MESOTHERAPY - SPOT FAT REDUCTION
You know that sagging skin develops slowly as collagen, elastin, and hyaluronic acid become deficient. Now just imagine the body areas of sagging skin where fat accumulates underneath. Mesotherapy is an injected solution that has been well proven[1] to cause permanent fat necrosis; therefore, it safely dissolves fat.
 
These are the “spot fat” areas that can be successfully treated with mesotherapy:
 
  • Eye pads
  • Double (or triple) chin/submental region/jowls
  • Arms
  • Buffalo hump
  • Love handles
  • Abdomen
  • Back bra bulge area
  • Flanks
  • Hips
  • Thighs: saddlebags (upper outer)
  • Thighs: inner
Since 1987, physicians from Italy and France used phosphatidylcholine for the first time to treat localized fat deposits. After numerous smaller studies later showed it to be effective and safe, the first mesotherapy training programs were established in North America in 2004. I attended one of those in Las Vegas, NV in 2005, although I never implemented it into practice at that time. Since 2010 there have been more than 100,000 healthcare providers of mesotherapy worldwide and have provided hundreds of thousands of treatments cumulatively.[2]
Mesotherapy ingredients
You’ll be pleased to know that there are only three simple ingredients in the mesotherapy solution that is injected into these spot fat body areas listed above. It is the combination of these ingredients that quite safely dissolves fat cells. Let me tell you about them.
 
Phosphatidylcholine (PC)
It was first identified as a common fat emulsifier in foods, called Lecithin.  In 1959 a study showed it increases the solubility of cholesterol and reduced triglyceride levels. Since then, the FDA has classified phosphatidylcholine as a nutrient supplement to boost cognitive function; phosphatidylcholine makes up nearly 40% of human cell membranes.
 
Sodium deoxycholate (DC)
This is a natural, non-allergenic bile salt that dissolves fat.
L-carnitine
This amino acid is naturally produced in your body from lysine and methionine. It is important for heart, brain and muscle function. It is used in mesotherapy because it shuttles fat into the mitochondria of cells to be utilized as energy.
Mesotherapy procedure technique and results
Although the procedure is similar, the amounts and injection details vary depending on the body area. In general, many small injections of 0.1 to 0.8 ml are placed 1-2 inches apart, into the center of the fat pad area being treated using a tiny 30 or 31-gauge needle. Lidocaine mixed with the solution makes it almost painless. Most small fat pocket areas require 3-4 injection sessions, every 4-5 weeks to allow for healing between treatment sessions.
 
In general, you can expect to have 85% overall satisfaction from mesotherapy lipolysis, with tolerable pain (after injections for a few hours) and minimal risks. 
ideal mesotherapy patient
  • Small areas of asymmetry, small localized areas of fat.

  • Good metabolism and BMI below 25.

  • Post-liposuction resulting in unevenness or lumps.

  • Understands the "alternative" nature of the procedure. 

  • Has realistic expectations

  • Does not want surgery of liposuction.

  • Does not have loose skin or stretch marks

  • Is more concerned with how clothes fit than appearance in the mirror, understands mesotherapy is not for weight loss.

  • Able to follow a high-protein, low fat diet during the treatments. 

relative contraindictions
  • Obesity​

    • BMI over 30 (results will be poor at best)

  • Age under 21 (Diet)​​

  • Inability to follow a weight loss plan for 1/2 to 1 pound a week.

    • High protein/low fat diet is required

  • Poor metabolism ​

    • Stress, lack of sleep or lack of exercise​

    • Hypothyroid state

  • Unrealistic expectations or distorted body image​

  • Unhappy with prior cosmetic procedures​

COMMON TREATMENT AREAS
  • Eye pads

  • Double (or triple) chin/submental region

  • Jowls and chin

  • Arms

  • Buffalo hump

  • Love handles

  • Abdomen spot fat pockets

  • Back bra bulge area

  • Flanks

  • Hips

  • Thighs: saddlebags (upper outer)

  • Thighs: inner

PRE-TREATMENT INSTRUCTIONS
  • AVOID will bark or Gingko Biloba supplements for at least 10 days prior to treatment. 

  • AVOID aspirin, vitamin E, anti-inflammatory drugs such as Motrin, Advil, or Aleve for at least 5 days prior to treatment. 

  • On the morning of your treatment:

    • Wash area to be treated vigorously with antibacterial soap. ​

    • Do not use any lotions, creams, bath oils, or sprays on the areas to be treated. 

    • Apply your arnica cream 2+ hours before treatment.

  • Eat a light, high-protein meal 2-4 hours before you treatments. ​

POST-TREATMENT INSTRUCTIONS
  • You may go back to work

  • AVOID hot baths or showers for at least 48 hours. 

  • Drink at least 72 ounces of water the day of your treatment.

  • No hot tubs (over 102 degrees) or saunas for at least two weeks after your treatment. 

  • No vigorous exercise for 48 hours. 

  • Continue to use your ARNICA cream 3-4 times a day for the next 2-3 days. 

    • DO NOT use any other creams or lotions on the treated areas for 48 hours. ​

  • AVOID even casual sunbathing for 48 hours. After then, use at least an SPF ​30 sunscreen whenever treated areas are exposed to any sunlight for two weeks after the procedure. Do not sunbathe intensely or use tanning beds during these two weeks, 

MESO-LIPOTHERAPY DIET
  • Any high protein/ low fat diet can be used

  • 25GM high protein, low fat meals on day of treatment.

    • Consider protein shake or bar before treatment​.

  • 72 ounces of water per day​

    • Restrict caffeine intake​

  • Low-Carb, low saturated fat diet designed to lose 1/2 pound per week. Foods include:​

    • Salad​

    • Steamed Vegetables

    • Baked Meat

    • Baked Chicken

    • Baked Fish

REACTIONS TO PC/DC LIPOTHERAPY
  • Itching - 95% of patients

    • Minutes after injection​

    • Histamine release, activation of lipase

  • Erythema & hives at injection sites - 70%+​

  • Stinging and burning - 90%

  • Lumps of inflammatory debris (avoid intramuscular injections)

    • 2 weeks or longer​

    • possible necrosis of tissue

  • Brusing - 16% ​

  • Nausea - 10%

  • Persistent swelling/erythema

    • Rare beyond 24 hours - erythema​

    • Swelling peaked at 1-3 days a week = <10%

    • Consider steroid taper is symptoms do not improve after 72 hours

    • Always rule out infection

  • Side effects with successive treatments​

    • Limit your injection volume to 10cc on first visit​

      • Higher risk of side effects encountered for first visit​

    • No more than 20cc total volume on second visit​

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