It's clean because it hasn't been used, but thank you for your understanding. Chest pad, chest pillow, massage pillow, face-down pillow Esthetics, massage, chiropractic, cushion This item has been stored at home. I am an amateur, so the inspection is not from a professional perspective. There may be discrepancies in the description or oversight of stains, etc. Please purchase only if you understand that this item has been stored at home. Items other than those in the photos are not included. The photos are everything, so please check the images carefully before considering a purchase.