Someone in the reviews said the lymphatic massage was done with a machine, but mine was actually manual. The table they are using isn't a massage table, so it doesn't have a head hole. When working on my back I had to turn my head sideways and by the end I had a sore neck. There was a very loud machine (dehumidifier I think) in the room that didn't help relax. I didn't feel any of the effects that the massage therapist said I would feel after the session.