other words, it is a lifestyle disease. The French Ministry of Health, for example, has already officially recognized it as a disease of subcutaneous fat. There is an opinion that severe fibrosis and impaired microcirculation in estrogen-dependent areas of subcutaneous fat (abdominal part, thighs, buttocks) lead to disturbances in the processes of hormonal metabolism and, through a feedback mechanism, contribute to ovarian dysfunction. Eight out of ten women suffer from cellulite, regardless of age, body type, weight or physical activity. It can be formed as early as eight years of age.

Therefore, a massage therapist needs to take a holistic approach to working with a client, since the treatment of cellulite is a complex process that includes the treatment of a disease (cellulite) caused by the individual’s lifestyle. This is not only an anti-cellulite massage, but also exercise, proper nutrition, getting rid of bad habits, and stress relief. Therefore, it is so important to collect anamnesis, to know the etiology and pathogenesis of each of the causes of the disease.

Cellulite or liposclerosis?

Let’s define it right away: cellula is a cell, adipocyte is a fat cell. What is called cellulite today and what it actually is are two different things. Strictly speaking, the use of the term “cellulite” in the context familiar to us is incorrect, since cellula is a cell, and the ending “-itis” in medical vocabulary implies the presence of an inflammatory process (bronchitis, cystitis, peritonitis, etc.), that is, cellulite - This is inflammation of some cell.

Inflammation can occur only at the beginning of the disease, when metabolic disorders occur in adipocytes. The balance between lipogenesis (accumulation) of fats and lipolysis (breakdown) in fat cells is disrupted. Uneven growth of fat cells occurs in adipose tissue. These problems in fat metabolism at the cellular level are called cellular pathology of adipocytes. They lead to hypertrophy and hyperplasia of adipose tissue (its increase due to an increase in cell volume and number) and hypercellular growth of adipocytes. As a result, insufficient blood supply to the tissue occurs and edema develops (overhydration). The “edema (edematous) stage” begins.

As a result of hypercellular growth of adipocytes, collagen fibers stretch and thicken, fluid circulation in tissues is limited, and hormones cannot penetrate the cell for lipolysis. Further, due to vascular sclerosis of adipocytes (caused by insufficient blood supply) and the accumulation of toxins, the cells become sclerotic (thickened) and cellular sclerosis occurs, in which the fibrous structures of the connective tissue are produced by fibroblasts or functionally similar cells to them - liposclerosis occurs. Next, panniculitis begins (fibrous inflammation of the subcutaneous tissue), turning into fibrosis (overgrowth of fibrous connective tissue). Sclerotic adipocytes aggregate into hypertrophied adipocyte clusters. The liposclerotic (fibrous) stage begins.

In fact, the so-called “cellulite” is adipocyte dystrophy, or “degenerative-dystrophic change in subcutaneous fat.” (Dystrophy is a pathological process that occurs in connection with metabolic disorders and is characterized by the appearance and accumulation in cells and tissues of quantitatively and qualitatively changed metabolic products.) Therefore, we can say that cellulite is a combination of all the above names, to which others can be added names that characterize certain processes occurring in the body. But, given medical knowledge, it would be more correct to call cellulite liposclerosis or lipodystrophy.

Clear sequence

Programs for the treatment and prevention of lipodystrophy must be etiopathogenetic, purely individual, comprehensive and consistent. When constructing such programs, it is necessary to identify the main link of pathogenesis and determine the type or stage of liposclerosis.

When working with patients, a massage therapist must take into account all possible correction options, starting with drug treatment of hormonal disorders and ending with physiotherapeutic (in particular massage) and psychological methods of influence. Of course, there are many ways to treat liposclerosis, but in this article we will consider mainly the massage direction in the treatment program.

I would also like to draw the attention of specialists to the fact that the lipomodeling massage technique is not intended for the treatment of overweight and obesity, but is used for figure correction and the treatment of cellulite. Massage can also promote weight loss, but this requires a special diet and additional physical activity, the use of elements of visceral chiropractic, etc.

After making a diagnosis and determining the stage of the disease, it is necessary to select a work plan and prescribe an individual course, which includes a special massage program consisting of certain massage movements designed to eliminate a particular problem. For each stage of lipodystrophy, there are special movements leading to the elimination of liposclerosis, if these disorders can be removed by massage and cosmetics.

According to stage

Edema (edematous) stage. It is almost always worth starting with work to eliminate it, since one of the main causes of liposclerosis is a violation of the outflow of lymph and venous blood. Therefore, the technique is designed taking into account the anatomical location of the lymphatic system and is performed using a suction technique. First, the abdomen is worked superficially with lymphatic drainage movements, then viscerally, working to squeeze out the mesentery. After this, we switch to lymphatic drainage, gradually adding elements of lipolytics.

The work takes place in four planes (or directions) of the client’s location:

1) The client lies on his back, the massage therapist works from the side;

2) The massage therapist works facing the client’s head;

3) The massage therapist works with his back to the client’s head;

4) The client lies on his side, the massage therapist works from the side (from the abdomen and from the back).

Next, we begin breathing exercises that help create negative intra-abdominal pressure, which enhances the outflow of lymph into the intra-abdominal lymph nodes and intestinal lymph nodes, i.e. we carry out lymphatic drainage at a deep level. First, we carry out “vibration while inhaling”: the massage therapist’s hands are on the lateral surfaces of the client’s chest, while exhaling we apply light pressure with light vibration. This ensures surging of the thoracic duct. Next comes the “abdominal breathing” technique. The patient breathes with his stomach, and as he exhales, the intestines are palpated clockwise. This technique stimulates peristalsis and provides good surging of the lymph nodes. And the last of the breathing exercises is “silent”, non-inspiratory breathing, i.e. imitation of belly breathing.

Having worked the stomach, we move on to the legs, having previously focused on the regional lymph nodes. A special feature of working on the legs is the special position of the legs, which maximizes the outflow of lymph.

After this, we turn the client over and perform a massage, taking into account the above features. The general algorithm for working with this technique after working out the abdomen is as follows:

• stroking – neutral, wavy, wavy, enhanced, bilaterally symmetrical;
• lymphatic drainage block - superficial drainage, deep drainage, zonal squeezing (pumping and dumping), general squeezing;
• kneading block – lipolytic-drainage kneading, trophic-lipolytic kneading, “approach-divergence” kneading to activate reabsorption and relieve hydrostatic pressure in tissues, lipolytic kneading, vibration kneading.

Liposclerotic (fibrous) stage. The most difficult stage of lipodystrophy to eliminate. Here the effect is carried out directly on adipose tissue. The fact is that usually during anti-cellulite massages, all the massage therapist’s energy is dispersed and goes to the muscle level. In this technique, all movements are aimed only at adipose tissue and liposclerosis. We also involve the client himself in the work, forcing him to perform dynamic movements, thereby influencing the adipose tissue from all sides.

Flabby (atonic) stage. At this stage, among other things, due to the atonicity of the muscles, the effect occurs at the muscular level and on strengthening the turgor of the skin, which is stretched or has stretch marks (stretch marks). Therefore, we act on muscle tissue, adipose tissue and skin. It is necessary to take into account the condition of the tissues - in one case we will descend from the skin level deep to the muscle level, and in the other, on the contrary, we will rise from the deep layers to the superficial. The technique used at this stage is ideal when working with clients in the postpartum period (lost weight, gained weight + anti-aging effects).

Symbiosis of stages. Also, one client can observe the presence of all three stages at once. In this case, it is necessary to combine movements intended for a particular stage.

This technique can be mastered by any experienced massage therapist - both men and women. The main thing is to know the biomechanics of the body. The technique does not require large energy consumption. Your client will mostly rest during the procedure (except when performing dynamic movements) without experiencing any pain.

First published: KOSMETIK international journal, No. 4(42), 2010, pp. 78-81