MESOTHERAPY in DERMATOLOGY

Dr. Amr Ismail MD

Consultant Dermatologist
Member of American Academy of Aesthetic Medicine

email:ahmismai@gmail.com
 Definition

zA minimally invasive aesthetic procedure

employs multiple microinjections of
pharmaceutical medications , amino
acids , vitamins and others into the
mesoderm.
 Introduction

z Mesotherapy was 1st described by a

French Physician Michael Pistor 1952.
z In 1987, French Academy of Medicine
recognized Mesotherapy as part of
traditional medicine.
Skin Structure
 Skin Structure
Embryonic origin Adult Derivative
Ectoderm Skin Epidermis
Brain
Breast
Sweat glands

Mesoderm Fibrous tissue (connective)

Cartilage
Bone
Muscle
Fat

Endoderm Gut
Liver
Lung
Pancreas
 Dermis

z Connective tissue is often used to

describe the extracellular matrix plus the
cells found in it, such as fibroblasts,
macrophages, and mast cells.
 ECM Structure

z3 major fiber-forming proteins:

Collagen, elastin, and fibronectin
z GAG : Hyaluronic acid one of 7.
z Proteoglycans.
 Mesotherapy

Connective Tissue Shock Therapy

 Indications

z Hair:
Telogen effluvium
Androgenetic Alopecia
z Face :
Facial rejuvenation (wrinkles + Firming)
Facial pigmentation e.g. melasma.
 Indications

z Body
Localised fat areas .
Cellulite.
Stretch marks.
 How To Start

1. Materials & protocols / indication.

2. Injection sites.
3. Injection Depths.
4. Needle size.
5. Machine.
 Materials

Classified into :
z Principals(Major)
z Complementary(Minor)

TIP:
Mixture should contain 2-3 principals to
achieve satisfactory results(>90%).
 Hair

z Telogen Principals Complementary

Effluvium
Biotin Pyridoxine
Hair
(Vitamin H/B7) (Vitamin B6)
Growth
Pantothenic Zinc + Azelaic
Stimulants acid acid
(Vitamin B5) MV + MTE
 Hair

z AGA
Hair Principals Complementary
Growth Minoxidil
Stimulants Finasteride Zinc + Azelaic
5-ARI Dutasteride acid
 MesoHair Protocols
Telogen Effluvium Androgenetic Alopecia

Biotin (P) Minoxidil(P) /

Dexenol(P) Dutasteride(P) +
MV + MTE (C) Biotin(P)
Dexenol(P)
Zinc + Azelaic (C)
 MesoHair
Injection sites & depths 1-2mm
 Face MesoLift / MesoGlow

z Rejuvenation (Major)
Proven to Stimulate collagen synthesis
z Hyaluronic acid
z Amino acids
z Vitamin C
z Organic Silicium
z Fibronectin + Vegetal proteins (Collagen &
Elastin)
z Vitamin A
 Face MesoLift / MesoGlow

z Rejuvenation (Complementary)
z Glycolic acid
z Taurine

z XADN

z MV & MTE
 Major Firming

z DMAE :
1. Potent firming acts quickly and lasts
long.
2. Acts in the neuromuscular union, as a
precursor of acetylcholine, the
neurotransmitter responsible for
muscular contraction, increasing the
overall tone of the skin.
z DMAE + Organic Silicium
 MesoGlow Protocols
Glow Lift (Firming)
HA (P) HA (P)

Silorg (P) Silorgamine = Silorg + DMAE (P)

Purascorbol / Vitamin C (P) Puretinol / Vitamin A (P)

Xadenal (C) Taurinox (C)

 MesoGlow/Lift
Injection sites & depths 1-2mm
 Face Pigmentation

Principals Complementary

Glutathione
z MesoLighten
Kojic Glycolic acid
▼ Melanogenesis
Vitamin C Tretinoin
Azelaic acid
 MesoLighten Protocols

Kojic acid (P) Glutathione (P)

Azelaic acid (P) Kojic acid (P)
Vitamin C (P) Vitamin C (P)
Tretinoin (C) Glycolic acid (C)
 MesoLighten
Injection sites & depths 1-2mm
 MesoLighten
Injection sites & depths 1-2mm
 MesoLighten
Injection sites & depths 1-2mm
MesoLighten
 Body

z Localized Fat
z Cellulite
z Stretch marks
 Localized Fat

z LipoDissolve = Injection Lipolysis

 Localized Fat
IAAL
Injection Lipolysis Mesotherapy

Deep 12mm 2 - 4 mm
PPC + DOC (PCDC) L-Carnitine
Hyaluronidase-Collagenase- Aminophylline
Artichoke Pentoxifylline
Intermediate 6mm
Effective complement
(L-Carnitine-Aminophylline-
Yohimbine- Artichoke)
 Phosphatidyl Choline (PPC)

z An antioxidant derived from soy lecithin.

z PPC penetrates the adipocyte , breaks
down fat . Dissolved fat is carried
through bloodstream and excreted by
kidneys and bowel.(P)
z LipoDissolve + proper diet + Exercise.
Localized Fat/ Injection Lipolysis

Lipolytic Enhancers:
z Deoxycholate: Bile salt(P).
z L-Carnitine: Enhances both lipolysis and
fatty acid oxidation(P)
z Artichoke: Direct lipolytic (P)
z Aminophylline , Caffeine & Xanthine(P)
z Hyaluronidase & Collagenase: PPC
enhancer Enzymes (C)
 PPC + DOC
z Detergent Effects of Sodium Deoxycholate Are a Major
Feature of an Injectable Phosphatidylcholine Formulation
Used for Localized Fat Dissolution.
Rotunda AM, Suzuki H, Moy RL, Kolodney MS. Dermatol Surg 2004;30:1001-8.
Division of Dermatology, University of California Los Angeles, David Geffen School of Medicine, Los Angeles, California, USA.

Conclusions:
The phosphatidylcholine formula popularly used in subcutaneous
injections for fat dissolution works primarily as a detergent
causing nonspecific lysis of cell membranes. Our findings suggest
that sodium deoxycholate is the major active component
responsible for cell lysis.Thus,eliminating unwanted adipose
tissue.
Localized Fat/ Injection Lipolysis

Circulatory Enhancers:
z Yohimbine:Alpha2-adrenergic Blocker.
z Aminophylline &Pentoxiphylline: PDEI
Drainage Enhancers:
z Artichoke:Diuretic and stimulates
lymphatic drainage
Localized Fat/ Injection Lipolysis
Protocols
Phosphatidylcholine(P)
Phosphatidylcholine(P) Deoxycholic Acid (P)
Deoxycholic Acid(P) Taurine
Vitamin complex Organic silicium
Alpha Lipoic Acid
Amino Acids

Phosphatidylcholine(P)
Deoxycholic Acid (P)
L-Carnintine
Aminophylline
Pantothenic Acid
 LipoDissolve
Injection sites & depths12mm
LipoDissolve
 LipoDissolve
Injection sites & depths12mm
 Cellulite

z Aesthetically cellulite is a problem

consisting of the visual presentation of
weakened and damaged fatty tissue and
connective fibrous tissue in the form of
bumps and dimples, commonly known as
“orange skin”.
Cellulite
Cellulite
 Cellulite

Treatment must act in two different ways:

z on the fat (Lipolytic effect)

z on circulation (Venotonic effect + Drainage)

 Cellulite

z Lipolytic:
L- Carnitine + Caffeine .
z Venostatic:
Rutin – Aminophylline –Pentoxiphylline.
z Drainage:
Artichoke.
 Cellulite Protocols
z L- Carnitine z L- Carnitine
z Aminophylline z Aminophylline
z Pentoxiphylline z Pentoxiphylline
z Yohimbine z DMAE
z DMAE z Vitamin C
z Procaine z Procaine

All are Principals

 MesoCellulite
Injection sites & depths 2mm
MesoCellulite
 Stretch Marks

The connective tissue, including collagen

and elastin, becomes increasingly
damaged until eventually causing the
formation of stretch marks.
 Stretch Marks
Collagen Elastin Stimulating/ Restoring agents
z Organic Silicium / Silorg
z Centella Asiatica

z Vegetal proteins + Fibronectin

Firming agents
z DMAE + Vitamin C

z DMAE + Idebenone.
 MesoStretch Marks Protocols
z Silorgamine =
z Centella Asiatica
Silorg + DMAE
z Fibronectin
z Vegetal Proteins

z Idebe = z Vitamin C
Idebenone + DMAE z DMAE
z Silorg
All are Principals
MesoStretch Marks
Injection sites
 Needle size

z 30/32 G x 4 mm
z 30/32 G x 6 mm

z 30/32 G x 12.7 mm
MesoGuns
 Injection Techniques

z PAPULE:
1 to 2mm, with bevel upwards
z NAPPAGE:
2 to 4mm, angle of 30° to 60°
z POINT BY POINT:
deep injections, 4 to 12mm
 Contraindications

Pregnancy, blood thinners, IDDM,

cancer patients, AIDS patients, coronary
artery heart disease or heart dysfunction,
People with arrhythmias, history of blood
clots or strokes, autoimmune diseases or
organ transplant recipients and skin
conditions including: herpes & psoriasis.
 MESOPORATION

z Mesotherapy ------ Non invasvive

z No needles are required.
 MESOPORATION

A new complex process utilizes the

skin's water based "channels" to allow
ionic drug solutions to penetrate into the
skin, via controlled "electroporation - like"
electrical pulses.
MESOPORATION
MESOPORATION
MESOPORATION
email:ahmismai@gmail.com