What Is Mesotherapy?
You may have heard of mesotherapy. I came across the term while researching Kybella (treatment for a double chin) for a post. I didn't know much about it. Turns out, mesotherapy has been around a while, but it never really caught on here in the U.S. I found an article about mesotherapy in the International Journal of Pharmaceutical Sciences Review and Research. The article defines mesotherapy this way:
"Mesotherapy is a general term describing a technique that utilizes a series of injections to perfuse liquid preparations inclusive of medications and other substances into the subcutaneous tissue (the “mesoderm”) to treat local medical and aesthetic conditions. It does not denote treatment of a specific medical or cosmetic condition, although it has widely been publicized as a method for anti-aging and as a means of “melting fat” for body contouring."
What does that mean - in plain English, please?
Mesotherapy is an injection technique. You're given a LOT of shots into the bottom layer (hypodermis) of your skin where it attaches to your muscles. Often the procedure uses a medication that has been mixed specifically for the patient. Many times, these drugs are not approved by the FDA for injection.
Mesotherapy is used to treat different conditions. Antiaging and body contouring are the most common.
So why is it called mesotherapy? A human embryo goes through rapid growth in the first few days after it is conceived. During this time, the mesoderm is formed. It is one of three important embryonic layers and later becomes our organs. As the embryo develops the mesoderm forms the inner layers of our skin - thus the name mesotherapy - the muscles and bones, the kidneys, bladder and ovaries or testes. Too much science? Ok, ok! I'll move on. : )
The French Like Mesotherapy.
One WebMD article calls mesotherapy, "The French Way to Lose Weight:"
"Developed in 1952 in France by Dr. Michel Pistor, originally for the treatment of vascular and infectious diseases, sports injuries, and the improvement of circulation, the technique involves the injection of small amounts of various medications into the mesoderm, the layer of fat and connective tissue under the skin. The theory is that when these small amounts of medication are injected into the mesoderm, underlying fat is melted."
In fact, mesotherapy is so widely used in France that in 1987, it was recognized by the French Academy of Medicine as an integral part of their traditional medicine.
Why hasn’t mesotherapy caught on here?
I think part of the problem is that mesotherapy is used to inject medications that are not FDA approved. Either the medications are not approved by the FDA at all - OR - they're not approved to be used in lots of small injections (like in mesotherapy).
Here's a great example. The Hair Transplant Clinic in Dubai offers mesotherapy for hair restoration. This is the way they describe it on their website:
"It (mesotherapy) involves the administration of numerous micro-injections to the middle/dermal layer of the skin. The injections contain vitamins, minerals, collagens, acids, and enzymes."
Because this Hair Transplant Clinic is in Dubai, the U.S. FDA guidelines don't apply. But that still doesn't mean the treatment is safe.
Dr. Rod Rohrich, a plastic surgeon in Dallas, Texas, explains in an interview with WebMD (2003), that there there have been no proven scientific benefits or merits of mesotherapy.
"This borders on medical experimentation. Injecting unknown substances into someone with multiple needle sticks is almost unconscionable."
Dr. Rohrich also adds that proponents of mesotherapy say it can be used for almost anything, "but with no scientific data, this should not be done on human beings." He says, "It preys on the consumer who wants to look for a quick solution, but there are no shortcuts to good health."
So why do people get mesotherapy?
Some clinics offer mesotherapy for face and neck rejuvenation. And it's said that it can reduce pain and restore hair. Mesotherapy is also used to treat cellulite and for weight loss / body contouring. When it's used for fat loss, you may hear it called injection lipolysis (some people use mesotherapy as an alternative to liposuction).
Two commonly used ingredients in mesotherapy for body contouring / injection lipolysis are phosphatidylcholine (PPC) and sodium deoxycholate (DC). Both ingredients are found naturally in the human body. Both ingredients are also approved by the U.S. FDA for use as surfactants and drug carriers. Neither is approved for subcutaneous injection into fat.
Formulas with these 2 ingredients are commonly used in mesotherapy. They are injected into subcutaneous fat to kill fat cells. The two that are most commonly used are Lipodissolve™ and Lipostabil.™ As mentioned above, neither is approved by the FDA. In fact, in the United States, it is illegal to import or use them.
Some pharmacies have compounded their own formulations of PPC & DC. Again, the problem is that there is no set standard for manufacturing and sterility. You have no way to know if the injection you get is safe or effective.
What made some doctors think that PPC & DC might work for body contouring?
Interest in using Lipostabil for aesthetics started in 2001. That's when Dr. Patricia Guedes Rittes, a dermatologist in Brazil, reported her results from injecting Lipostabil below her patients' eyes. She treated about 1300 patients with PC for fatty eye bags. Soon after that, articles appeared in American magazines about people who had successfully used Lipostabil to eliminate eye bags.
Lipostabil is the trade name for intravenous (IV) 5% PPC + 2.5% DC. It's been used for over 30 years in Europe, South America and South Africa. The manufacturer, Aventis, markets it as an IV drug to treat high blood cholesterol. PPC is an inactive ingredient in several FDA approved drugs. It's also used to treat respiratory distress in premature babies. But the Brazilian Health Ministry banned Lipostabil for cosmetic use in 2002 because of a lack of proof that it works and is safe. Following this, the Medicines and Healthcare products Regulatory Agency in the U.K. and the FDA issued strong warnings against its use.
Research on PPC + DC continued and it was discovered that DC, sodium deoxycholate, was the active ingredient in mesotherapy that caused weight loss - not PPC as previously thought. Researchers think DC works as a detergent. It destroys the fat cell membrane, causing cell death.
The FDA approved ATX-101 (deoxycholic acid [DCA] injection) - you've probably heard it called Kybella - in 2015 for treatment of fat underneath the chin. It is the first - AND ONLY - FDA approved drug for injection adipolysis (also called lipolysis).
Why do people get liposuction - and what is it?
Liposuction is a kind of cosmetic surgery that requires anesthesia. A hollow tube called a cannula is inserted underneath the skin then a high pressure vacuum sucks out fat. It permanently removes fat cells to change the shape of your body. Liposuction is used for body contouring. It isn't a treatment for obesity. The most commonly treated areas are the abdomen, back, butt, chest, inner knees, hips, love handles, neckline, thighs, upper arms, and the area under the chin.
People who maintain a healthy weight get the best results. Those who gain weight may find their fat accumulates in new areas. For example, say you had pockets of fat on your stomach before liposuction. If you gained weight, you might see it on your hips after liposuction.
Liposuction was the most common cosmetic surgery in the U.S. in 2014.
For the sake of argument, let's compare traditional mesotherapy for body contouring (not Kybella) & liposuction.
Advantages of Liposuction for Body Contouring:
- Developed in 1987 and has since become the gold standard for subcutaneous fat removal.
- The medical equipment and medications used for liposuction are regulated by the FDA.
- The FDA oversees problems with liposuction via it's MedWatch Program. In the program, health professionals or consumers are asked to report serious adverse reactions or other problems related to equipment or medications used for liposuction.
- Liposuction is effective and permanently removes fat from areas like your stomach, thighs, and back (if you maintain a stable weight & stay fit).
- Immediate weight loss.
- Large amounts of fat can be removed (5 liters or more).
Advantages of Mesotherapy for Body Contouring:
- When an anesthetic cream is used, there's very little pain.
- Little to no scarring when done well.
- Less expensive than liposuction. Well, maybe. See disadvantages of mesotherapy below.
- Mesotherapy injections are not as invasive as surgery.
- Some doctors have seen good results.
Disadvantages of Liposuction for Body Contouring:
- Liposuction is expensive. In 2016, the average cost of liposuction was $3,200. That cost does not include anesthesia, the operating room, or any other related expenses.
- Liposuction is surgery.
- Scarring is possible and is dependent on the skill of your surgeon.
- Recovery can take weeks. Swelling may take several months to go away.
- Not covered by insurance
- Does not improve skin tone
- Requires anesthesia
- Possible side effects include swelling, bruising, infection, blood clots, skin numbness, loose skin, and fat embolism.
Disadvantages of Mesotherapy for Body Contouring:
- This procedure uses compounded drugs that are not approved by the FDA for injection.
- Healthline.com says the treatment costs between $250 - $600 per session. Anywhere from 3 - 15 sessions may be needed. So your total cost can range anywhere from $750 - $9,000.
- There's no proof that mesotherapy works. So it may not work for you.
- There are no standard formulas for mesotherapy. So different doctors will give very different treatments for the same condition in the same person.
- Not covered by insurance
- Does not improve skin tone
- Side effects may include nausea, pain, sensitivity, swelling, itching, bruising, bumps at the injection site, dark patches of skin, rash, infection & scars.
- Because there are no standards for manufacturing and sterility, there's a chance the injections could hurt you.
Well, if Kybella is based on mesotherapy . . .
I think it's worth stating - it looks like there's some good science behind mesotherapy for body contouring. But I think it's important to wait until the research has been done before jumping into a treatment that lacks scientific proof.
There’s a very big difference between Kybella and the mainstream mesotherapy you hear advertised.
Kybella is a drug that has been approved by the FDA. That means it's been studied in clinical trials and proven safe.
But that's not the case with other drugs used in mesotherapy – like hair restoration with vitamins, minerals, collagen, and enzymes, etc. Often these drugs have been approved for other purposes. But they are NOT approved to be combined in injections or injected into multiple places.
As you've seen, Kybella's roots are in mesotherapy. And it works! Right now, Kybella is only approved for use underneath the chin. But in Europe, it's already being used on elbows, knees, and abdomens. I really think it's just a matter of time till it's approved for use on other body parts.
I guess I'm trying to say . . . if liposuction isn't for you, I think Kybella - and new injection lipolysis studies - are worth the wait.
How about you? Have you tried mesotherapy? Did it work? I'd love to hear! Email amy {at} masterpieceskinrestoration {dot} com. Let's talk!
You may also enjoy our posts, Liquid Facelift Vs. Surgical Facelift – Which is Better?, Tattoo Safety – 13 Ways to Stay Healthy When You Get a Tattoo and 8 Ingredients in Lip Balm & Cosmetics That Cause Allergies.
Amy Takken, RN
Amy Takken is a registered nurse with 20+ years of experience helping people improve their health. Her in-depth skincare articles have been featured on Nazarian Plastic Surgery and The Palm Beach Center for Facial Plastic & Laser Surgery. She's also been quoted on Dermascope.com.
Amy loves research and constantly watches for new products and treatments to help you improve your skin’s health – because healthy skin is beautiful! To reach Amy, visit our contact page.
Masterpiece Skin Restoration is your online resource for all things medical aesthetics, skincare, beauty, and wellness. We keep you up to date on leading edge technology and the services available to help you restore your natural beauty.
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References:
https://pdfs.semanticscholar.org/9b6f/af40d5ff3b40413b398df7789d2f481a6231.pdf Mesotherapy - A Non-Surgical Cosmetic Medicine Treatment: A Review
https://www.plasticsurgery.org/cosmetic-procedures/liposuction/cost
https://www.healthline.com/health/mesotherapy#cost
https://www.oregon.gov/omb/board/philosophy/Pages/Mesotherapy-and-Injection-Lipolysis.aspx
https://www.medicalnewstoday.com/articles/95640.php What Is Mesotherapy Treatment?
https://www.webmd.com/diet/features/french-way-to-lose-weight#3
https://www.drjhall.com/1756-2/ The History of Kybella
https://www.ncbi.nlm.nih.gov/pubmed/18370980 Tissue-toxic effects of phosphatidylcholine/deoxycholate after subcutaneous injection for fat dissolution in rats and a human volunteer.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5300726/ Injection Adipolysis: Mechanisms, Agents, and Future Directions
https://www.sanovadermatology.com/neck-lift/what-is-mesotherapy/
https://www.quackwatch.org/06ResearchProjects/meso3.html
https://www.webmd.com/beauty/news/20100407/fda-cracks-down-lipodissolve-hype#1
https://study.com/academy/lesson/mesoderm-layer-definition-development-formation.html
https://www.leaf.tv/3352412/exercises-to-lose-cellulite-in-the-thighs/
https://en.wikipedia.org/wiki/Mesoderm
https://academic.oup.com/asj/article/23/5/413/215303 Lipostabil: The Effect of Phosphatidylcholine on Subcutaneous Fat
https://www.realself.com/question/long-beach-ca-kybella-areas-body-fat-gathers-elbow
https://en.wikipedia.org/wiki/Injection_lipolysis
https://www.medicalnewstoday.com/articles/180450.php What are the benefits and risks of liposuction?
https://journals.lww.com/psnjournalonline/Citation/2015/04000/Plastic_Surgical_and_Nonsurgical_Procedure.1.aspx Plastic Surgical and Nonsurgical Procedure Statistics 2014
Disclaimer:
The Information provided on our website is not medical advice and should not be viewed as such. By law, only a medical doctor can diagnose or give medical advice. As a registered nurse, my goal is to educate, so I provide information on skin care, skin care products, and skin care treatments. If you have any condition that concerns you, please see a medical doctor. While most skin conditions are benign, some - like melanoma - can be deadly. If there is any doubt, please, please consult your physician. Thank you!