Mesotherapy is widely practiced in France as a weight-loss technique, but it hasn't caught on in the U.S. And some doctors are glad about that.
By Carol Sorgen
Reviewed By Brunilda Nazario
It should come as no surprise that France, land of l'amour, has come up with a way to give us the svelte, sexy bodies we crave. But even if you can afford it (it's not cheap and it's not covered by insurance), is it something you should consider? Like many therapies that loosely come under the heading of "alternative medicine," it all depends on whom you ask.
The French-imported medical technique that's all the buzz these days is called mesotherapy. Developed in 1952 in France by Dr. Michel Pistor, originally for the treatment of vascular and infectious diseases, sports injuries, and the improvement of circulation, the technique involves the injection of small amounts of various medications into the mesoderm, the layer of fat and connective tissue under the skin. The theory is that when these small amounts of medication are injected into the mesoderm, underlying fat is melted.
Since 1952, approximately 15,000 doctors in France and South America have been using mesotherapy, and now doctors in the U.S. are rapidly jumping on the bandwagon. In August, about 40 doctors attended the first intensive course in mesotherapy offered in the U.S. Prior to this course, presented by the International Society of Mesotherapy and the Pan American Mesotherapy Society, doctors had to travel to France to be trained.
One of those who did just that is Marion Shapiro, DO, a former emergency room doctor who is the director of Mesotherapy Associates PC in New York City and West Orange, N.J. Since opening her practice last year, Shapiro sees approximately 150 patients a week. Mesotherapy doesn't work in approximately 5% of patients, says Shapiro, but in the other 95%, "the results are spectacular."
Patients come to Shapiro seeking a quick fix for cellulite, spot weight reduction, or overall weight loss. The compounds injected depend upon what Shapiro is trying to treat -- i.e. cellulite vs. fat -- but generally include a combination of medications such as aminophylline and Novocain and plant extracts and vitamins. The compounds injected are all FDA-approved for their original use, says Shapiro. But they have not been approved specifically for mesotherapy.
According to Shapiro, mesotherapy can be used to treat everyone, from obese people who need treatment on the trunk, abdomen, buttocks, arms, and legs, as well as those who are generally thin but frustrated at dealing with stubborn fatty areas such as saddlebags or love handles. After the fat is melted, it is naturally excreted. Unlike endermologie, a noninvasive technique of treating cellulite, mesotherapy is permanent, says Shapiro, provided the patient doesn't gain the weight back. In order to facilitate more rapid results for her patients and help them keep the weight off in the future, Shapiro gives each of her patients what she calls a "Meso Meal Plan."
Some patients report seeing results after only the first treatment, but the majority report losing a dress size or belt notches after approximately four treatments, says Shapiro. For weight loss and/or cellulite reduction, Shapiro recommends 5 to 10 sessions; the number of injections at each session varies, from 50 to 150.
Because the injections are given with a chemical injector or "meso-gun" using a very tiny needle, patients generally report feeling no more sensation than an ant bite. The cost for each session ranges from $400 to $500. Not cheap, but as Shapiro says, "In the long run, it's significantly less than the price of liposuction."
Shapiro will see anyone between the ages of 18 and 70 who is in good health. Those who are on blood thinners, have blood clots or heart arrhythmia, or are pregnant or undergoing treatment for cancer, diabetes, or other significant major medical problems are not good candidates for the treatment.
While Shapiro uses mesotherapy solely for weight loss and cellulite, mesotherapy has long been used in Europe and South America for a number of other conditions as well, ranging from hair loss to herpes, fibromyalgia, ankle sprains, bursitis, carpal tunnel syndrome, and Bell's palsy, to name a few.
Allyn Brizel, MD, medical director for the Center for Clinical Age Management in Boca Raton, Fla., attended the recent U.S. training course in mesotherapy and will soon be offering the treatment to his patients, not only for cosmetic purposes, but also for hair loss and sports-related injuries. Brizel admits, though, that mesotherapy is receiving most of its attention in the U.S. because of its weight-loss benefits. "In this country, money is made from weight loss," he says.
According to Brizel, using mesotherapy for medical conditions as well makes sense, although he acknowledges that it is a treatment that's not widely recognized or accepted in this country. "You're using the same medications that you would take orally, but in injectable form," he says, adding that when drugs are given under the skin, the dose is 10% to 20% of the normal oral dose. "If you're going to take a medicine at all, why not take it by injection where you can take less of it?" he says.
No Evidence It Works
Not everyone is so gung-ho on the benefits of mesotherapy. Even though it was recognized in 1987 by the French Academy of Medicine as a part of traditional medicine, there have been no proven scientific benefits or merits, says Rod Rohrich, MD, president-elect of the American Society of Plastic Surgeons and chairman of plastic surgery at the University of Texas Southwestern Medical Center in Dallas. "This borders on medical experimentation," he says. "Injecting unknown substances into someone with multiple needle sticks is almost unconscionable."
Rohrich adds that proponents of mesotherapy say it can be used for almost anything, "but with no scientific data, this should not be done on human beings.
"This is just another fad," Rohrich says. "It preys on the consumer who wants to look for a quick solution, but there are no shortcuts to good health."
That's what Leroy Young, MD, says as well. To Young, chairman of the nonsurgical procedures committee for the American Society of Aesthetic Plastic Surgery, mesotherapy is nothing more than "quackery."
"There's just no proof that it works for any kind of fat," he says, adding that even those doctors who are in favor of mesotherapy advise their patients to eat well and exercise more. "If you eat properly and burn more calories, then guess what? You're going to lose the fat," says Young.
Wendy Lewis, author of The Beauty Battle and a skin care and surgery consultant who counsels men and women in both the U.S. and the U.K. about cosmetic surgery, face and body treatments, and anti-aging issues, agrees with Rohrich and Young. "Mesotherapy is being touted as a cure for just about everything," she says. "But there are no guidelines and nothing documented."
Every doctor has his or her own "cocktail" of drugs, says Lewis. "My fear is that you really don't know what they're injecting into you." If you do decide to go ahead with the treatment, Lewis says that it's important to do your homework first. "You need to know what is being injected into you, what are the side effects, how many injections you'll need, the fees ... get as much information as you can up front."
At this time, mesotherapists in the U.S. don't have to be licensed, although efforts are under way to establish a chapter of the International Society of Mesotherapy in this country. At the moment, though, says Lewis, there is no way to qualify those who are offering the treatment. "I think it's tricky stuff," says Lewis. But if you want to do it, "pay attention and ask questions."
Published Sept. 1, 2003.
SOURCES: Marion Shapiro, DO, director of Mesotherapy Associates PC, New York City and West Orange, N.J. Allyn Brizel, MD, medical director, Center for Clinical Age Management, Boca Raton, Fla. Rod Rohrich, MD, president-elect, American Society of Plastic Surgeons; chairman of plastic surgery, University of Texas Southwestern Medical Center, Dallas. Wendy Lewis, skin care and surgery consultant; author, The Beauty Battle. Leroy Young, MD, chairman, nonsurgical procedures committee, American Society of Aesthetic Plastic Surgery.
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