European Staple of Reshaping Gaining Ground Here

by Lorraine Olivero-Rivera, NP

Mesotherapy has been used in Europe and South America for more than 50 years, and the French Academy of Medicine has officially recognized it as an inherent component of traditional medicine.^1, Michel Pistor, a French physician, developed mesotherapy in 1952. Its applications in aesthetics, particularly for fat and cellulite reduction, are now receiving attention in the United States.³

How Does Mesotherapy Work?

The use of mesotherapy for body contouring, spot weight reduction and cellulite reduction involves multiple injections into the mesoderm using a 0.4-cm to 0.6-cm needle. These injections contain a combination of therapeutic medications chosen based on clinical purpose and treatment goals.

In the United States, phosphatidylcholine is commonly used to dissolve localized fat. Peer-reviewed clinical studies and recent abstract presentations support its use for localized fat loss. It has lipid-modulating effects in the blood and liver, leading to lypolytic effects after subcutaneous injection.⁴Mesotherapy involves a combination of medications intended to cause shrinkage of fat cells in the Scarpa's fascia. Dissolved fat is excreted through the kidney and bowels without disruption of normal bowel habits. This application of mesotherapy targets the receptors on fat cells that fuel lipogenesis (fat production) and lipolysis (fat breakdown). Receptors that break down fat are known as beta receptors; those that create fat are alpha receptors.

In men as well as women, the ratio of alpha to beta receptors above the waist is generally 1:1. But below the waist, women have six to eight alpha receptors for each beta receptor in men — which is the main reason why women have difficulty losing fat in the abdomen, buttocks and thighs.

Mesotherapy for cellulite reduction helps eliminate dimpling and malformed fat underneath the skin. Cellulite is an accumulation of fat, fluid and toxins trapped in a hardened network of connective tissue fibers that trap fat and causes dimpling.⁵It is created by poor microvascular circulation associated with declining estrogen levels, weakened connective tissue, fat herniation and lymphatic congestion. Medications used in mesotherapy are intended to destroy connective tissue bands and dissolve trapped fat. They increase venous and lymphatic circulation, creating a smooth, dimple-free appearance within 4 weeks.

The initial consultation for a patient who requests mesotherapy must include a medical history, weight history and body measurement. Based on individualized factors (such as type of fat, genetics, etc.) as well as patient goals, the provider then customizes a formula to achieve optimal results.

To enhance the effects of mesotherapy, patients should eat a healthy diet, drink plenty of water (to help flush toxins and dissolved fat) and exercise approximately 4 hours per week to circulate medications.

Candidates for Mesotherapy

Healthy adults between the ages of 18 and 75 are candidates for body contouring with mesotherapy. The ideal candidate is someone who exercises regularly, is within 25 pounds of ideal body weight and has normal deposits of fat or cellulite that have not responded to diet and exercise. Contraindications include pregnancy, type 1 diabetes, history of stroke or blood clots, current blood thinner therapy, history of recent cancer and multidrug treatment for heart disease.

Typical Results

Mesotherapy results are measured in inches and visible reduction of cellulite. Mesotherapy treatment may be applied to the arms, waist, abdomen, hips, back and legs. A typical patient can lose up to two dress sizes within five to 10 treatments. No down time or recovery time is needed, so the patient may immediately resume regular activities.

Potential side effects of mesotherapy include bruising, itching, swelling, redness and burning. For most patients, these effects are short lived. Pain and itching rarely last more than a few days, and bruising and swelling subside within a week. Most patients receive three to five treatments spaced 4 weeks apart.

Thorough Training Required

Training by an accredited entity is required to administer mesotherapy. This process should require demonstrated competency in advanced techniques. The box below lists a few training options.

References

1. Pistor M. What is mesotherapy? Chir Dent Fr. 1976;46(288):59-60.

2. Matarasso A, Pfeifer TM, and the Plastic Surgery Educational Foundation DATA Committee. Mesotherapy for body contouring. Plast Reconstr Surg. 2005;115(5):1420-1424.

3. American Society for Aesthetic Plastic Surgery. National plastic surgery statistics: cosmetic and reconstructive procedures trends. Available at: http://www.plasticsurgery.org/media/statistics/loader.cfm?url=/commonspot/security/getfile.cfm&PageID=23628. Accessed Sept. 4, 2008.

4. Rotunda AM, Kolodney MS. Mesotherapy and phosphatidylcholine injections: historical clarification and review. Derm Surg. 2006;32(4):465-480.

5. Salas AP, Asaadi M. Aesthetic application of mesotherapy: a preliminary report. Presented at the annual meeting of the American Society of Aesthetic Plastic Surgery, Vancouver, British Columbia, April 17, 2004.

Lorraine Olivero-Riverab> is a family nurse practitioner who has a doctorate in nursing practice. She is an assistant clinical professor in nursing at Columbia University in New York City and the medical and program director for the Columbia University Center for Metabolic and Weight Loss Surgery. She owns Spa Life Anti-Aging and Wellness MedSpa in Valley Cottage, N.Y. (www.spalife.net).

Mesotherapy Training Resources

American Board of Cosmetic Medicine: www.americanboardofcosmeticmedicine.org

Bissoon Institute of Mesotherapy: www.bissooninstitute.com

American Academy of Aesthetic Medicine: www.aaamed.org