Comparison of Extracorporeal Shock Wave Therapy versus Manual Lymphatic Drainage on Cellulite after Liposuction: A Randomized Clinical Trial

Abstract

Introduction. Cellulite is associated with variations in the skin appearance with cottage cheese, mattress-like, or orange peel. The most common areas for these lesions are the posterior or upper thighs and buttocks and mainly affect females after puberty. The objective of the study was to determine whether extracorporeal shock wave therapy (ESWT) or manual lymphatic drainage (MLD) is more effective for the reduction of the grade of cellulite after liposuction. Methods. This study is a single-blinded randomized controlled clinical trial. Thirty females with grade 3 cellulite were randomly distributed into two groups equal in number (n = 15), group A was equipped to ESWT and group B was equipped to MLD. The cellulite grading scale was used to assess cellulite grade, and the skinfold caliper was used to assess the thickness of subcutaneous fat. The assessment was carried out before and four weeks after starting the treatment. Both groups received topical retinol twice daily for four weeks; in addition, group A received ESWT, while group B received MLD, two times/week for 4 weeks. Results. The mean values of the skinfold caliper in group A decreased by 24.4% and in group B by 15.38% with a significant difference between the two groups p < 0.001 . Also, the mean values of the cellulite grading scale decreased significantly after treatment in group A compared with the mean values of group B p < 0.001 . Conclusions. There was more reduction in the grade of cellulite and thickness of subcutaneous fat in the ESWT group than the MLD group after liposuction.

Aesthetic Rehabilitation Medicine: Enhancing Wellbeing beyond Functional Recovery

“…Thirty females with grade 3 cellulite were divided into two groups. Results showed a more significant reduction in cellulite grade and subcutaneous fat thickness in the ESWT group compared to the manual lymphatic drainage group, indicating ESWT's superiority in cellulite reduction after liposuction [123].…”

Performance of the Dermatofunctional Physiotherapist in Complications Arising From the Post-Operative Liposuction and Abdominoplasty

“…In the clinical trial study by Allam et al (2021), in which 30 women participated, compared the effects between extracorporeal shock wave therapy and manual lymphatic drainage, concluding that wave therapy presented more effective results for minimizing the degree of cellulite, in addition to leveraging the process of microcirculation and transport of lymphatic vessels, the parameters used were: frequency 3.5Hz, flow density 0.16 mJ/mm2 and 2,000 shot in the anterior portion of the thigh. However, lymphatic drainage also showed positive results, but they were not superior to waves.…”