Skip to main content
Top
Published in: Aesthetic Plastic Surgery 6/2008

01-11-2008 | Review

Cosmetic Mesotherapy: Between Scientific Evidence, Science Fiction, and Lucrative Business

Authors: Bishara S. Atiyeh, Amir E. Ibrahim, Saad A. Dibo

Published in: Aesthetic Plastic Surgery | Issue 6/2008

Login to get access

Abstract

Mesotherapy, originally conceived in Europe, is a minimally invasive technique that consists of the intra- or subcutaneous injection of variable mixtures of natural plant extracts, homeopathic agents, pharmaceuticals, vitamins, and other bioactive substances in microscopic quantities through dermal multipunctures. Its application in cosmetic medicine and surgery is gaining in popularity and acceptance and is rapidly growing in profile at an alarming rate. Despite their attraction as purported rejuvenating and ‘‘fat-dissolving’’ injections, the safety and efficacy of these novel cosmetic treatments remain ambiguous, making mesotherapy vulnerable to criticism by the generally more skeptical medical community. The technique is shrouded in mystery and the controversy surrounding it pertains to its efficacy and potential adverse effects that are subject of much concern. As with any new technology, it is important to assess the benefits, safety, experience, and standardization of mesotherapy. More studies are necessary before it can be advocated as a safe and effective treatment for body contouring and facial rejuvenation. Although the claims made about mesotherapy may be hard to believe at face value, we must be cautious about rejecting new ideas. Just as absence of proof is not proof of absence, lack of scientific validation is not proof that it does not work.
Literature
2.
go back to reference Rittes PG (2001) The use of phosphatidylcholine for correction of lower lid bulging due to prominent fat pads. Dermatol Surg 27:391–392PubMedCrossRef Rittes PG (2001) The use of phosphatidylcholine for correction of lower lid bulging due to prominent fat pads. Dermatol Surg 27:391–392PubMedCrossRef
3.
go back to reference Nagore E, Ramos P, Botella-Estrada R, Ramos-Níguez JA, Sanmartín O, Castejón P (2001) Cutaneous infection with Mycobacterium fortuitum after localized microinjections (mesotherapy) treated successfully with a triple drug regimen. Acta Derm Venereol 81:291–293PubMedCrossRef Nagore E, Ramos P, Botella-Estrada R, Ramos-Níguez JA, Sanmartín O, Castejón P (2001) Cutaneous infection with Mycobacterium fortuitum after localized microinjections (mesotherapy) treated successfully with a triple drug regimen. Acta Derm Venereol 81:291–293PubMedCrossRef
4.
go back to reference Micali G, Lacarrubba F, Tedeschi A, Nodstrom R (2008) Mesotherapy for rejuvenation of photoaged skin: Ultrasound evaluation. J Am Acad Dermatol 58:AB23 Micali G, Lacarrubba F, Tedeschi A, Nodstrom R (2008) Mesotherapy for rejuvenation of photoaged skin: Ultrasound evaluation. J Am Acad Dermatol 58:AB23
5.
go back to reference Rotunda A, Kolodney MS (2006) Mesotherapy and phosphatidylcholine injections: historical clarification and review. Dermatol Surg 32:465–480PubMedCrossRef Rotunda A, Kolodney MS (2006) Mesotherapy and phosphatidylcholine injections: historical clarification and review. Dermatol Surg 32:465–480PubMedCrossRef
8.
go back to reference Brown S (2006) The science of mesotherapy: chemical anarchy. Aesthetic Surg J 26:95–98CrossRef Brown S (2006) The science of mesotherapy: chemical anarchy. Aesthetic Surg J 26:95–98CrossRef
9.
go back to reference Tanrikulu L (2007) Mesotherapy: medical education. Turk Klinikleri J Med Sci 27:272–275 Tanrikulu L (2007) Mesotherapy: medical education. Turk Klinikleri J Med Sci 27:272–275
10.
go back to reference Kalil A (2006) Aesthetic mesotherapy: the US approach and contribution. Cosmet Dermatol 19:753–758 Kalil A (2006) Aesthetic mesotherapy: the US approach and contribution. Cosmet Dermatol 19:753–758
11.
go back to reference Rotunda AM, Avram MM, Avram A (2005) Cellulite: is there a role for injectable? J Cosmet Laser Ther 7:147–154PubMedCrossRef Rotunda AM, Avram MM, Avram A (2005) Cellulite: is there a role for injectable? J Cosmet Laser Ther 7:147–154PubMedCrossRef
12.
13.
go back to reference Seon MY, Yong BC, Kyu JA (2005) A case of panniculitis following mesotherapy. Korean J Dermatol 43:431–433 Seon MY, Yong BC, Kyu JA (2005) A case of panniculitis following mesotherapy. Korean J Dermatol 43:431–433
14.
go back to reference Matarasso A, Pfeiffer TM, the Plastic Surgery Educational Foundation DATA Committee (2005) Mesotherapy for body contouring. Plast Reconstr Surg 115:1420–1424PubMedCrossRef Matarasso A, Pfeiffer TM, the Plastic Surgery Educational Foundation DATA Committee (2005) Mesotherapy for body contouring. Plast Reconstr Surg 115:1420–1424PubMedCrossRef
15.
go back to reference Stachowski J, Botts K, Rine L, Kato D, Pollock J (2006) Mesotherapy: cosmetic applications. Int J Pharmaceut Compound 10:331–334 Stachowski J, Botts K, Rine L, Kato D, Pollock J (2006) Mesotherapy: cosmetic applications. Int J Pharmaceut Compound 10:331–334
16.
go back to reference Caruso MK, Roberts AT, Bissoon L, Self KS, Guillot TS, Greenway FL (2007) An evaluation of mesotherapy solutions for inducing lipolysis and treating cellulite. J Plast Reconstr Aesthet Surg October 20. doi:10.1016/j.bjps.2007.03.039. (Epub ahead of print) Caruso MK, Roberts AT, Bissoon L, Self KS, Guillot TS, Greenway FL (2007) An evaluation of mesotherapy solutions for inducing lipolysis and treating cellulite. J Plast Reconstr Aesthet Surg October 20. doi:10.​1016/​j.​bjps.​2007.​03.​039. (Epub ahead of print)
17.
go back to reference Bryant R (2004) Controversial mesotherapy: could it be the next Botox? Dermatol Times 25:1 Bryant R (2004) Controversial mesotherapy: could it be the next Botox? Dermatol Times 25:1
18.
go back to reference Lawrence N (2003) Commentary: no smoking gun: findings from a national survey of office-based cosmetic surgery adverse event reporting. Dermatol Surg 29:1099 Lawrence N (2003) Commentary: no smoking gun: findings from a national survey of office-based cosmetic surgery adverse event reporting. Dermatol Surg 29:1099
19.
go back to reference Tonkovic-Capin M, Riddle CC, Schweiger ES, Aires DJ, Manson SH, Tonkovic-Capin V (2007) Brief discussion: medicolegal aspects of consent and checklists for common cosmetic procedures. Cosmet Dermatol 20(5):291–294 Tonkovic-Capin M, Riddle CC, Schweiger ES, Aires DJ, Manson SH, Tonkovic-Capin V (2007) Brief discussion: medicolegal aspects of consent and checklists for common cosmetic procedures. Cosmet Dermatol 20(5):291–294
21.
go back to reference Salti G, Ghersetich I, Tantussi F, Bovani B, Lotti T (2008) Phosphatidylcholine and sodium deoxycholate in thetreatment of localized fat: a double-blind, randomized study. Dermatol Surg 34:60–66PubMedCrossRef Salti G, Ghersetich I, Tantussi F, Bovani B, Lotti T (2008) Phosphatidylcholine and sodium deoxycholate in thetreatment of localized fat: a double-blind, randomized study. Dermatol Surg 34:60–66PubMedCrossRef
22.
go back to reference Prins JB, O’Rahilly S (1997) Regulation of adipose cell number in man. Clin Sci 92:3–11PubMed Prins JB, O’Rahilly S (1997) Regulation of adipose cell number in man. Clin Sci 92:3–11PubMed
23.
go back to reference Londos C, Brasaemle DL, Schultz CJ, Adler-Wailes DC, Levin DM, Kimmel AR, Rondinone CM (1999) On the control of lipolysis in adipocytes. Ann N Y Acad Sci 892:155–168PubMedCrossRef Londos C, Brasaemle DL, Schultz CJ, Adler-Wailes DC, Levin DM, Kimmel AR, Rondinone CM (1999) On the control of lipolysis in adipocytes. Ann N Y Acad Sci 892:155–168PubMedCrossRef
24.
go back to reference Gryskiewicz JM, Adams WP Jr (2006) Plastic surgeons rate the “hot topics”. Aesthetic Surg J 26:479–484CrossRef Gryskiewicz JM, Adams WP Jr (2006) Plastic surgeons rate the “hot topics”. Aesthetic Surg J 26:479–484CrossRef
25.
go back to reference Rittes PG, Rittes JC, Carriel Amary MF (2006) Injection of phosphatidylcholine in fat tissue: experimental study of local action in rabbits. Aesthetic Plast Surg 30:474–478PubMedCrossRef Rittes PG, Rittes JC, Carriel Amary MF (2006) Injection of phosphatidylcholine in fat tissue: experimental study of local action in rabbits. Aesthetic Plast Surg 30:474–478PubMedCrossRef
26.
go back to reference Greenway FL, Bray GA, Heber D (1995) Topical fat reduction. Obes Res 3(Suppl 4):561S–568SPubMed Greenway FL, Bray GA, Heber D (1995) Topical fat reduction. Obes Res 3(Suppl 4):561S–568SPubMed
27.
go back to reference Kolehmainen M, Ohisalo JJ, Kaartinen JM, Tuononen V, Pääkkönen M, Poikolainen E, Alhava E, Uusitupa MI (2000) Concordance of in vivo microdialysis and in vitro techniques in the studies of adipose tissue metabolism. Int J Obes Relat Metab Disord 24:1426–1432PubMedCrossRef Kolehmainen M, Ohisalo JJ, Kaartinen JM, Tuononen V, Pääkkönen M, Poikolainen E, Alhava E, Uusitupa MI (2000) Concordance of in vivo microdialysis and in vitro techniques in the studies of adipose tissue metabolism. Int J Obes Relat Metab Disord 24:1426–1432PubMedCrossRef
28.
go back to reference Aicher R (2003) Cosmetic surgery and the law. The American Society for Aesthetic Plastic Surgery. Aesthetic Soc News 7:11 Aicher R (2003) Cosmetic surgery and the law. The American Society for Aesthetic Plastic Surgery. Aesthetic Soc News 7:11
29.
go back to reference Brandão C, Fernandes N, Mesquita N, Dinis-Ribeiro M, Silva R, Viana HL, Dias LM (2005) Abdominal haematoma – a mesotherapy complication. Acta Derm Venereol 85:446PubMed Brandão C, Fernandes N, Mesquita N, Dinis-Ribeiro M, Silva R, Viana HL, Dias LM (2005) Abdominal haematoma – a mesotherapy complication. Acta Derm Venereol 85:446PubMed
30.
go back to reference Rosenbaum M, Prieto V, Hellmer J, Boschmann M, Krueger J, Leibel RL, Ship AG (1998) An exploratory investigation of the morphology and biochemistry of cellulite. Plast Reconstr Surg 101:1934–1939PubMedCrossRef Rosenbaum M, Prieto V, Hellmer J, Boschmann M, Krueger J, Leibel RL, Ship AG (1998) An exploratory investigation of the morphology and biochemistry of cellulite. Plast Reconstr Surg 101:1934–1939PubMedCrossRef
31.
go back to reference Young VL (2003) Lipostabil: the effect of phosphatidylcholine on subcutaneous fat. Aesthetic Surg J 23:413–417CrossRef Young VL (2003) Lipostabil: the effect of phosphatidylcholine on subcutaneous fat. Aesthetic Surg J 23:413–417CrossRef
33.
go back to reference Amin S, Phelps R, Goldberg D (2006) Mesotherapy for facial skin rejuvenation: a clinical, histologic, and electron microscopic evaluation. Dermatol Surg 32(12):1467–1472PubMedCrossRef Amin S, Phelps R, Goldberg D (2006) Mesotherapy for facial skin rejuvenation: a clinical, histologic, and electron microscopic evaluation. Dermatol Surg 32(12):1467–1472PubMedCrossRef
34.
go back to reference Serra M, Pereira FB (2002) Subcutaneous infiltration with phosphatidylcholine solution for treatment of buffalo hump and fatty pads. In: Program and abstracts of the 3rd International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV. Athens, Greece, October 23–26, 2001, vol 6, pp 75–76 Serra M, Pereira FB (2002) Subcutaneous infiltration with phosphatidylcholine solution for treatment of buffalo hump and fatty pads. In: Program and abstracts of the 3rd International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV. Athens, Greece, October 23–26, 2001, vol 6, pp 75–76
35.
go back to reference Rose PT, Morgan M (2005) Histological changes associated with mesotherapy for fat dissolution. J Cosmet Laser Ther 7:17–19PubMedCrossRef Rose PT, Morgan M (2005) Histological changes associated with mesotherapy for fat dissolution. J Cosmet Laser Ther 7:17–19PubMedCrossRef
36.
go back to reference Duncan DI, Hasengschwandtner F, Leonfelden B (2005) Lipodissolve for subcutaneous fat reduction and skin retraction. Aesthetic Surg J 25:530–543CrossRef Duncan DI, Hasengschwandtner F, Leonfelden B (2005) Lipodissolve for subcutaneous fat reduction and skin retraction. Aesthetic Surg J 25:530–543CrossRef
37.
go back to reference Hexsel D, Serra M, Mazzuco R, Dal’Forno T, Zechmeister D (2003) Phosphatidylcholine in the treatment of localized fat. J Drugs Dermatol 2:511–518PubMed Hexsel D, Serra M, Mazzuco R, Dal’Forno T, Zechmeister D (2003) Phosphatidylcholine in the treatment of localized fat. J Drugs Dermatol 2:511–518PubMed
38.
go back to reference Singh K (2006) Nonsurgical facial rejuvenation. J Int Med Sci Acad 19:158–164 Singh K (2006) Nonsurgical facial rejuvenation. J Int Med Sci Acad 19:158–164
41.
go back to reference Nagore E, Ramos P, Botella-Estrada R, Ramos-Níguez JA, Sanmartín O, Castejón P (2001) Cutaneous infection with Mycobacterium fortuitum after localized microinjections (mesotherapy) treated successfully with a triple drug regimen. Acta Derm Venereol 81:291–293PubMedCrossRef Nagore E, Ramos P, Botella-Estrada R, Ramos-Níguez JA, Sanmartín O, Castejón P (2001) Cutaneous infection with Mycobacterium fortuitum after localized microinjections (mesotherapy) treated successfully with a triple drug regimen. Acta Derm Venereol 81:291–293PubMedCrossRef
42.
go back to reference Lee DP, Chang SE (2005) Subcutaneous nodules showing fat necrosis owing to mesotherapy. Dermatol Surg 3:250–251 Lee DP, Chang SE (2005) Subcutaneous nodules showing fat necrosis owing to mesotherapy. Dermatol Surg 3:250–251
43.
go back to reference Bessis D, Guilhou JJ, Guillot B (2004) Localized urticaria pigmentosa triggered by mesotherapy. Dermatology 209:343–344PubMedCrossRef Bessis D, Guilhou JJ, Guillot B (2004) Localized urticaria pigmentosa triggered by mesotherapy. Dermatology 209:343–344PubMedCrossRef
44.
go back to reference Tan J, Rao B (2006) Mesotherapy-induced panniculitis treated with dapsone: case report and review of reported adverse effects of mesotherapy. J Cutan Med Surg 10:92–95PubMed Tan J, Rao B (2006) Mesotherapy-induced panniculitis treated with dapsone: case report and review of reported adverse effects of mesotherapy. J Cutan Med Surg 10:92–95PubMed
45.
go back to reference Rosina P, Chieregato C, Miccolis D, D’Onghia FS (2001) Psoriasis and side-effects of mesotherapy. Int J Dermatol 40:581–583PubMedCrossRef Rosina P, Chieregato C, Miccolis D, D’Onghia FS (2001) Psoriasis and side-effects of mesotherapy. Int J Dermatol 40:581–583PubMedCrossRef
46.
go back to reference Henry F, Piérard-Franchimont C, Piérard GE (2005) Clinical case of the month. Atypical mycobacteria and mesotherapy. Rev Med Liege 60:7–10PubMed Henry F, Piérard-Franchimont C, Piérard GE (2005) Clinical case of the month. Atypical mycobacteria and mesotherapy. Rev Med Liege 60:7–10PubMed
47.
go back to reference Colón-Soto M, Peredo RA, Vilá LM (2006) Systemic lupus erythematosus after mesotherapy with acetyl-L-carnitine. J Clin Rheumatol 12:261–262PubMedCrossRef Colón-Soto M, Peredo RA, Vilá LM (2006) Systemic lupus erythematosus after mesotherapy with acetyl-L-carnitine. J Clin Rheumatol 12:261–262PubMedCrossRef
48.
go back to reference Furlong W, Cunanan BA, Weymouth LA, Pearson JL, Sockwell DC, Jenkins SR, Marr J, Tipple M, Shah DD, Blythe D, Lum GR, Glymph AC, Davies-Cole JO, Srinivasan A, Meites E, Sunenshine RH (2005) Outbreak of mesotherapy-associated skin reactions—District of Columbia area, January–February 2005. MMWR Morb Mortal Wkly Rep 54:1127–1130 Furlong W, Cunanan BA, Weymouth LA, Pearson JL, Sockwell DC, Jenkins SR, Marr J, Tipple M, Shah DD, Blythe D, Lum GR, Glymph AC, Davies-Cole JO, Srinivasan A, Meites E, Sunenshine RH (2005) Outbreak of mesotherapy-associated skin reactions—District of Columbia area, January–February 2005. MMWR Morb Mortal Wkly Rep 54:1127–1130
49.
go back to reference Sañudo A, Vallejo F, Sierra M, Hoyos JG, Yepes S, Wolff JC, Correa LA, Montealegre C, Navarro P, Bedoya E, Sanclemente G (2007) Nontuberculous mycobacteria infection after mesotherapy: preliminary report of 15 cases. Int J Dermatol 46:649–653PubMedCrossRef Sañudo A, Vallejo F, Sierra M, Hoyos JG, Yepes S, Wolff JC, Correa LA, Montealegre C, Navarro P, Bedoya E, Sanclemente G (2007) Nontuberculous mycobacteria infection after mesotherapy: preliminary report of 15 cases. Int J Dermatol 46:649–653PubMedCrossRef
52.
go back to reference Rohrich RJ, Janis EJ, Reisman NR (2003) Use of off-label and non-approved drugs and devices in plastic surgery. Plast Reconstr Surg 112:241–243PubMedCrossRef Rohrich RJ, Janis EJ, Reisman NR (2003) Use of off-label and non-approved drugs and devices in plastic surgery. Plast Reconstr Surg 112:241–243PubMedCrossRef
54.
go back to reference Donofrio LM (2007) Mesotherapy. Cosmet Dermatol 20:97-98 Donofrio LM (2007) Mesotherapy. Cosmet Dermatol 20:97-98
55.
go back to reference Rivera-Olivero IA, Guevara A, Escalona A, Oliver M, Pérez-Alfonzo R, Piquero J, Zerpa O, de Waard JH (2006) Soft tissue infections due to non-tuberculous mycobacteria following mesotherapy. What is the price of beauty? Enferm Infecc Microbiol Clin 24:302–306PubMedCrossRef Rivera-Olivero IA, Guevara A, Escalona A, Oliver M, Pérez-Alfonzo R, Piquero J, Zerpa O, de Waard JH (2006) Soft tissue infections due to non-tuberculous mycobacteria following mesotherapy. What is the price of beauty? Enferm Infecc Microbiol Clin 24:302–306PubMedCrossRef
Metadata
Title
Cosmetic Mesotherapy: Between Scientific Evidence, Science Fiction, and Lucrative Business
Authors
Bishara S. Atiyeh
Amir E. Ibrahim
Saad A. Dibo
Publication date
01-11-2008
Publisher
Springer-Verlag
Published in
Aesthetic Plastic Surgery / Issue 6/2008
Print ISSN: 0364-216X
Electronic ISSN: 1432-5241
DOI
https://doi.org/10.1007/s00266-008-9195-x

Other articles of this Issue 6/2008

Aesthetic Plastic Surgery 6/2008 Go to the issue

Announcement

Announcements