What Is Mesotherapy?

Treatments most properly called “injection lipolysis” have been commonly associated with the term “mesotherapy” to reduce or eliminate unwanted local accumulations of fat.  Various terms for treatments that purport to “dissolve” fat seem to be used interchangeably, although “mesotherapy” has gained prominence in the public vernacular.

Injection lipolysis is typically done with trade-named products such as Lipodissolve™ and Lipostabil™ or with proprietary formulations provided by compounding pharmacies.  The one common ingredient in all injection lipolysis formulations is phosphatidylcholine (PPC).

In the United States, sodium deoxycholate (DC), a constituent of bile, is a second major ingredient used to keep the PPC soluble and in an injectable form without precipitating out of solution.

Phosphatidylcholine (PPC) and sodium deoxycholate (DC) are both phospholipids, emulsifiers, and surfactants. PPC is the most abundant phospholipid component of cell membranes, a precursor to acetylcholine, and a constituent of lipoproteins.  DC is a constituent of bile.  Both substances are naturally present in the human body.

In contrast to injections into the mesoderm, injection lipolysis treatments are delivered into the subcutaneous fat.  In both cases, the depth of injection is critical to prevent damage to fascia.  It has been hypothesized that treatment with PPC and DC reduces subcutaneous fat by adipocyte necrosis due to direct toxic or surfactant effects.

Phosphatidylcholine (PPC) and sodium deoxycholate (DC) are both approved by the U.S. Food and Drug Administration (FDA) for use as surfactants and drug carriers, among other applications, but neither is approved for subcutaneous injection.  Lipodissolve™ and Lipostabil™ are not approved by the FDA.

Proprietary formulations of PPC / DC and other drugs have been manufactured by compounding pharmacies, yet such formulations lack standardization in terms of good manufacturing practices and sterility.

The FDA is well aware that injections to reduce fat deposits are performed, but the agency thus far has not exercised its enforcement power to restrict the use of compounded PPC / DC.

What Are The Benefits Of Mesotherapy Over Liposuction?
Liposuction does not treat cellulite. In fact, liposuction often causes existing cellulite to appear more prominent. Mesotherapy treats cellulite directly, promoting smoother skin and reducing fat in selected areas. Fat deposits are flushed from the body, and do not reappear in other areas, which often occurs after liposuction. Mesotherapy does not require hospitalization, general anesthesia or downtime.

How Is This Treatment Performed?
Using a fine needle, Jannelle Riguez ARNP injects into the mesoderm the specific formula selected to treat your condition. The needles penetrate the body at only a very small depth. The number of injections and strength of each medication treatment is determined on an individual basis. Generally, patients require one treatment every ten to fourteen days depending on the location and size of the area being treated. The injections are made at small distances, 1 inch intervals along the affected area, and in small doses per treatment.  Following the injections, the fat is emulsified into fatty acids and burned off as energy and otherwise metabolized. The mesotherapy injections are performed by hand or using a specially designed gun delivery system.

What Can Patients Expect Following Treatment?
Results vary depending on your body type and the condition being treated. On average, patients notice visible improvement in two to three sessions. For certain conditions, patients see results after the first session.

Safety and Efficacy of Injection Lipolysis

To date, reports on the safety and efficacy of injection lipolysis have been anecdotal.  Any clinical study involving subcutaneous injection of these drugs requires FDA approval of an investigational new drug (IND) application plus IRB approval.

Reports of adverse events, including mycobacterium skin infections have been reported following the injection of compounded preparations for injection lipolysis.