The term mesotherapy itself is nothing more than a method of delivery of medications. It was believed that by injecting certain medications into the middle (meso) skin layer, different clinical results could be obtained. In this discussion, I will use the term mesotherapy, or lipodissolve, to discuss the treatment of unwanted cellulite and unwanted areas of adipose (fat) tissue.

Mesotherapy is a treatment where injections of differing agents (drugs, nutrients, botanicals, enzymes, and vitamins) are used to treat localized conditions. In the past, mesotherapy was used to treat a variety of conditions. As I mentioned, this discussion will tend to focus on the treatment of unwanted fat and the bumpy or cottage cheese appearance of cellulite. One of the modern proponents of mesotherapy is Dr. Patricia Rittes from Brazil. Dr. Rittes actually uses the term ‘lipodissolve’ for a specific type of mesotherapy that can both reduce nwanted areas of fat and smooth out bumpy skin known as cellulite.  There are many different combinations of medications used by physicians performing mesotherapy around the world; however, in our office, we tend to use one with two components, namely, phosphatidyl choline (which is actually an extract from soybeans) and an emulsifying agent known as sodium deoxycholate. Recent evidence shows that deoxycholate is probably the more important of the two agents. There are many formulations used, but this is the one we tend to use exclusively in our office due to its very low side effect profile.

One of the benefits is that, in the appropriate patient, we have had some very satisfactory results, especially when it comes to treating unwanted cellulite and unwanted areas of fat. Compared to liposuction, it is relatively inexpensive and there is relatively little down time. I should mention that mesotherapy is not for everyone and we do not achieve perfect results in 100 percent of patients, but the vast majority of our patients achieve very satisfactory results.

A typical treatment takes 15 to 30 minutes. The procedure consists of making multiple injections into the desired target area. We define a target area to be about the size of the palm of your hand. After the injection, there can be some tenderness, swelling, and discomfort that may last one to two days.  Usually the injections  injections are made with a very small needle to the point where the discomfort is minimal and if the patient is anxious or concerned, we will usually apply a topical numbing cream to the skin before the procedure to increase comfort. I tell patients it usually takes four to eight treatment sessions to achieve the desired results. I also tell patients that it works in approximately 80 percent of the appropriately selected patients. I tell my patients that after two treatments they should definitely notice a difference. In the small percentage of patients who do not see results after two sessions, I do not encourage them to continue.  Treatment sessions are spaced out optimally at two-week intervals. A typical treatment strategy involves injections over two to three months to achieve the desired results.