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It's been called "hope in a syringe" and a nonsurgical alternative to liposuction. Its proponents tout it as a medical specialty that uses natural extracts, homeopathic agents, pharmaceuticals, and vitamins to promote weight loss, battle cellulite, and rejuvenate the body. But professional organizations like the American Society of Plastic Surgeons (ASPS) and the American Society for Aesthetic Plastic Surgery (ASAPS) do not endorse mesotherapy because they say the procedure is not scientifically proven, lacks objective data on safety and efficacy, and has not been approved by the U.S. Food and Drug Administration (FDA). ASPS and ASAPS maintain that the only proven method to safely and permanently remove fat is liposuction, and both advise that patients avoid mesotherapy treatments until further research on the procedure is completed.

What Is Mesotherapy?

Developed in France by Dr. Michel Pistor in the early 1950's, mesotherapy involves a series of injections containing small quantities of vasodilators (to dilate blood vessels), nonsteroidal anti-inflammatory medications, enzymes, nutrients, antibiotics, and hormones into the layer of fat under the skin. Mesotherapy was originally developed to treat vascular and lymphatic disorders; depending on the substances used, its practitioners also use it on patients with chronic pain, alopecia, bone and joint disorders, and psoriasis. It is used widely in Europe, where France recognizes it as a medical specialty, and in South America.

Its most common use in the United States is body contouring. More specifically, it's used to treat cellulite, reduce body fat, and promote spot weight loss. Mesotherapy for cellulite is promoted under a variety of names, including dermatoliposclerosis, lipotherapy, lipolysis, mesoplasty, lipodissolve, and Lipostabil®.

Mesotherapy Results

A mesotherapy session begins with the person doing the injections using a pen to mark up the areas of the body to be treated. These usually include the neck, legs, abdomen, arms, and hands, and localized fat deposits such as "love handles" and "saddle bags." The site is then cleaned with alcohol. The injector uses a very fine needle or a cannula to deliver the injection into the subcutaneous tissue (mesoderm) and the adipose fat tissue in the treatment area. Two of the most common injectables used to treat cellulite and reduce body fat are lecithin (phosphatidylcholine, or PPC), which emulsifies and breaks down fat, and isoproterenol. The actual content mix reportedly varies depending on the individual being treated and the specific area to be treated. The number of injections during a session depend on the size of the area treated. No anesthesia is used. A series of 8 to 15 treatments at 2-week intervals is usually recommended.

The theory behind mesotherapy isn't clear, but there are claims that the injections cause an increased blood flow in the capillary networks and increased lymphatic flow through the mesoderm. There's also a theory that the medications dissolve fat cells, which are then excreted through the urine and bowels.

Side Effects of Mesotherapy

Potential complications of mesotherapy include headaches, nausea, diarrhea, a temporary burning sensation, swelling and soreness that can last for several days, blisters, skin discoloration, tissue necrosis (death), bacterial infection, granulomas (disfiguring masses of chronically inflamed tissue), and scarring at the injection site. Patients who are allergic to soy may have an allergic reaction (blisters, rash, hives) to mesotherapy since one of its main components is lecithin, a soy byproduct.

The American Society for Dermatologic Surgery (ASDS) notes that there are no randomized, double-blinded controlled studies that establish the safety or efficacy of mesotherapy for medical or aesthetic reasons, no published scientific studies showing that mesotherapy results are permanent or why or if certain ingredients work, no standard mesotherapy formulations, and no precise protocol for the quantity or frequency of injections. There are also no regulations on who can perform mesotherapy or how they are trained. Consequently, the person doing the injections may have little or no medical background. One mesotherapy product, Lipostabil®, was banned by the Brazilian government in 2003 for lack of efficacy.

The Aesthetic Surgery Education and Research Foundation (ASERF) is sponsoring a placebo-controlled study under FDA supervision to determine the safety and efficacy of one type of mesotherapy injection treatment (PPC and sodium deoxycholate, or DC), a combination that has shown the most promise in smaller trials. Neither drug in this trial is FDA approved for subcutaneous injection for any purpose; furthermore, the FDA has not approved any of the medications for use in mesotherapy or body contouring. Neither ASPS nor ASAPS recommends the use of injection lipolysis for fat reduction until appropriate research has documented the safety and efficacy of this non-FDA approved treatment.

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