Mesotherapy

Mesotherapy is a new and revolutionary treatment with multiple applications for clinical medicine, performed personally by Dr Wong.

At Grace Life Medical Center, a variety of nutraceutical, herbal, homeopathic substances can be injected into the mesoderm to effect the desired clinical effects.

The mesoderm include cells that make up the structure between the skin and internal organs, such as fat, muscles, tendon, cartilage, joint capsule, fibrous tissues. The acupuncture points are also located at the mesoderm.

By injecting selected substances into the mesoderm, one can treat many illnesses including allergies, asthma, chronic pain, arthritis, endocrine conditions and many chronic illnesses.

Mesolift is a process by which the injected substances stimulate the laying down of new collagen underneath the skin, thus providing a non-surgical facelift.

Mesoshape is a process by which a nutraceutical substance is injected into the mesoderm to dissolve fat, thus shaping unwanted fat from the body

What is Mesotherapy?

Pioneered by the French physician, Dr. Michel Pistor in 1952, mesotherapy is a non-surgical, relatively painless injection technique with a broad range of applications. Mesotherapy promotes the body’s circulatory, lymphatic, and immune system to create a biological response and reverse abnormal physiology.

Mesotherapy is commonly practiced in France, where more than 15,000 physicians utilize mesotherapy for the care of their patients.  In France, mesotherapy is actually taught in medical school.  Mesotherapy is also practiced in many other countries around the world, including Germany, Spain, Belgium, Columbia, Argentina and throughout Europe.

Mesotherapy is an interventional injection technique that is performed by licensed health care clinicians who are permitted to do injections.  Mesotherapy is a safe and effective alternative for the treatment of cellulite, weight loss, hair loss (alopecia), and face and neck rejuvenation. Unlike surgery, mesotherapy is virtually painless, requires no post-operative recovery time, requires no heavy bandages or girdles, and no anesthesia is necessary. While many surgical procedures require one to two weeks of recovery, patients undergoing mesotherapy have no interruptions to their daily life, while obtaining a natural cosmetic rejuvenation. Mesotherapy involves the injection of a customized mixture of vitamins, amino acids, and medications, placed just millimeters under the skin into the problematic area. Just a “drop” of solution is used at each injection site.

The results obtained with mesotherapy are dramatic. After completing a series of mesotherapy treatments, generally over a three month period of time, patients can notice improvement in skin quality, less dimpling of the skin, and weight reduction including a  loss of approximately ten pounds and one to two clothing sizes. For those suffering from sagging skin and poor skin quality of the face and neck, a “mesolift” may be beneficial.

Uses for Mesotherapy

Fat Loss

For those patients seeking fat loss, mesotherapy is a revolutionary and essential tool. This is how it works: the biology of the fat cell is modified by blocking the signals of fat accumulation and simultaneously triggering the release of stored fat. Again, the desired area of treatment can be patient specific, targeting your most problematic areas. Additionally, a complete dietary and nutrient evaluation will help you maintain your weight loss goals.

Cellulite Reduction

Cellulite affects the majority of women over the age of 20. It is caused by poor circulation, fat herniation, a weakening of connective tissues, lymphatic congestion and hormonal imbalances. Cellulite is classified into four stages, based upon its appearance while standing, laying, and pinching the skin. Causing a dimpling and cottage cheese appearance of the skin, cellulite is not a disease of excess weight. Mesotherapy treatment is targeted to correct these problems by improving circulation, strengthening connective tissues, and dissolving excess fat.

Hair loss/Alopecia

The loss of hair, affects both men and women. Alopecia results from poor circulation, nutritional imbalances, and the excess of a hormone known as DHT (dihydrotestosterone). Mesotherapy can correct these problems, stimulating the body to naturally grow lost hair.

Face and Neck Rejuvenation with Mesolift

Aging, sagging and wrinkling of the skin occurs from accumulation of fat, loss of skin elasticity and excessive free radical damage. Using antioxidants and amino acids, mesotherapy can remove fat from under the neck, remove free radical damage, and tighten loose skin. The effects rejuvenate the face, eyelids, and neck without the unnatural appearance and painful recovery of surgical face lifting.

Body Sculpting

Contouring of the abdomen, arms, back, legs and hands can be obtained with mesotherapy. Vitamins and amino acids are used to tighten sagging skin while other agents are used to remove areas of fat, restoring a more youthful and athletic appearance to the body’s contours.

Medical uses

Mesotherapy also has a variety of medicinal uses. Treatments can benefit those patients suffering from muscle spasms, stress, insomnia, carpal tunnel syndrome, fibromyalgia, infections, RSD (reflex sympathetic dystrophy), and osteoarthritis, among other conditions. Such a wide variety of conditions can be treated with this technique as each treatment is formulated to meet each patient’s unique problem. Mesotherapy is administered only into the problematic area, avoiding the side effects of taking oral medications. For example, the dosage of medication used to alleviate the pain of osteoarthritis is approximately 1/50th of the comparable to the equivalent oral dose taken over a one-week period.

Mesotherapy:

Cosmetic uses:

Medical uses:

Frequently Asked Questions

How many treatments are required?

Generally, the average patient requires eight to ten treatments. However thin people with problem areas such as “love handles” or “saddlebags” may require less, whereas obese individuals may require more. For acute conditions, such as sports injuries, only one to three sessions may be needed.

What are the side effects?

Side effects are generally limited to bruising. The bruises usually fade within one week.

Can I go back to work after the treatment?

Yes. The procedure generally takes 30 minutes and requires no preparation or recovery time. Furthermore, no heavy bandages or girdles are used.

Are the treatments painful?

The majority of patients experience minimal discomfort with mesotherapy. For those with lower pain thresholds, a numbing cream or painkillers can be used.

How long do the benefits last?

Treatment areas will remain free of unwanted fat as long as the patient maintains a healthy diet and exercise. Treatments for cellulite and for mesolift will require maintenance on a six month to one year basis. Treatment of acute conditions generally do not require maintenance treatments.

How many treatments are required before I see results?

It depends on the patient’s body. Some patients see results after one treatment session while others may require four to five treatments to begin to see results. Often the patient’s clothing will become looser and friends and family will tell the patient they appear thinner. However, mesotherapy for fat reduction is more about losing inches than losing large amounts of weight.

Is mesotherapy different from liposuction?

Yes, it is very different. Besides involving no anesthesia and surgical risk, mesotherapy requires no recovery time. Mesotherapy also removes the fat from the fat cell without destroying it. We believe this helps give mesotherapy its natural appearance. Also, if you gain weight after having mesotherapy, the fat will simply return to the treated area, unlike liposuction, where fat can start to occur in places that had been thin in the past, such as the arms, neck, face and calves.

Symptomatic efficacy of stabilizing treatment versus laser therapy for sub-acute low back pain with positive tests for sacroiliac dysfunction: a randomised clinical controlled trial with 1 year follow-up.
Eura Medicophys. 2004 Dec;40(4):263-8.
Monticone M, Barbarino A, Testi C, Arzano S, Moschi A, Negrini S.

ISICO, Italian Scientific Spine Institute, Milan, Italy. marco.monticone@isico.it

AIM: Back pain is a highly frequent condition due to many causes, although most of them cannot be established with certainty. It is also the current clinical and scientific belief that sacroiliac joint syndrome can be a specific low back pain cause. Nonetheless the existence of clinical tests aimed at highlighting the responsibility for lumbar pain secondary to sacroiliac dysfunction, it is not easy to diagnose it with either manual or instrumental means. Moreover, uncertainty is diffuse when facing a correct treatment for patients involved. The aim of this study was to verify, in patients with acute or sub-acute low back pain and positive sacroiliac signs, the efficacy of a stabilising therapy (orthosis and exercises, with previous mesotherapy) directly targeted to sacroiliac dysfunction versus a symptomatic usual care such as He-Ne laser therapy. METHODS: Over a period of 14 months, we recruited 22 patients (10 females, mean age 44+/-11) with acute and sub-acute low back pain and symptoms and signs suggesting a sacroiliac dysfunction. They were randomised in a Group laser (GL), 11 patients treated with He-Ne laser therapy targeting the sacroiliac region, and a Group stabilisation (GS), 11 patients treated with mesotherapy, a specific dynamic sacroiliac support (ILSA) and specific exercises. Outcome criteria included VAS, and Mens and Laslett sacroiliac tests. RESULTS: Out of 449 acute and sub-acute low back pain out-patients, 22 (4.9%) had symptoms and signs suggesting a sacroiliac dysfunction. A reduction of pain was achieved only in the GS. All pain-provocation and stability tests were negative both after the end of treatment and at the follow-up only in the GS. CONCLUSIONS: A targeted approach based on mesotherapy, a specific sacroiliac belt and specific stabilizing exercises proved its efficacy in acute and sub-acute low back pain patients with symptoms and signs suggesting a sacroiliac dysfunction. As soon as it will be possible to identify particular spine syndromes in the universe of non specific low back pain, there will also be the possibility to employ specific therapies.

U.S. News & World Report, March 10, 2003

Mesotherapy promises to target your fat spots with little hassle, little pain, and big results

BY KATY KELLY, U.S. News & World Report, March 10, 2003

W hat if you could get liposuction results without surgery? In a doctor’s office, over several short visits, with only a smidgen of pain? What if like singer Roberta Flack, you could say, “I lost 21/2 chins almost immediately”?

Flack is mad for mesotherapy, a French alternative treatment that’s gaining popularity stateside. Patients receive 100 to 500 skin-deep injections directly into trouble spots like hips or thighs. The shots usually include tiny amounts of the emphysema drug aminophylline and the heart medication isoproteranol, said to melt fat, along with a homeopathic formula made of sweet clover. The liquefied fat then “time-releases into the body,” where it is either used as energy or excreted, says physician Lionel Bissoon.

… “I’m down from a size 16 to a 10,” says Flack. “I have lost 32 pounds.” Losses come from the right places. “It’s not about pounds,” says Marion Shapiro, a doctor who runs a mesotherapy clinic in West Orange, N.J. “It’s about inches.” After 10 sessions with Shapiro, Lisa Horowitz, 40, took 8 inches off her hips and waist. Says Bissoon patient Linda Marshall, 62: “I’m in a size 6, but suddenly I had a fat back.” After one treatment, she adds, “I could see and feel a difference. Every time I’ve gone there’s less. Now, it’s smooth and tight, the way it was when I was younger.”

The Following is the research paper presented on Mesolift at a Dermatological Conference by Dr Patricia Rittes,MD

The Use of Phosphatidylcholine for Correction of Lower Lid Bulging Due to Prominent Fat Pads
Patrícia Guedes Rittes, MD
Clínica Patrícia Rittes, São Paulo, Brazil

Presented at the 54th Brazilian Dermatology Congress, Belo Horizonte, Brazil, September 1999.

ROUND: Patients with prominent periorbital fat pads often complain of having a persistent "tired" look and seek treatment from their dermatologist.

Objective: A non-surgical treatment of fat pads.

Method of use: Thirty patients were treated for prominent lower eylid fat pads with phosphatidylcholine injection. Pre- and posttreatment photographs were taken for long-term analysis.

Results: A marked reduction of the lower eyelid fat pads was noted over the 2-year follow-up period. There were no recurrences.

Conclusion: The injection of phosphatidylcholine (250 mg/5ml) into the fat pads is a simple office procedure that may postpone or even substitute for lower eyelid blepharaplasty.

INFRAORBITAL FAT PAD herniation results in a prominence of the lower eyelids, causing patients to have a tired and aged appearance. These deformities consist of skin, subcutaneous fat, orbicular muscle, and suborbicular fat. Orbital fat exerts pressure both on the orbital septum and the orbicular muscle, causing a bulge. What appers to be excess skin is often merely the conversity caused by the fat pads appearing under the skin. The precise mechanism of this herniation is controversial.

This deformity may be managed by surgical resection or reinsertion of the herniated fat into the orbital cavity. (1-4) Continuous suture of the capsular palpebral fascia maintains it in its original anatomic site. Herniation of the infraorbital fat pad entity must be distinguished from periorbital edema due to medical problems (such as angioneurotic edema or fluid imbalance).

Phosphatidylcholine has been shown to reduce the systemic levels of cholesterol and triglycerides. (5,6) Bobkova et al. (7) showed that upon increasing phosphatidylcholine, the cell membranes improved their receptor properies, augmented their sensitivity to insulin, and accelerated lipolysis. Phosphatidylcholine has also been employed intravenously in patients with cardiac ischemia. (8) A marked reduction of atheromatous plaques withour a reduction in plasma cholesterol occurs. Phosphatidylcholine is a bile component and is responsible for the lipids’ emulsification from the diet. (9) This article describes the use of phosphatidylcholine injection into the infraorbital fat to reduce the size of infraorbital fat pads.

Materials and Methods

This study conformed to guidelines of th 1975 Declaration of Helsink . An informed consent was obtained from all individuals. Preoperative evaluation included examining the size and location of the fat pads. Baseline photographs were obtained. Patients were also examined for any coexisting ocular pathology. The procedure was performed in an outpatient setting with the patient seated. The skin of the lower lid was pulled downward with the forefinger. Gentle pressure was applied over the globe for better visualization of the fat pad. Using a 0.5 inch, 30-gauge needle, 0.4 ml of phosphatidylcholine

(250 mg/5 ml) was injected into the infraorbital fat pad. The medication was distributed among the there bulging periorbital fat pads (central, medial, and lateral) based on the individual patient’s need.

Anesthetics were not utilized in this study.

Thirty patients with varying degrees of bulging fat pads were included in the study. The patient population included 22 women and 8 men, with ages ranging from 30 to 70 years.

Injections were given at 15-day intervals to allow for complete resolution of infraorbital swelling. Two patients received a total of four aplications, 5 patients a total of three applications, 12 patients a total of two applications, and 11 patients a total of one application. The number of additional injections administered was determined by the clinical response at the end of the 15-day period as observed by the physician and patient.

etic improvement occurred in all patients. Pre-and postprocedure photographs were utilized to document the changes (Figures 1 and 2). All patients complained of mild burning following the injections, which typically lasted about 15 minutes. Immediately following the injections, infiltrative edema and local erythema were noted. Edema of the entire lower lid was noted over the initial 6 hours and persisted for approximately 72 hours.                       

 Figure 1. A 71-year-old patient with prominent fat pads. B) Postprocedure view after three injections of phosphatidylcholine.

Figure 2. A 55-year-old patient with prominent fat pads. B) Postprocedure view after four injections of phosphatidylcholine.

This study offers a nonsurgical alternative for improving "old-looking" eyes by reducing the prominence of bulging infraorbital fat pads through phosphatidylcholine injection. Up until now, all options for treating this entity have been surgically based. Proper patient selection is essential, as this method only treats infraorbital fat . Prominent infraorbital fat pads must be distinguished from other periocular conditions, including prominent malar folds and lax lower eyelid skin. (10)

Because phosphatidylcholine injection does not create scar tissue, ectropion is not a risk. In our experience, the postoperative results offered by phosphatidylcholine injection were as natural in appearance as those obtained from surgical procedures. Postoperative discomfort was also relative to surgery. In addition, no recurrences of protruding infraorbital fat pads were noted.

The cosmetic results observed in this study were satisfactory from both the patients’ and the dermatologists’ point of view. Patient selection is essencial for optimal results. This study provides a simple, nonsurgical office-based procedure for treating prominent infraorbital fat pads.

Acknowledgment I wish to thank Marcelo Gandelman, MD for his help in editing this article and to A.S. Noel MD, French dermatologist and pionner in the surgical excision of fat pads.

Presented at the 54th Brazilian Dermatology Congress, Belo Horizonte, Brazil, September 1999.

References

1. Parsa FD, Miyashiro MJ, Elahi E, Mirzai TM. Lower eyelid hernia repair for palpebral bags: a comparative study. Plast Reconstr Surg 1998;102:7.
2. Sachs ME, Bosnick SL. Correction of true periorbital fat herniation in cosmetic lower lid blepharoplaty. Aesthetic Plast Surg 1986;10:111.
3. Loeb R. Fat pad sliding and fat grafting for livelimp lid depression. Clin Plast Surg 1981;8:757.
4. Hamra ST. The role of orbital fat preservation in facial aesthetic surgery: a new concept. Clin Plast Surg 1996;23:17.
5 . Warembourg H, Jaillard J. Experimentation clinique du lipostabil dans le traitement des angiopathies diabetiques. Lille Med 1968; XIII (suppl):721-3.
6 . N avder KP, Baraona E, Lieber C. Polyenyphosphatidylcholine decreases alcoholic hyperlipemia without affecting the alcoholinduced rise of HDL cholesterol. Life Sei 1997;61:1907.
7 . Bobkova VI, Lokchina LI, Korsunsk BH, Tamamova GV. Metabolic effect of lipostabiforte. Kardiologia 1989;29:57.
8 . Pogozheva AV, Bobkova SN, Samsonov , MA, Vasilév. AV. Comparative evaluation of hypolipidemic effects of omega-3 polyunsaturated acids and lipostabil. Vopr Pitan 1996;4:31.
9 . Montgomery R, Conway T. Bioquímica, 5th ed. 1994:249.
10. Farrior RT, Kassir RR. Management of malar folds in blepharoplasty. Laringoscope 1998;108:1659-63.

MD has indicated no significant interest with commercial supportes.
Address correspondence and reprint requests to: Patricia Guedes Rittes, MD, Rua José do Patrocínio, 92 Aclimação, São Paulo SP – Brazil, CEP 04108-13, or e-mail: prittes@prittes.com.br.

© 2001 by the American Society for Dermatologic Surgery, Inc. – Published by Blackwell Science, Inc. ISSN: 1076-0512/01/$15.00/0 – Dermatol Surg 2001;27:391-392

 The Following is a research article on the use of Mesotherapy in treating pain and sports injuries

The Use of Mesotherapy in Sports Medicine
Bernard Montalvan, M.D., Jacques Parier, M.D., and Denis Laurens, M.D., French Tennis Federation, Stade Roland Garros, 2, Av. Gordon Bennett, 75016 Paris, France

Mesotherapy is a simple French therapeutic technique that is widely used in Europe, although it is not well known in the US. It involves a local injection of medication into the mesoderm, as close to the site of injury as possible. It is used primarily for its analgesic, anti-inflammatory and muscle-relaxing effects.

In sports medicine, it can be of benefit to players with soft tissue injuries, who naturally aim to be able to return to play at the earliest opportunity. Sports trauma is often implicated in the treatment of soft tissue injuries. In most cases, the congestive and inflammatory reaction of these tissues before healing justifies taking pain-killing and anti-inflammatory medication.

The physician must not ignore the possibility of recurring traumatism, however, which means that repeated doses of medication will be needed and can be a cause of concern to the prescribing doctor (for reasons of digestive tolerance, risk of allergies, etc).

In the mesotherapeutic treatment of sports trauma, we currently use the following products.

• Procaine or Lidocaine, which serve as vectors and improve the diffusion of the products (Lidocaine for acute pathologies, Procaine for chronic pathologies)
• An anti-inflammatory (Piroxicam)
• A muscle relaxant (Thiocolchicoside)
• Salmon calcitonine and vasodilators.

These are injected into the mesoderm around the area to be treated, using 4 mm 'Lebel' needles. These can be used once only. The syringe can contain 1ml, 5ml or 10 ml according to the zone to be treated.

Procaine and Lidocaine are Class IIIC products. Local injections are authorized only when administration is medically justified. Where health regulations require, it may be necessary to notify the authorities.

When to use mesotherapy
Mesotherapy can be used for the following indications:

• Post-traumatic articular or peri-articular inflammation, such as sequelae of a sprained ankle
• Inflammation of a tendon and/or peritendonitis
• Achilles tendinopathy, plantar fasciitis or extensor carpi ulnaris tendinopathy
• Quadricipital tendinopathy
• Muscle contraction: backache, torticollis or lumbago
• Spinal pain: facet syndrome.

The main two types of contra-indications are:

• Known allergy to one of the injectable substances
• Poor skin condition.

Treatment
The equipment must only be used once. The physician should wash his hands with an antiseptic product and the skin around the area to be treated must be disinfected with an iodised product.

The injection technique is very simple. The needle penetrates at an angle of 60º up to the stop. On average, 6 to 10 injection points are used, introducing a mean of 0.1 cc mixture. If the zone to be treated is larger, more liquid is injected. After treatment, no cream or ice should be applied and no massage should be used. A dressing should be kept over the treated area for at least three hours.

Follow-up sessions can be given on the third and seventh day after the first treatment. Efficiency should then be evaluated.

Tolerance and side-effects
Tolerance of the mesotherapy technique was examined in a French national study of 2,839 patients. Overall, tolerance of the technique was excellent. No anaphylactic or vagal shock was observed. Neuro-vegetative reactions (sweating, pallor) decreased in follow-up sessions. Side-effects essentially involved the injection site. The table below shows the local effects. The most frequent were pain at the injection points, which was frequent but tolerable. Haematomas were small and disappeared in a few days.

The French Mesotherapy Society is currently conducting studies to explore and explain the method of action of this therapeutic technique. Further details are available at the Society's website: www.sfmesotherapie.ifrance.com.

Conclusion
In our experience, mesotherapy can be a useful technique for the treatment of sports trauma and micro-trauma. There are virtually no adverse effects if the contra-indications are respected. The doses of medicinal drug injected are tiny, which contributes to the good general tolerance of the technique. However, the technique has not yet been explored sufficiently and the lack of scientific validation is a frequent handicap that we encounter in sports medicine and the fight against pain.

http://www.healthplusweb.com/alt_directory/mesotherapy.html

http://www.mesodoc.com/http://www.mesodoc.com/

http://www.azcentral.com/health/diet/articles/mesotherapy.html

http://www.drmagaziner.com/mesotherapy.htm