National report — With headlines like "Thin-Jection" and "Lipo-Dissolve," popular media is fueling patient inquiries about mesotherapy.
Until science provides answers to questions few patients know to ask — particularly in regard to the safety and efficacy of mesotherapy — Alan Matarasso, M.D., advises physicians to just say "no.""Plastic surgeons are as interested as patients in less-invasive procedures, and mesotherapy has great allure as a non-surgical body contouring treatment," emphasizes Dr. Matarasso, spokesman for the American Society of Plastic Surgeons (ASPS). "But until mesotherapy is scientifically proven, liposuction remains the treatment of choice. Liposuction is proven as a safe surgical procedure that effectively removes fat cells. While mesotherapy is very appealing on the surface, it's an unknown, unproven commodity."
Little data In preparing a safety and efficacy report on mesotherapy for the American Society of Plastic Surgeons, ("Mesotherapy for Body Contouring," Plastic and Reconstructive Surgery, April 15, 2005), Dr. Matarasso and Tracy Pfeifer, M.D., found little data on the safety, efficacy and mechanism of action of mesotherapy.
Injection formulations vary widely, with ingredients ranging from vasodilators and anti-inflammatory agents to hormones, enzymes and even plant extracts. Injecting patients with unstandardized, unproven products poses a tremendous liability risk.
"Approach mesotherapy with caution," Dr. Matarasso advises. "On the surface it's very appealing, but there's much to learn."
One recent double-blind prospective study of mesotherapy reported dramatic reductions in the appearance of cellulite. Dr. Matarasso says the mechanism of action was not clear. Additionally, he points to another recently published study on the architecture and biochemistry of cellulite which showed no correlation between lipolysis and cellulite.
Body contouring In addition to safety and efficacy questions on product formulation, injection depth, number and timing of treatments, the next step will be to determine mesotherapy's role in body contouring.
"It's entirely possible that in a few years, science will prove mesotherapy as a safe and effective treatment," he says. "Then the question will be its role in body contouring.
"Popular media gets ahead of science," he adds. "Right now we're seeing more and more meetings and societies springing up to teach mesotherapy. But we couldn't find any practical research taking place."