Plastic surgeons caution against unknown dangers of mesotherapy

The allure of shedding unwanted pockets of fat with a series of simple injections, known as mesotherapy, sounds too good to be true - and it just might be. According to an ASPS Device & Technique Assessment (DATA) Committee report published in the April 15 issue of Plastic and Reconstructive Surgery® (PRS), the official medical journal of the American Society of Plastic Surgeons (ASPS), patients should be wary of mesotherapy until the safety and effectiveness of the procedure are confirmed.

"The promise of a non-surgical, permanent method for fat removal and body contouring is obviously very appealing, but mesotherapy is not proven to be the miracle cure to a thinner you," said Alan Matarasso, MD, study co-author. "The problem with mesotherapy is the whole technique is shrouded in mystery. Liposuction remains the only proven method to safely and permanently remove fat."

Touted as a non-surgical alternative to liposuction, mesotherapy involves injecting medications and plant extracts into layers of fat and connective tissue under the skin. The injected ingredients may include agents that are used to open blood vessels, non-steroidal anti-inflammatory medications, enzymes, nutrients, antibiotics and hormones. Mesotherapy may be used in conjunction with dietary modification, hormone replacement therapy, exercise and nutritional supplements. No drug is approved by the U.S. Food and Drug Administration for use in mesotherapy.

Although the practice of mesotherapy has been around for decades in Europe, it has only recently been introduced in the United States. There are no published scientific studies demonstrating if the effects are permanent, why or if certain ingredients work, or how safe mesotherapy is for patients. In addition, there is no standardization in mesotherapy. The types of drugs used vary from physician to physician as does the quantity and frequency of injections.

Mesotherapy may cost $1,000 to $1,500 per treatment with three to six treatments required. This can prove costly for patients who may not receive the desired results.

"Plastic surgeons are constantly researching better methods to help patients achieve their desired look; however, patients' health and safety is always foremost on our minds," said Dr. Matarasso. "There is no information on what happens to fatty acids once they leave the targeted area or how the various ingredients affect the body's organs and other tissues. There is simply too much we do not know about mesotherapy to say it is unquestionably safe for patients."

Currently, liposuction is the only method that has been proven to safely and effectively remove fat. According to ASPS statistics, liposuction was the most popular cosmetic surgical procedure in 2004, with more than 325,000 procedures performed.

"Without data to support claims that mesotherapy works, the procedure appears to be a mystic type of therapy," said Susan Kaweski, MD, ASPS DATA Committee chair. "The DATA Committee has not seen any long-term studies that would prove mesotherapy actually removes fat from the body. We need to know a lot more about this procedure before plastic surgeons can endorse mesotherapy and recommend it to patients."

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