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Comment on “Mesotherapy and Injection Lipolysis”
Comment on ‘‘Mesotherapy and Injection Lipolysis’’ Jack A. Friedland, MD KEYWORDS
The authors of ‘‘Mesotherapy and Injection Lipolysis’’ state that the purpose of their article is to familiarize readers with the evolution of mesotherapy, injection lipolysis, and the use of phosphatidylcholine and deoxycholate for subcutaneous fat reduction. The clinical application of mesotherapy was not preceded by rigorous scientific study of the chemicals and their use, which is necessary to establish their safety and efficacy. The process and the formulas have not been approved by the US Food and Drug Administration. The evolution of mesotherapy for reducing subcutaneous fat and improving body contour is reviewed by the authors in great detail. Opinion differs regarding the various formulas and ingredients, and a debate exists within the community of mesotherapy practitioners as to which techniques are most appropriate. Differences exist regarding exactly where, how much, and how often the chemicals are to be injected. This lack of standardized formulas and protocols makes it virtually impossible to validate results and compare reports of efficacy. In addition, many complications and side effects from the treatments have been reported. Although some practitioners of mesotherapy are properly trained in medicine, in many countries, including the United States, unlicensed or unsupervised practitioners are providing treatments. These individuals may not be properly trained, and more often than not they do not have the ability to fully evaluate a patient’s
condition or offer appropriate alternative treatments necessary to care for complications. In addition, mesotherapy injections contain ingredients that are inexpensive and easily obtainable, and the solutions used may not be standardized or even completely sterile. The promise of a simple nonsurgical, noninvasive, permanent method of reducing subcutaneous fat is very appealing. I do not believe that mesotherapy should be considered as an alternative to surgical liposuction. When mesotherapy is used in conjunction with dietary modification, hormone replacement, exercise, and nutritional supplements, the attribution of the results from mesotherapy (any reduction of subcutaneous fat) is difficult to precisely identify. ‘‘Mesotherapy and Injection Lipolysis’’ thoroughly reviews the research that has been done to clarify mechanisms by which mesotherapy might possibly work, but the reduction of fat deposits after subcutaneous injections is not completely understood. As physicians, we must strive to evaluate new treatment modalities through rigorous scientific study, while at the same time keeping an open mind about potential new therapies that could benefit patients. This article by Drs. Matarasso and Pfeifer is one of the most extensive, yet most easily understandable reviews of this subject, and it should be required reading for all plastic surgeons who perform procedures for body contour improvement.
7425 East Shea Boulevard, Suite 103, Scottsdale, AZ 85260–6411, USA E-mail address: [email protected] Clin Plastic Surg 36 (2009) 193 doi:10.1016/j.cps.2008.11.012 0094-1298/08/$ – see front matter ª 2009 Elsevier Inc. All rights reserved.
plasticsurgery.theclinics.com
Mesotherapy Injection lipolysis Subcutaneous fat reduction Non-surgical body contour improvement
The authors of ‘‘Mesotherapy and Injection Lipolysis’’ state that the purpose of their article is to familiarize readers with the evolution of mesotherapy, injection lipolysis, and the use of phosphatidylcholine and deoxycholate for subcutaneous fat reduction. The clinical application of mesotherapy was not preceded by rigorous scientific study of the chemicals and their use, which is necessary to establish their safety and efficacy. The process and the formulas have not been approved by the US Food and Drug Administration. The evolution of mesotherapy for reducing subcutaneous fat and improving body contour is reviewed by the authors in great detail. Opinion differs regarding the various formulas and ingredients, and a debate exists within the community of mesotherapy practitioners as to which techniques are most appropriate. Differences exist regarding exactly where, how much, and how often the chemicals are to be injected. This lack of standardized formulas and protocols makes it virtually impossible to validate results and compare reports of efficacy. In addition, many complications and side effects from the treatments have been reported. Although some practitioners of mesotherapy are properly trained in medicine, in many countries, including the United States, unlicensed or unsupervised practitioners are providing treatments. These individuals may not be properly trained, and more often than not they do not have the ability to fully evaluate a patient’s
condition or offer appropriate alternative treatments necessary to care for complications. In addition, mesotherapy injections contain ingredients that are inexpensive and easily obtainable, and the solutions used may not be standardized or even completely sterile. The promise of a simple nonsurgical, noninvasive, permanent method of reducing subcutaneous fat is very appealing. I do not believe that mesotherapy should be considered as an alternative to surgical liposuction. When mesotherapy is used in conjunction with dietary modification, hormone replacement, exercise, and nutritional supplements, the attribution of the results from mesotherapy (any reduction of subcutaneous fat) is difficult to precisely identify. ‘‘Mesotherapy and Injection Lipolysis’’ thoroughly reviews the research that has been done to clarify mechanisms by which mesotherapy might possibly work, but the reduction of fat deposits after subcutaneous injections is not completely understood. As physicians, we must strive to evaluate new treatment modalities through rigorous scientific study, while at the same time keeping an open mind about potential new therapies that could benefit patients. This article by Drs. Matarasso and Pfeifer is one of the most extensive, yet most easily understandable reviews of this subject, and it should be required reading for all plastic surgeons who perform procedures for body contour improvement.
7425 East Shea Boulevard, Suite 103, Scottsdale, AZ 85260–6411, USA E-mail address: [email protected] Clin Plastic Surg 36 (2009) 193 doi:10.1016/j.cps.2008.11.012 0094-1298/08/$ – see front matter ª 2009 Elsevier Inc. All rights reserved.
plasticsurgery.theclinics.com
Mesotherapy Injection lipolysis Subcutaneous fat reduction Non-surgical body contour improvement