Mesotherapy Gaining Ground as Surgery-Free Fat Reducer


ORLANDO, FLA. — Mesotherapy targets and reduces spot fat without surgery and offers several advantages, compared with liposuction, said Gerald M. Parker, D.O., at an obesity symposium sponsored by the American Society of Bariatric Physicians.

Originally developed to manage localized pain, mesotherapy has aesthetic possibilities that have gained recognition in the past 2-3 years, said Dr. Parker. "It is now being touted as the latest breakthrough in body sculpting, cellulite reduction, and spot fat reduction," he said.

Proper patient selection is paramount. "This is a new therapy in the United States. If you get into this, make sure you are doing it on the right candidates," Dr. Parker emphasized. Appropriate candidates are 15-30 pounds overweight with small or moderate areas of fat. Patients who are more overweight than that will not get the same results, said Dr. Parker, a bariatric physician in private practice in Dallas.

Blood work is recommended before starting. A physician injects various substances into the skin's mesoderm layer—which gives mesotherapy its name—including vitamins, minerals, amino acids, essential phospholipids, homeopathic remedies, or medication. The selected substances target fat cell surface receptors and lyse the cell walls.

"Just about anywhere you have fat, you can treat it," Dr. Parker said. Generally, patients request 4-6 treatment sessions. Mesotherapy can be used for the abdominals, legs, inner thighs, arms, and cellulite.

"Cellulite is a big area because there are no effective treatments. Cellulite is even a problem in younger women who are not overweight," he said.

Another application is treatment of lower eyelid fat pads. In a study at the University of California at Los Angeles, 80% of 13 patients injected with the lecithin-derived phospholipid phosphatidylcholine showed improvement (Dermatol. Surg. 2004;30:422-7). Results after three to five sessions indicate that mesotherapy may be a good alternative to blepharoplasty surgery, according to the authors.

In an unpublished study conducted for the American College of Medical Meso-Lipotherapy, Dr. Parker treated the abdominal area of 50 patients in four sessions. After 6 weeks, the average reduction in waist circumference was 3.34 inches, although there was a "pretty typical" range of 1-8 inches.

"I tell my patients they can expect to lose about a quarter inch per session if they do nothing else and half an inch with diet and exercise," Dr. Parker said. "We've seen up to 2 inches to 3 inches at a time—striking results—if people are very aggressive."

Researchers agree that to maintain results, patients treated with mesotherapy need to eat properly and exercise. "About the only people who do not get a response to mesotherapy are those who go out and do everything they shouldn't," Dr. Parker said.

Unlike liposuction, mesotherapy carries no risk of postprocedure "denting" if a patient gains weight, and almost no risk of infection if good hygiene practices are followed. Patients typically experience some minor swelling.

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