Lymphatic drainage The Phlebology Clinic / Services / Lymphatic drainage Introduction Indications Specialists Frequently asked questions Introduction Lymphatic drainage and pneumatic compression massage also known as pressotherapy — these are methods for treating edema as well as venous and lymphatic circulation disorders using controlled, sequential pressure applied to the limbs or torso. At Phlebology Clinic we use a professional system BTL-6000 Lymphastim, which combines pressure-control precision with patient comfort and high clinical efficacy. Unlike compression garments (such as stockings or elastic wraps), pressotherapy is an active treatment procedure performed in the office. Using a specialized suit or cuffs, the device exerts a wave of pressure on the body that moves sequentially from the lower parts toward the heart, mimicking physiological lymphatic drainage and supporting venous return. Pressotherapy is not merely a relaxation or cosmetic treatment — in the hands of a phlebologist, it is a recognized method for treating and supporting the treatment of lymphedema, venous-lymphatic edema, and lipedema., recommended by phlebological and lymphological societies worldwide. The lymphatic system — why is its insufficiency a serious health problem? The lymphatic system is a network of delicate vessels and lymph nodes distributed throughout the entire body, whose primary role is the drainage of interstitial spaces. Every day, approximately 20 liters of tissue fluid leak through the walls of the capillaries into the tissues. The vast majority of it (about 17-18 liters) returns to the bloodstream through the venous vessels, but about 2–3 liters per day are collected by the lymphatic vessels and transported as lymph to the thoracic duct, and from there into the vena cava. Although this seems like a small volume, if the physiological mechanisms of lymphatic drainage fail, fluid accumulates in the tissues, causing edema to build up. The flow of lymph within the lymphatic vessels is forced by regular contractions of the smooth muscles within the vessel walls (the so-called lymphangions), but it is also supported by the activity of skeletal muscles during movement and by pressure changes caused by respiratory movements. Any factor that disrupts these mechanisms—such as immobilization, obesity, thrombosis, past surgical procedures, radiotherapy, or primary developmental disorders of the lymphatic vessels—can trigger chronic lymphedema, czyli that is, lymphedema. Schemat układu limfatycznego kobiety. Untreated, progressive lymphedema stimulates the growth of connective and adipose tissue (fibrosis, liposclerosis), the skin loses its elasticity and becomes increasingly resistant to treatment, and the risk of recurrent skin and subcutaneous tissue infections (so-called erysipelas) significantly increases. This is why, at the Phlebology Clinic, we treat disorders causing lymphatic stasis as conditions requiring active causal treatment, rather than just temporary reduction of the swelling. What does mechanical lymphatic drainage (pressotherapy) involve? Pressotherapy automated utilizes sequential, graduated pneumatic compression. The patient puts on a specialized suit (full trousers or lower limb cuffs and an abdominal cuff). The suit is divided into segments that fill with air in a strictly defined order, pace, and pressure, as programmed by the therapist. The pressure wave causes the mechanical displacement of lymph and venous blood against the force of gravity. Upon completion of each cycle, the segments deflate, the pressure drops, and the tissues remain under minimal compression for a brief moment. The cycle then repeats a set number of times, depending on the selected therapeutic program. The physiological effects of well-planned pressotherapy are multidirectional: edema reduction — mechanical removal of excess interstitial fluid and lymph from the limb improvement of venous return — acceleration of venous blood flow — reduction in the risk of thrombosis and — alleviates the symptoms of chronic venous insufficiency. stimulation of lymphangions — rhythmic compression strengthens the spontaneous contractions of lymphatic vessels, improving the long-term efficiency of the lymphatic system. anti-inflammatory effect — improved microcirculation facilitates — the removal of inflammatory mediators from the tissues. reduction of pain and the sensation of heavy legs — significantly improving the patient’s quality of life. The BTL-6000 Lymphastim System — a pressotherapy system at the Phlebology Clinic At the Phlebology Clinic, we utilize professional BTL-6000 Lymphastim pressotherapy system — a medical-grade device manufactured by BTL, one of the world's leading producers of physiotherapy and physical medicine equipment. A woman with lymphedema during a therapeutic session with the BTL-6000 system at the Phlebology Clinic. The BTL-6000 offers programmable, multi-segment compression sequences — with precise operating pressure control ranging from 20 to 80 mmHg, independently for each segment. Key clinical features of the device include: Sequential multi-chamber compression. The suit is divided into numerous chambers (12 chambers for each limb), providing a precise, smooth pressure wave that moves from the foot up to the abdomen. Such a detailed zonal division is crucial in lymphedema therapy, where working on narrow segments allows for bypassing lymph node areas damaged by radiotherapy or lymphadenectomy. Pressure and cycle time regulation. The applied pressure, the inflation time for each chamber, and the pause duration between cycles—all parameters are under full control within the selected therapeutic program. This allows the treatment to be tailored to everything from gentle relaxational drainage to more intensive therapy for venous-lymphatic edema or lipoedema. Simultaneous bilateral treatment mode The BTL-6000 Lymphastim allows for the simultaneous treatment of both lower limbs, which shortens the therapy session and is particularly important for patients with bilateral edema. Integration with classical compression therapy. At the Phlebology Clinic, we always treat pressotherapy using the BTL-6000 as an element of Complex Decongestive Therapy (CDT) — device sessions are supplemented by individually selected compression garments between treatments. This combination is the gold standard for lymphedema therapy according to the International Society of Lymphology (ISL) recommendations. Jakie są wskazania do drenażu limfatycznego (presoterapii)? The primary indications for pressotherapy with the BTL-6000 Lymphastim system include: Venous-lymphatic edema (phlebolymphedema) — the most common type of edema encountered in daily phlebological practice; chronic venous insufficiency (CVI), particularly in stages C3–C6 according to the CEAP classification, leads to overload and secondary insufficiency of the limb's lymphatic system. chronic venous insufficiency automated pressotherapy serves as an essential adjunct to compression therapy and surgical treatment post-thrombotic syndrome automated pressotherapy, combined with the regular use of compression garments, reduces the risk of venous ulcers. swelling in pregnancy; Lymphedema,both primary (congenital lymphatic vessel development disorders) and secondary (e.g., following oncological treatment, trauma, or venous thrombosis); automated pressotherapy, combined with systematic use of compression garments, improves patient comfort and enables normal daily functioning. Lipedema (lipoedema)particularly stages II and III, where concomitant lymphatic drainage disorders (lipolymphedema) and chronic inflammation of the adipose tissue are the primary causes of pain and progressive swelling; automated pressotherapy, combined with consistently worn, properly fitted compression garments, improves patient comfort and significantly slows disease progressionit is also recommended as pre-operative preparation and as a vital component of rehabilitation after medical liposuction.. venous thrombosis (acute and subacute phase); Prophylaxis and treatment of edema following surgical and reconstructive procedures, primarily after orthopedic surgeries (joint replacements, ligament reconstructions), gynecological and urological procedures, and liposuction. Edema during pregnancy and the postpartum period; automated pressotherapy can be used as a safe, non-pharmacological method for reducing edema in the lower limbs and sacral region. Idiopathic edema in female patients with cyclic, hormone-related lower limb swelling. Contraindications – when should pressotherapy be avoided? Like any medical procedure, lymphatic drainage and pressotherapy have their limitations. Absolute contraindications to pressotherapy include: acute venous thrombosis (up to 2 weeks from diagnosis or until full anticoagulation therapy is established and risk assessment is performed), uncompensated heart failure, active malignancy in the treated area, acute bacterial soft tissue infection (e.g., erysipelas), active ulcers, burns, or other open wounds at the cuff application site, and advanced peripheral artery disease in the stage of critical limb ischemia. Relative contraindications, which require an individual assessment by a physician, include advanced-stage varicose veins, particularly when accompanied by lipodermatosclerosis (fatty hardening of the skin), severe blood clotting disorders, and any conditions in which the mobilization of interstitial fluids could excessively strain the circulatory system. Therefore, before starting pressotherapy treatments at the Phlebology Clinic, every patient undergoes a medical clearance by a phlebologist based on their medical history, physical examination and, if necessary, a Doppler ultrasound of the venous system. Comprehensive Decongestive Therapy — pressotherapy as a component of CDT Global lymphological societies, including the Polish Lymphological Society (PTL) and the International Society of Lymphology (ISL), recommend treating lymphedema using Complex Decongestive Therapy (CDT) (ang. Complete Decongestive Therapy, CDT). CDT consists of four elements: manual lymphatic drainage (performed by a certified therapist), compression therapy, exercise, and skin care Presoterapia aparatem BTL-6000 jest medycznie uznanym uzupełnieniem CDT — szczególnie pomocnym w fazie podtrzymującej terapię (po osiągnięciu maksymalnej redukcji obrzęku), gdy regularne sesje aparatowe w Klinice zastępują lub uzupełniają manualny drenaż limfatyczny. W Klinice Flebologii presoterapię traktujemy jako świadome połączenie: aparatowy drenaż limfatyczny + dobrany indywidualnie wyrób kompresyjny pomiędzy sesjami = optymalna kontrola obrzęku. Is did you know that? Edema reduction and management are critical elements in preventing complications of venous and venous-lymphatic insufficiency, most importantly: the formation and recurrence of venous leg ulcers. Professor Tomasz Grzela, MD, PhD Treatment Procedure — What does a pressotherapy session at the Phlebology Clinic look like? Pressotherapy drainage is completely non-invasive and painless. The patient changes into a special garment and assumes a comfortable lying position. A nurse or therapist applies the BTL-6000 suit to the lower limbs, initiates the programmed compression sequence, and monitors the drainage procedure. Throughout the session, the patient feels the rhythmic inflation and deflation of the suit's chambers — similar to the graduated pressure of a compression stocking, but dynamic and moving upwards The duration of a single session is 30 to 45 minutes, depending on the type of edema.. The recommended series usually consists of 5-10 sessionsusually performed every other day or daily during the intensive phase of treatment. The number and frequency of sessions are determined individually by a phlebologist, based on the type and stage of the edema, clinical response, and the results of follow-up limb circumference measurements. After the pressotherapy session, the patient immediately puts on a fitted compression garment (stocking) or compression wraps to maintain and consolidate the drainage effect — fluid moved by the device to the central vessels must be prevented from returning to the peripheral tissues. Price range Pressotherapy Venous drainage (45 min.) PLN 150 Make an appointment Pregnancy drainage (30 min.) PLN 150 Make an appointment Lymphatic drainage (60 min.) 200 PLN Make an appointment Lipedema drainage (45 min.) PLN 150 Make an appointment Reusable pressotherapy suit PLN 100 Make an appointment Pressotherapy vs. Compression Therapy — How do we combine them at the Phlebology Clinic? Pressotherapy and compression therapy are the two pillars of edema treatment that act synergistically. The BTL-6000 pressotherapy session actively reduces edema. by mechanically moving the fluid toward subsequent groups of lymph nodes and central veins. The compression garment (stocking, bandage) applied immediately after the treatment maintains this effec — preventing the return of tissue fluid to the drained limb for the rest of the day. Without properly selected compression therapy, the effects of pressotherapy are short-lived. Without regular pressotherapy sessions — especially in cases of lymphedema and mixed venous-lymphatic edema — wearing stockings alone does not allow for further edema reduction, but only slows its progression. Therefore, at the Phlebology Clinic, we plan both treatments together as part of a coherent therapeutic strategy. Specialists qualifying for pressotherapy the qualification for pressotherapy and the selection of treatment parameters take place during: phlebology consultation or a follow-up visit with one of the doctors at the Phlebology Clinic Array ( [0] => 263 [1] => 261 [2] => 251 [3] => 247 [4] => 249 [5] => 6930 [6] => 259 ) Consulting specialists dr n. med. Cezary Szary - phlebologist, radiologist radiology and diagnostic imaging, phlebology dr n. med. Justyna Wilczko – flebolog, internista Phlebology, internal medicine, radiology and diagnostic imaging Dr Krzysztof Celejewski - phlebologist, surgeon general surgery, phlebology dr n. med. Małgorzata Łodyga – flebolog, kardiolog cardiology, phlebology, Doppler ultrasonography dr n. med. Marcin Napierała – flebolog, chirurg ogólny, chirurg onkolog general surgery, phlebology dr Piotr Błachowicz – flebolog, chirurg ogólny general surgery, phlebology prof. dr hab. n. med. Tomasz Grzela – flebolog, chirurg General surgery, phlebology Najczęściej zadawane pytania Can I come for pressotherapy without a prior medical consultation? At the Phlebology Clinic, every patient must be cleared by a phlebologist before their first series of pressotherapy sessions. This is necessary to rule out contraindications (especially active venous thrombosis) and to select the appropriate treatment parameters. Performing pressotherapy without a proper diagnosis can be dangerous — pressure applied to a limb with acute venous thrombosis can lead to a pulmonary embolism. Is pressotherapy painful? The pressotherapy procedure is painless. Patients describe it as a pleasant sensation of rhythmic compression and relaxation of the limbs. In cases of advanced edema with skin hypersensitivity (e.g., in lipedema), the initial sessions can be performed at a lower pressure, which is gradually increased during subsequent treatments. Does BTL-6000 pressotherapy replace manual lymphatic drainage? Mechanical and manual drainage are complementary methods, not mutually exclusive. Manual lymphatic drainage (MLD), performed by a certified therapist, has the advantage in working on hard-to-reach areas (such as the neck, trunk, and groin area), in manual stimulation of the lymph nodes, and in treating tissue scarring. Automatic pressotherapy with the BTL-6000 device is more accessible, repeatable, and can be used regularly during follow-up visits. At the Phlebology Clinic, we recommend a combination of both methods wherever clinically justified. Is pressotherapy safe during pregnancy? Lymphatic drainage with the BTL-6000 device can be used during pregnancy to treat lower limb edema — provided there is a prior medical clearance, venous thrombosis has been ruled out via a Doppler ultrasound, and appropriate pressure parameters are used. During pregnancy, the use of abdominal cuffs must be strictly avoided. Each case is assessed individually. Is pressotherapy effective for weight loss and cellulite? BTL-6000 pressotherapy is a therapeutic method used in the treatment of venous and lymphatic diseases. It may provide a visual improvement in limb contour by reducing tissue edema – however, it should not be confused with strictly cosmetic treatments. Permanent reduction of adipose tissue requires a caloric deficit, physical activity, and a proper diet, and in selected cases (such as lipedema), it may also require therapeutic surgical intervention. The Phlebology Clinic's services are based on the causal treatment of venous and lymphatic diseases, not on aesthetic medicine. How many pressotherapy sessions do I need? There is no single answer for everyone. In venous edema with a moderate lymphatic component, effects are visible after 5–8 sessions. In typical secondary lymphedema, such as after oncological treatment, a series of 15 sessions is the standard, followed by maintenance therapy (1–2 sessions weekly or every few weeks, depending on the individual). The final treatment plan is determined by the doctor during the qualification visit. How long do the effects of pressotherapy last? The duration of the results depends on the underlying cause (type) of the edema. In edema resulting from chronic venous insufficiency, the effects are long-lasting, provided that the underlying cause of the insufficiency is properly treated, compression therapy is used between sessions, and regular follow-up visits are maintained. In the case of lymphedema and lipedema, pressotherapy serves as maintenance therapy – it does not eliminate the cause of the swelling but effectively controls its severity over the long term. Dr Venus: virtual patient counsellor Looking for an answer to your vein question? Ask our Dr. Venus! Ask Dr Venus a question If I have varicose veins should I fly in compression stockings? Yes, wearing compression stockings is recommended for people with varicose veins, especially on long flights. Explorepresoterapię Odkryj innowacyjny drenaż limfatyczny dla zdrowia i urody. Poczuj lekkość, redukuj obrzęki i popraw krążenie już po pierwszym zabiegu. Make an appointment Make an appointment at the Phlebology Clinic i dobierzaplanuj swój drenaż limfatyczny! Give us a call!
