## 1 Introduction  
In the 1970s, [PERSON] (LPG) survived a motor vehicle accident that resulted in significant skin and muscle damage. The resulting scarring was treated with manual therapeutic massage; however, [PERSON] found this approach labor-intensive, time-consuming, and highly dependent on the therapist's skill. In response, he developed a unique mechanostimulation device, the CelluM6, which delivers endermologie technology (LPG Systems, Valence, France). This device replicates the effects of manual massage, including compression, pinching, slurring, grazing, and rotation, with the goal of standardizing physical therapy. Initially, it was designed for the treatment of post-traumatic and burn scars.  
The term endermologie (or endermotherapy) originates from two words: \"ende\", meaning \"under\", and \"derm\", meaning \"skin\". The primary objective of this innovation was to create a massage technique that was consistent, controlled, and repeatable, while also reducing the physical effort required from the practitioner. During its application in scar therapy, improvements in the aesthetic quality of the skin were observed. As a result, the method was later introduced for cosmetic purposes, primarily for cellulite reduction. Over time, its indications have expanded significantly, paralleling technological advancements such as additional settings (sequential modes, rhythmic frequency from 0.2 Hz to 30 Hz, minimum and maximum intensity control) and specialized treatment heads with rollers, flaps, or a combination of both [1; 2; 3], allowing infinity modes of tissue stimulation to adapt continuously to tissue state.  
In English, this technique is described using various terms, including depressomasage, mechanical massage, mecano-stimulation, vacuum massage, endermotherapy, endermology, and suction massage. However, the term endermologie is exclusively associated with CelluM6 devices, which pioneered this technology.  
Endermologie is believed to exert both local and systemic therapeutic effects, contributing to the metabolic recovery of tissues following trauma, surgery, or implantation. This natural method of skin mobilization is employed by professionals across multiple disciplines, including physiotherapists, osteopaths, phlebologists, aesthetic medicine doctors, cosmetologists, beauticians, dermatologists, and surgeons. It is particularly valued in pre- and post-liposuction care, as well as in the management of swelling and scar tissue [2].  
The effects of mechanical forces on tissues trigger cellular responses, making endermologie a non-invasive and painless method for addressing conditions related to circulation, connective tissue, fat metabolism, and muscle tone. While the treatment is widely recognized for its aesthetic benefits, including cellulite reduction, adipose tissue remodeling, and anti-aging effects, its therapeutic applications are also gaining attention.  
The purpose of this paper is to provide a narrative review of the available literature on endermologie, summarizing its medical, aesthetic, and rehabilitation applications. This review aims to synthesize current knowledge, highlight key findings from relevant studies, and discuss the potential mechanisms of action underlying endermologie's effects. Additionally, it seeks to identify gaps in the existing research and propose directions for future studies in this field.