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Bellezza Clinic by Sebastiano Accaputo - 1d ago

Instagram: @masnax

💙A HUGE THANK YOU TO @bellezzacliniclondon for my Non-surgical boobs & but enhancement. This treatment is know as Adopegen-C where glucose is injected to help create more fat cells in the targeted areas.

I have a full in-depth YouTube video(link in the bio) with before/after photos, my experience, how it works, price just everything you need to know! Feel free to check it out.😏

Why I opted for Adipogen-C: When I lost weight, I was very unhappy with how I lost a lot of volume in my breast/bum. But I never wanted to go under the knife so when I heard about Adipogen-C I was very intrigued with this less harmful procedure.

Disclaimer: I’m only promoting this in the light that this is an optional, more natural and non-surgical treatment for what is traditionally know as the boob job/but implants etc. I’m in no way shape or form saying people need to look a certain way. EVERY BODY IS BEAUTIFUL! 😘

#londonclinic #bellezzaclinic #adipogenc #nonsurgical #boobjob #beforeandaftersurgery #naturaltreatment #clinic

Non-Surgical Boob Job + BBL | My Experience with AdipoGen-C | MASNAX - YouTube
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Before and just after non surgical breast lift with radio frequency

The uplifting effects of Radiofrequency is clearly and immediately visible on the right breast of this client. 

#Radiofrequency has the capacity to produce heat to induce new collagen and elastin production and encourage cell turnover, helping skin become firmer, thicker and more youthful-looking.

An advantage of using Radiofrequency to heat tissues, as opposed to lasers (which use higher-frequency light waves), is that the lower frequency of RF can safely penetrate to a deeper level, helping to improve skin tone and structure, even lifting tissues. Moreover, RF can safely treat more patients with different skin tones without risking permanent discoloration.

Skin is tighter, firmer and lifted with no downtime and pain.

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Bellezza Clinic by Sebastiano Accaputo - 1M ago

Cellulite treatments? Do they work?

by Savina  


A few months ago I was invited by Bellezza Clinic to try a complimentary treatment of my choice from their website in exchange for an honest blog review.
I’ve never really done any beauty/cosmetic procedures like this before, so I was intrigued to test their “Carboxy Therapy” for cellulite removal.
What is Carboxy Therapy? Quoting doctor Sebastiano: “Carbon Dioxide Therapy or Carboxy Therapy is the biggest beauty breakthrough since Botox. Carboxy Therapy is a safe, minimally invasive, and clinically proven treatment to rejuvenate and recondition the skin. Carboxy Therapy introduces CO2 beneath the skin’s surface. The body interprets this as an oxygen deficit and responds by increasing blood flow and growth factors such as VEGF (Vascular endothelial growth factor.) This stimulates the production of new blood vessels and provides a surge of oxygen and nutrients to the treated area, improving circulation and resulting in cell restoration. Increased oxygen concentration also reduces the water retention or oedema in the area. As CO2 is non-embolic and is a natural by-product of the body - it is safe to use. Carboxy Therapy can be used cosmetically to treat dark circles under eyes, facial wrinkles, stretch marks and can also improve the appearance of cellulite.”
When I first met doctor Sebastiano and told him my chosen procedure, he said that I am quite thin and I don’t really need a cellulite treatment, as I don’t have much cellulite. Well, I still wanted to give it a go because I was genuinely curious - would it work? Would it actually remove all my cellulite?
The treatment lasts around 30min and you need 6 sessions for an optimal result.
What’s the process?
Imagine a needle, attached to a tiny tube that is connected to a machine. The needle goes into different bits of your thighs a few times, injecting CO2 beneath your skin. The carbon dioxide (CO2) stimulates the blood flow and treats the cellulite.
Does it hurt? Yes. I found it quite painful myself, but I have a low pain threshold, according to doctor Sebastiano. Plus, I HATE needles.
Does it work? YES. After the second procedure I lost 2cm off each thigh and looking at my legs now (after the treatment is finished), I can definitely see a reduction in cellulite.
Are there any side effects? Quoting doctor Sebastiano: - “The only side effect may be bruising”.
Is there a minimum age to have this treatment? Yes, 18 years old.
Here’s something interesting that is worth mentioning. My very first question after meeting doctor Sebastiano was - “Would the Carboxy therapy remove my cellulite for good?”. I was very surprised to hear his answer: “There is no treatment/surgical procedure/diet/medicine or pill that will remove your cellulite for good. Women are prone to having cellulite and no matter how well you eat, how much you exercise or what treatments you do, it will eventually come back.”
So the Carboxy therapy is a great way to treat it, but you need to do it twice a year to maintain the result.
That’s the Bellezza Clinic address, should you want to try it: 2 Wimpole Street, London.
P.S. Have you tried any cellulite treatments before? If not, would you?
P.S.2. Don't forget to sign up for my VIP members list to be the first to receive invitations for events, meetups, giveaways and the newest blog content!

Антицелулитни процедури. Действат ли?
Преди няколко месеца от клиника Bellezza в Лондон се свързаха с мен с покана за колаборация. Предложиха ми да си избера процедура от сайта им, която да пробвам безплатно и да споделя впечатленията си в блог пост.
Приех поканата им, тъй като една специфична процедура ми грабна вниманието. Чували ли сте за Carboxy Therapy (“Карбокситерапия” преведено на български)? Аз не бях до този момент.
“Carboxy терапията е…” - цитирам думите на доктор Себастиано - “…най-големият хит в козметичната индустрия в момента. Това е минимално инвазивна, клинично одобрена терапия, която регенерира кожата и подобрява цялостния й вид. Карбокситерапията вкарва молекули CO2 под повърхността на кожата. Тялото ги интерпретира като кислороден дефицит и ответната му реакция е повишаване на скоростта на кръвния поток, което от своя страна стимулира и подобрява кръвообращението, активира клетъчния метаболизъм и регенерира производството на колагеновите фибри. Увеличената концентрация на кислород също така спомага премахването на задържана вода в третираните зони. Карбокситерапията е добър метод за третиране на тъмни кръгове под очите, бръчки, стрии, целулит.”
Никога досега не си бях правила подобна процедура (или каквато и да е било козметична процедура от този вид, като се замисля) и реших да я пробвам. Исках да премахна онзи досаден целулит, който се образува отстрани и отвътре на бедрата, и се вижда под даден ъгъл, обикновено на слънчева светлина. Не бих казала, че имах много (доктор Себастиано ми врътна очи, като му казах за какво идвам). Но исках да пробвам. Нямаше какво да губя.
Процедурите траят по около 30 минути и са нужни 6 за завършване на пълната програма.
Какво представлява процедурата, описано с не-медицински термини?
Представете си игла, свързана с тръбичка към някакъв уред. Тази игла се слага на различни места във всяко едно от бедрата, вкарвайки в тях CO2 газ, който, както обясни докторът по-горе, стимулира кръвообращението и третира целулита.
Болезнена ли е процедурата? ДА. Или поне за мен беше. (Д-р Себастиано каза, че имало хора, които не усещали нищо). Аз може би имам нисък праг на болка, но ако трябва да сложа оценка от 1 до 10, бих сложила 9.
Има ли резултат? ДА. Целулитът несъмнено е намален и всяко от бедрата ми е загубило по 2см.
Има ли странични ефекти? Самата процедура, по думите на доктора, е “напълно безопасна и единственият страничен ефект е някоя друга синина от убождането”. На мен (естествено) ми се образуваха синини след всяко посещение.
Интересен факт тук да спомена е, че още в началото, когато попитах “Карбокситерапията ще премахне ли целулита ми ЗАВИНАГИ?”, докторът категорично отвърна, че няма до момента измислен метод/хапче/крем/лечение, което да премахва целулита завинаги. Ние, жените, сме предразположени към образуване на целулит и дори той да бъде третиран (било то чрез правилно хранене, движение, тренировки, Карбокситерапия, липосукция или друг метод), пак ще се върне. Съответно Карбокситерапията е добра за пречистване на тялото, но дори и тя трябва да се повтаря два пъти годишно за поддържане на оптимален резултат.
А какво е вашето мнение по въпроса? Тествали ли сте подобен тип процедури? Какъв бе ефектът?
ПП. Aко все още не сте се, а имате желание, може да се запишете и във ВИП Списъка ми с блог читатели, за да получавате първи ексклузивни покани за събития в и извън България, игри с награди (giveaways) и най-новите ми блог публикации. Напълно безплатно е, просто трябва да впишете името си и имейл адрес за връзка във тази форма.

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Histological and Ultrastructural Effects of Ultrasound-induced Cavitation on Human Skin Adipose Tissue

Plast Reconstr Surg Glob Open. 2013 Sep; 1(6): e41.

AbstractBackground:

In aesthetic medicine, the most promising techniques for noninvasive body sculpturing purposes are based on ultrasound-induced fat cavitation. Liporeductive ultrasound devices afford clinically relevant subcutaneous fat pad reduction without significant adverse reactions. This study aims at evaluating the histological and ultrastructural changes induced by ultrasound cavitation on the different cell components of human skin.

Methods:

Control and ultrasound-treated ex vivo abdominal full-thickness skin samples and skin biopsies from patients pretreated with or without ultrasound cavitation were studied histologically, morphometrically, and ultrastructurally to evaluate possible changes in adipocyte size and morphology. Adipocyte apoptosis and triglyceride release were also assayed. Clinical evaluation of the effects of 4 weekly ultrasound vs sham treatments was performed by plicometry.

Results:

Compared with the sham-treated control samples, ultrasound cavitation induced a statistically significant reduction in the size of the adipocytes (P < 0.001), the appearance of micropores and triglyceride leakage and release in the conditioned medium (P < 0.05 at 15 min), or adipose tissue interstitium, without appreciable changes in microvascular, stromal, and epidermal components and in the number of apoptotic adipocytes. Clinically, the ultrasound treatment caused a significant reduction of abdominal fat.

Conclusions:

This study further strengthens the current notion that noninvasive transcutaneous ultrasound cavitation is a promising and safe technology for localized reduction of fat and provides experimental evidence for its specific mechanism of action on the adipocytes.

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Going from B cup to the C cup at Bellezza Clinic

October 26, 2018Diane Jordan

As you might already know Bellezza Clinic is one of my favourite places in London if not in the World. It’s also one of my all time favourite collaborators. I have a massive amount of love for Sebastiano and Maria. I can’t thank them enough for not only for  boosting my outter beauty, but other fantastic personal experiences. I might discuss them later on. 

Today you might hear something you’ve heard before or maybe not. 

Lately I was getting more messages about my non surgical boob job and even my butt job, known as Adipogen C at Bellezza Clinic. 

I was glad to receive them as the genuine interest was triggered. 

In this blog post I will only discuss the breast augmentation. The peach will be left for the dessert. 

Click here to read the full article

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Bellezza Clinic by Sebastiano Accaputo - 4M ago
Hair Mesotherapy

Zekayi Kutlubay* and Özge Karakuş

Mesotherapy is a minimally invasive technique that consists of the intradermal injection of variable mixtures of natural plant extracts, homeopathic agents, pharmaceuticals, vitamins, enzymes, hormones and other bioactive substances in microscopic quantities. Mesotherapy was first described by Frenchman Dr. Michel Pistor in 1952. He first administered procaine intravenously to treat an asthmatic patient and found that the patient’s hear loss was treated. Then he started to experiment on intradermal injections of procaine for various indications and named the method as “mesotherapy” in 1976. The use of mesotherapy, whether scientifically proven or not, has been outspreading over 50 years [1,2,3]. The term mesotherapy means the treatment of the mesoderm, which is one of the three primary germ layers in the early embryo that develops into connective tissue, muscle and the circulatory system. Mesotherapy is used in the treatment of cellulite, local fat deposits - xanthelasma, lipoma, alopecia, rejuvenation - wrinkles, skin tightening, hyperpigmentation and melasma, body contouring and scar reduction.

Hair Mesotherapy

Hair mesotherapy can also be called “mesoplasty” or “mesohair”.

It represents a variety of minimally invasive techniques in which medications are directly injected into the scalp in order to improve alopecia and hair growth. Mesotherapy acts on the epidermis, dermal connective tissue, the circulation, the immune system and the neurosensory system. This therapy is effective at some certain forms of alopecia. Acute diffuse alopecias such as telogen effluvium and stress alopecias androgenetic alopecias, alopecia areata are the forms that mesotherapy can be used with good results. It is not effective at hair shaft dystrophies or scarring alopecias.

In the hair mesotherapy, there is lack of mixture and application scheme whose effectiveness has been proved scientifically. Content of cocktails changes due to physician’s practice and experience [9,10,11].

The effects of treatments are to restore and increase local microcirculation, provide nutritional input, slow down the programmed process of follicular involution, stimulate the hair’s environment through needling and complement other treatments [4,12].

The chemicals that are claimed to stimulate hair growth and new hair production are buflomedil, minoxidil, finasteride, dutasteride, biotin, vitamins and organic silicium.

Conclusion

Hair mesotherapy is a non-surgical, relatively painless injection technique. Despite the fact that there is very little scientific evidence sustaining its widespread use, the field of hair mesotherapy have grown enormously in the past few years, becoming a common method in cosmetic medicine.

Its use in cosmetic medicine to eliminate hair loss is gaining in popularity. To ensure a satisfying cosmetic result, it is critical to use the correct cocktail and injection technique. No long term side effects have been seen in thousands of patients.

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THE "WHAT I'VE HAD DONE" TAG VIDEO || STYLE LOBSTER - YouTube

Here part of a video posted on Youtube by Emily Parr, a beautiful London blogger that is very careful when is time to take care of her skin. Subscribe to her channel to have a look at the full video and to keep following her.

Emily Valentine Parr

Published on 11 Jul 2018

You guys asked (or hinted) so I made the video! Talking about all my cosmetic and aesthetic procedures I've tried out or had done. Leave your comments below if you enjoyed the vid & let me know what other tags vids you'd like to see me do!

SUBSCRIBE HERE: http://bit.ly/1m2bToJ

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Bellezza Clinic by Sebastiano Accaputo - 4M ago

VAGINAL REJUVENATION

During the course of life, genital organs undergo physiological changes of shape and volume as well as functional changes. In particular, during menopause, tissues surrounding the perineum often atrophy or degrade, reaction to stimulus may decrease, tissues may lose functionality and turgidity and the area may suffer a loss of sensitivity.

Loss of elasticity and strength in vaginal tissue occurs also for a number of reasons, including:

– Aging
– Smoking
– Obesity
– Childbirth
– Hysterectomy
– Surgery

These events replace the skin’s natural collagen with fibers that do not recoil or stretch properly. VagiLift Vaginal tightening with Carboxytherapy is a cosmetic procedure that restores the appearance and function of the vaginal area.

In Cosmetic Medicine it is possible to use Carboxytherapy to obtain a non-surgical vaginal rejuvenation. The role of this therapy is to oxygenate and reactivate the metabolic and draining processes that slow down with physiological ageing with the aim of making the area more turgid and hydrated and giving shape back to lost volumes.

VagilLift  CarboxyTherapy consists of 5 or 6 micro injections of Carbon Dioxide performed in the area, to stimulate the growth of new capillaries in the tissues. It is a quick procedure with no downtime and patients may go back to normal activities immediately after treatment.  The results are: renewed turgidity in the treated area, improved circulation and consequent reactivation of tissue functions and an increase in the quantity of tissue in the area.

Thanks to Carboxytherapy it is possible to improve not only the aesthetic aspect of the treated area, but also the quality of the patients’ sex life, with an increase in orgasmic activity thanks to renewed tissue turgidity, tone and functionality and to improved lubrication.

THE USE OF CARBOXITHERAPY AND PRP FOR THE TREATMENT OF VAGINAL ATROPHY

Miembros del equipo: adrian gaspar

TREATMENT OF VAGINAL ATROPHY USING CARBOXYTHERAPY

A. Gaspar; H. Brandi.
Gynecology Department, Faculty of Medicine, University of Mendoza, Argentina.

OBJECTIVE:
To show our experience in the use of carbonic anhydride (Carboxytherapy) in the treatment of hypotrophy and atrophy of the vaginal mucosa.

PATIENTS AND METHODS:
We selected two groups of patients (Case and Control). Symptoms of study and treatment: vaginal dryness and dyspareunia. Case group (16 patients, average age 57 years) was treated with vaginal carboxytherapy. Carbonic anhydride is administered two times a week for 12 weeks through a handpiece designed for this purpose. Control group (20 patients, average age 54 years) received topical estrogen therapy with estriol, a daily application of 0.5 mg per day for 2 weeks, and then followed by three times a week for another 2 weeks and finally twice-weekly applications for 4 more weeks.

RESULTS:
Monitored by vaginal biopsies and clinical evaluation. There was substantial clinical improvement and significant differences in biopsies before and after treatment in the case group patients compared with the control group patients.

CONCLUSION:
The application of vaginal carboxytherapy in women with signs or symptoms of hypotrophy or atrophy of the vaginal mucosa, showed a marked improvement, not only in the epithelium, but also in the lamina propria, compared with the control group. This is in contrast to the documented effects in the epithelium observed with the use of topical estrogen therapy. We also observed a marked comparative improvement in terms of the sexual discomfort problems reported by the patients.

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Swapna S Khatu, Yuvraj E More, [...]Abstract

Platelet-rich plasma (PRP) has become a newer method for the treatment of various types of alopecia. In this prospective study, safety, efficacy and feasibility of PRP injections in treating androgenic alopecia were assessed. Eleven patients suffering from hair loss due to androgenic alopecia and not responding to 6 months treatment with minoxidil and finasteride were included in this study. The hair pull test was performed before every treatment session. A total volume of 2-3 cc PRP was injected in the scalp by using an insulin syringe. The treatment was repeated every two weeks, for a total of four times. The outcome was assessed after 3 months by clinical examination, macroscopic photos, hair pull test and patient's overall satisfaction.

Results:

A significant reduction in hair loss was observed between first and fourth injection. Hair count increased from average number of 71 hair follicular units to 93 hair follicular units. Therefore, average mean gain is 22.09 follicular units per cm2. After the fourth session, the pull test was negative in 9 patients.

Conclusion:

PRP injection is a simple, cost effective and feasible treatment option for androgenic alopecia, with high overall patient satisfaction.

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Bellezza Clinic by Sebastiano Accaputo - 4M ago
G SivagnanamAbstract

Mesotherapy involves the use of multiple intradermal or subcutaneous injections of a mixture of compounds in minute doses, by means of very fine needles, directly over/near the affected sites. Originally invented in France to manage painful medical conditions, it is presently the buzz word in the field of cosmetic dermatology, chiefly to get rid of disfiguring fat. Depending upon the condition treated, the drugs injected, the techniques followed and the number of sessions involved vary. The wider reception of mesotherapy by its stakeholders are probably due to factors like inexpensive equipments, relatively minimal training for providers, much reduced dosage need of the drugs with resultant minimal untoward effects, quicker realization of benefits, minimal invasiveness/pain involved and not the least it is an outpatient procedure. Despite so many plus points, it has to be noted that currently there is a dearth of rigorous scientific studies to prove its efficacy and safety. Further, the average cost per session alone ranges from 200 USD to 600 USD.

Keywords: Body sculpting, cellulite, injection lipolysis, intradermotherapy, nappage

INTRODUCTION

This mini-review is about one of the rapidly developing field of therapeutics called ‘mesotherapy’ which involves multiple intradermal or subcutaneous injections of a mixture of compounds (plant extracts, homeopathic agents, pharmaceuticals, vitamins, and other bioactive substances) in minute doses, using very fine gauge needles, to treat medical (mainly local) and cosmetic conditions. The term ‘meso’ also means ‘middle’ and ‘mean’, hence variably explained with reference to the injection route (into the middle layer of skin or ‘intradermotherapy’) and the mean dose of the medication used (dose in between allopathy and homeopathy).[1]

Mesotherapy does not denote a treatment of any condition in particular; it simply describes a method of drug delivery.[2] Mesotherapy is performed in those structures that were derived from mesoderm rather than itself since the latter ceases to exist beyond the embryonic stage of human development.

It has been suggested that the skin acts as a natural time-release system when drugs are injected by mesotherapy.[3] Other advantages claimed for mesotherapy include inexpensive equipments, relatively minimal training needed for providers, prompt and undiluted reach of drugs to the target area, much reduced dosage need of the drugs, quicker accomplishment of benefits, minimal invasiveness hence attendant pain and no necessity for hospitalization.

HISTORY

Insertion of needle(s) for alleviation of diseases has a long history, starting from Hippocrates (400 B.C.) who used a local application of cactus for shoulder pain, the Chinese using acupuncture (since 2000 years) and then, injection of substances following the invention of the hollow needle since nineteenth century.

Mesotherapy is a medical technique developed in 1952 by the renowned French physician, Dr Michel Pistor for the management of pain and vascular disorders.[4,5] Pistor was bestowed the Legion of Honor (“Legion d’Honneur”), the highest award to persons considered as national heroes with significant accomplishments in France.

It all started when Pistor injected procaine intravenously to treat an asthmatic, and discovered that though the original condition did not improve, the patient's impaired hearing did. With an intent to strengthen the effect, Pistor injected small doses of procaine 3 to 5 mm deep around the target area i.e. the ear itself. From then on scores of deaf patients paraded themselves to Pistor. However, it was noted that other associated conditions like eczema of the auditory canal, temporomandibular joint pain, and tinnitus were to benefit.[1]

Pistor coined the term ‘mesotherapy’ in his first publication of the technique, in a local medical journal in 1958. He defined it as treatment of the mesoderm (the primary germ layer that develops into connective tissue, muscle and circulatory system) referring to the effects of local procaine on such wide number of tissues.[6] Thus, ‘mesotherapy’ may be considered as an off shoot of pharmacotherapy, consequent to the serendipitous manipulation of the intradermal route, hitherto less well explored, to treat medical conditions.

Pistor founded the French Society of Mesotherapy in 1964 and extended the technique to treat general medical, veterinary, and cosmetic conditions. In 1987, The French National Academy of Medicine officially acknowledged mesotherapy as a medical specialty. In the meantime, mesotherapy became popular in most parts of Europe, South America, and more recently in the United States and Asian countries. Pistor died in the year 2003. It would be a fitting tribute if the mesotherapists worldwide pronounce Dr Pistor as the ‘The Father of Mesotherapy’.

MESOTHERAPY: INDICATIONS AND MEDICATIONS USED

Mesotherapists routinely employ FDA approved drugs for uses not reviewed by the FDA.[7] Such off-label use by physicians is not claimed to violate FDA rules and even the courts have held that off-label use by itself does not constitute negligence or medical malpractice, unless otherwise it is contraindicated or used experimentally in the given condition.[8] On the contrary, it is also argued that the mixture of drugs and other ingredients in mesotherapy formulations produce a new drug that is not FDA approved for any purpose, and hence would not be considered “off-label” use.[9] All said, the practice of mesotherapy not only endures but also grows.

Like corticosteroids, mesotherapy too is claimed to have a wide array of applications, with proof of ‘before-and-after-treatment’ photographs especially in the field of cosmetic dermatology. Only the current and widely practiced indications along with the drugs used in them are discussed below.

Pain

Evidence for mesotherapy in the treatment of pain are currently available in French, mainly as case reports. Mesotherapy was traditionally employed for pain relief, in conditions like fibromyalgia, gout, headache, neuralgia,[10] low back ache, sports injuries (i.e., sprains, strains, bursitis, tendinitis),[11] and dental procedures.[12] The procedure involves multiple small volume injections of an analgesic i.e. NSAID (commonly piroxicam or ketorolac), surrounding the painful area e.g. inflamed tendon. Skeletal muscle relaxants like baclofen or diazepam are also commonly co-administered. Another widely employed drug in France, for chronic pain disorders, is salmon calcitonin (sCT) which is already used in conventional medicine as an analgesic in painful bone disorders ranging from osteoporosis to cancer.[13]

In the vast majority of mesotherapy protocols, either lidocaine 1% (for acute conditions) or procaine 1% (for chronic conditions) without epinephrine is used to minimize the pain of the procedure. In France, drugs like buflomédil (vasodilator) and pentoxifylline are also commonly used which are believed to increase local tissue microcirculation, and facilitate metabolic waste elimination.[14] In animal studies, pentoxifylline has also been shown to possess antihyperalgesic effect.[15] Herbs like artichoke, ginko biloba, melilotus are also used to improve local circulation.

Unwanted fat removal

Mesotherapy is the buzz word in the cosmetic world of “melting fat” for weight loss and cellulite treatment. It is also a form of “injection lipolysis”. Presently, mesotherapy is gaining lure mainly for non-surgical cosmetic applications, like removal of disfiguring fat (cellulite)[16] in thighs, buttocks, hips, legs, arms, and facial areas[17] including eye pads;[18] skin rejuvenation, to minimize wrinkles and tighten loose skin, body contouring,[5] striae,[18] vitiligo, hyperpigmentation, acne,[19] and alopecia.

The drugs found to be very effective in the elimination of unwanted fat deposits and skin rejuvenation include phosphatidylcholine (PC), L-carnitine, aminophylline, hyalorunidase, collagenase, glycolic acid, retinoic acid, multivitamins (A, D, E, K), trace elements [minute quantities of zinc, copper, selenium, chromium and manganese], an acetylcholine analog dimethylaminoethanol (DMAE), lidocaine etc.

The proposed mechanisms for the various compounds in removal of unwanted fat are as follows. PC has lipolytic activity by affecting the permeability of the adipocyte membrane and subsequent fat mobilization. Some add small quantities of sodium deoxycholate[17] to increase the fat-dissolution effectiveness of PC through disintegration of adipocytes. Thyroid preparations, aminophylline and isoproterenol are supposed to stimulate insulin release which help in breaking down of fat cells.[8]

Hyaluronidase and collagenase disintegrate the bands of fibrous tissue formed between fat lobules in cellulite. Glycolic acid exfoliates the skin (peels). Vitamin A regulates cell turnover of skin and keratinization; Vitamin C enhances the synthesis of collagen and reduces hyperpigmentation as it inhibits melanin production; Vitamin E, an antioxidant, aids in anti-aging of the skin; Vitamin K affects clotting mechanisms and thus regulates the microcirculation of the skin; DMAE cause myofibril contraction and smoothen the lax skin; while trace elements are important for regulating turnover and repair of skin cells.[20]

Body contouring or sculpting is a sort of ‘image overhauling’, assists the body to reduce fat while moderately increases the muscles, thereby re-shaping the figure for a lean and toned look. Mesotherapy is considered as a non-surgical alternative to liposuction, though removal of large volumes of fat is not possible. Further, the individual must also care about fat intake and exercise. Upto ten or more sessions may be needed. As of 2004 the average cost range is 200 USD to 600 USD per session.[21]

Cellulite is a condition where collections of fat push against the connective tissue causing cosmetically unacceptable lumpy, dimpled appearance of skin resembling cottage cheese.

The drugs used to reduce cellulite include pentoxiphylline, carnitine, coumarin, hyaluronidase/collagenase, calcium pyruvate, aminophylline/caffeine, artichoke, melilotus or ginko biloba.

OTHER CONDITIONSBiorejuvenation

In a preliminary study in a small population of subjects (n=20), mesotherapy with multiple microinjections of hyaluronic acid has been found to be effective for skin photoaging, as confirmed by ultrasound, though not all patients responded uniformly.[22]

Alopecia

Injections of minoxidil, finasteride, lidocaine, multivitamins, T3/T4 are used in treatment of alopecia.

The concept of mesotherapy has been extended to other fields, e.g. an intermittent vaginal injection of rhFSH every 3 days has successfully been applied in women receiving in vitro fertilization (IVF) treatment, mainly in an attempt to reduce the number of hospital visits.[23]

As mentioned in the previous paragraphs, the medications used are a wide array of pharmaceutical substances, plant extracts, vitamins, and other ingredients. There is no standardized formulation for mesotherapy and ingredients vary depending on indications. The components and combination of injected material is based on anecdotal reports or the physician's experience. The purported mechanism of action of the components is yet to be substantiated. For exhaustive details of indications, drugs, doses and techniques one can to refer the text book.[24]

MODE OF ACTION

Other than the mechanism(s) of certain components discussed under the heading ‘Indications and medications,’ a general mode of action for mesotherapy has been proposed.

“The dermis is a common denominator of three units i.e. circulatory, neuro-vegetative and immunological functions. It is proposed that by an action at each of these units, mesotherapy corrects the functional disorder that causes the suspected pathology”.[24]

MESOTHERAPY INJECTION TECHNIQUES

Each session of mesotherapy involves superficial injections of medications using specialized short needles and specific techniques directly over the sites of the affected structures. Several hundred injections are given, though the number may vary depending upon the indication. In general, 1-3 sessions in acute cases, such as sports injuries, and 10-15 with maintenance sessions every 6 months or a year for chronic conditions such as “cellulite” may be required.[25]

Commonly three different techniques are used.[14]

Point by point

First described by Dr. Pistor, involves injection of 0.02 ml to 0.05 ml of drug solution perpendicular to the skin (4 mm deep), given 1 cm to 2 cm apart.

Nappage (French for “covering”)

Involves more superficial (2 mm deep) injections with a 4-mm needle, covering a large area. Injections are given at a 45 degree angle from the skin while applying light, constant positive pressure on the plunger, the practitioner rapidly flicks the wrist (mimics shaking a salt shaker or the action of a sewing machine). At each site, a drop of solution is introduced. Relatively, this is a more discomforting procedure to the patient.

Epidermic

The most superficial (1 mm deep) of all the techniques in which the basal layer of skin is not penetrated. Needle size of 27 to 31 gauges is used with the bevel oriented away from the skin and dragged along with light, positive pressure applied to the plunger. It is done in a grid pattern at 1-cm intervals over the entire affected area.

Multiple injections of small doses of medications, in precise locations, in a single sitting are highly demanding to the therapist. To overcome this difficult task, many practitioners in Europe and South America use a device called ‘mesogun’. The benefits of mesogun include faster injections, precise dose delivery, consistent depth of penetration and more comfort for the physician and patient.[16] Some experts use a special technique called ‘mesoperfusion’ wherein same volume is injected over 10 minutes instead of 30 seconds as in a normal session.[24]

ADVERSE EFFECTS[26,27]

It is claimed that side effects following mesotherapy are extremely rare in experienced hands and if they occur they are mild. Despite the involvement of multiple injections in mesotherapy, the main reason cited for less frequent untoward effects is the much less dosage than one large dose used in modern medicine.

Non-specific common adverse effects include nausea, vomiting, diarrhea, mild pain, skin hyperesthesia, edema, itching, erythema and tender subcutaneous nodules at injection site.

Pigmentation problems include post-inflammatory hyperpigmentation and urticaria pigmentosa which may remain for many months, and can be very distressing, though not serious. Rarely full-thickness skin and fatty tissue necrosis have also occurred.

Hypersensitivity reactions like immediate or delayed (especially to hyaluronidase, collagenase), pruritic, maculopapular rash distant from the treated area (phosphatidylcholine allergy) have also been reported.

Specific adverse effects due to individual components like isoproterenol, yohimbine, aminophylline, anxiety, tremor, palpitations, muscle cramps due to potassium wasting, phosphatidylcholine-induced mild, transient elevations in LFT's are known to occur.

Adverse effects due to faulty techniques include localized infections, scars and subcutaneous nodules. Very recently, several cases of nontuberculous mycobacterial skin infections manifesting as nodules and draining abscesses owing to poor aseptic measures were reported to occur within 1 and 12 weeks of the procedure.[28] One has to keep in mind the risk of transmission of infections (AIDS, HBV, HBC etc) which is applicable to any procedure that invades the intact skin, apart from the hitherto unknown long-term local and systemic effects.

CONTRAINDICATIONS[29]

The contraindications to mesotherapy include a body mass index greater than 30, known hypersensitivity to any of the components, less than 18 years of age, pregnancy, lactation, patients on anticoagulants, cardiac drugs (like amiodarone, hydralazine, calcium channel blocker, beta blocker), disease conditions like insulin dependent diabetes, liver and kidney disorders, AIDS, seizure disorders and lupus.

FLIPSIDE

Any new technique/therapy or for that matter drug will be accepted (depending upon the indication), if it is more effective or more safe or preferably both and not the least, cost-effective. The crux of mesotherapy is that there are no rigorous scientific studies comparing it to existing modes of gold standard therapy in a given condition. Until today, there is paucity of knowledge about the efficacy, mechanism of action and long-term consequences of mesotherapy.[5,30]

Even the few available evidence are of low validity[9] or even not encouraging.[31] We may have to wait for such studies to accept mesotherpay as a standard mode of therapy.

About 16,000 US physicians use mesotherapy in their daily medical practice, the growth of number of mesotherapy-trained physicians by 300 per month,[32] publication of a dedicated journal (American Journal of Mesotherapy), established clinics in reputed hospitals, mushrooming of mesotherapy centers across the globe and the conduct of numerous international congresses, all speak of its status. American Academy of Aesthetic Medicine[33] is one among the leading organizations advocating quality physician training and conducting professional assessment for certification in mesotherapy. Thus it may not be an understatement to say that mesotherapy is gaining popularity as a specialty discipline among both the therapists and public at a swift pace.

The needle of evidence oscillates between safety and efficacy on the one end and popularity on the other, while hovering through uncertain and controversial zones. The optimists would be content with the oft repeated quote ‘Just as absence of proof is not proof of absence, lack of scientific validation is not proof that it does not work’.[34]

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