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Mesotherapy liposculpture is an office procedure that uses multiple micro-injections of FDA approved pharmaceutical agents into the middle layer of skin to remove fat from fat cells. The fat is then eliminated or metabolized. Although new in the United States, this technique has been used successfully in France and Europe for over 50 years. The medications used in treatment are FDA approved and may be used for off label purposes.

The term “meso” means middle in Greek. The skin is composed mainly of the outer epidermis, middle dermis, and underlying fat (subcutaneous tissue). The dermis has its embryonic tissue origins from what is known as mesoderm. Mesotherapy can be thought of simply as another route of drug administration. You may have heard of other drug routes of administration. With the IV (intravenous) route, drugs or fluids are introduced directly into the veins. IM or intramuscular injections involve the introduction of substances into muscle. Transdermal patches place substances (such as nicotine, nitrates or hormones) in contact with the skin so they may be absorbed into the skin and eventually into the blood stream. With the SC or subcutaneous route, medicine is injected under the skin. A common example of this latter route is the administration of Insulin in diabetic patients.

Mesotherapy has many applications in Medicine. One example would be in the management of pain. A patient with pinpoint myofascial pain localized to the upper back may be treated conventionally with oral anti-inflammatory pain medication or even an intramuscular injection in the buttocks region. The medication is absorbed by the blood stream, and then delivered to the target site (the upper back). However, before it gets there, the medicine is partially eliminated by the liver—this is known as first pass elimination. With mesotherapy, the same anti-inflammatory medicine can be injected into the skin (intradermally) directly over the tender spot on the upper back. This circumvents the first pass elimination by the liver, and therefore a smaller quantity of the medicine can be used. The advantage with mesotherapy is that smaller drug quantities minimize systemic side effects and better target the problem area. The procedure is novel since it is minimally invasive.

With mesotherapy fat reduction, a recipe made up of carefully selected medications is injected into the skin directly adjacent to the unwanted fat. The skin becomes the reservoir for mesotherapy compounds that “dissolve” the fat. The fat is then absorbed by the portal circulation and eliminated by metabolism or excretion. One of the main ingredients commonly used for fat reduction is Phosphatidylcholine, a fat soluble phospholipid that is essentially a purified soy lecithin. It was approved in 1990 for the IV treatment of fat emboli in atherosclerosis. This substance helps facilitate the movement of fat in and out of cells. Other products used for fat reduction may also enhance the body’s metabolism and/or help transport fatty acids to the components of cells known as mitochondria, where energy is produced.

How many treatment sessions are necessary?

Mesotherapy for fat reduction is a slow process that requires multiple treatments. Treatments may be administered one to two weeks apart. The specific number of treatments required will vary from person to person. A noticeably significant change in the treatment area should be appreciated within four to nine treatments.

To help you understand the gradual changes that occur with the procedure in time, think of the body as a large ice sculpture. More specifically, think of the areas of fat treated as pieces of solid ice. The injection of medication would be analogous to the sprinkling of salt over those areas of ice. Treated areas would slowly melt away.