Mesotherapy in Dermatology
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MESOTHERAPY in DERMATOLOGY
Dr. Amr Ismail MDConsultant DermatologistMember of American Academy of Aesthetic Medicine
email:[email protected]
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Definition
A minimally invasive aesthetic procedure employs multiple microinjections of pharmaceutical medications , amino acids , vitamins and others into the mesoderm.
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Introduction
Mesotherapy was 1st described by a French Physician Michael Pistor 1952.In 1987, French Academy of Medicine recognized Mesotherapy as part of traditional medicine.
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Skin Structure
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Embryonic origin Adult Derivative
Ectoderm Skin EpidermisBrainBreastSweat glands
Mesoderm Fibrous tissue (connective)CartilageBoneMuscleFat
Endoderm GutLiverLungPancreas
Skin Structure
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Dermis
Connective tissue is often used to describe the extracellular matrix plus the cells found in it, such as fibroblasts, macrophages, and mast cells.
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ECM Structure
3 major fiber-forming proteins:Collagen, elastin, and fibronectinGAG : Hyaluronic acid one of 7.Proteoglycans.
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Mesotherapy
Connective Tissue Shock Therapy
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Indications
Hair: Telogen effluviumAndrogenetic AlopeciaFace :Facial rejuvenation (wrinkles + Firming)Facial pigmentation e.g. melasma.
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Indications
BodyLocalised fat areas .Cellulite.Stretch marks.
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How To Start
1. Materials & protocols / indication.2. Injection sites.3. Injection Depths.4. Needle size.5. Machine.
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Materials
Classified into :Principals(Major)Complementary(Minor)
TIP:Mixture should contain 2-3 principals to achieve satisfactory results(>90%).
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Hair
TelogenEffluviumHair Growth Stimulants
Principals Complementary
Biotin (Vitamin H/B7)Pantothenicacid (Vitamin B5)
Pyridoxine(Vitamin B6) Zinc + AzelaicacidMV + MTE
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Hair
AGAHair Growth Stimulants5-ARI
Principals Complementary
MinoxidilFinasterideDutasteride
Zinc + Azelaicacid
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MesoHair Protocols
Telogen Effluvium Androgenetic Alopecia
Biotin (P)Dexenol(P)MV + MTE (C)
Minoxidil(P) / Dutasteride(P) +Biotin(P)Dexenol(P)Zinc + Azelaic (C)
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MesoHairInjection sites & depths 1-2mm
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Face MesoLift / MesoGlow
Rejuvenation (Major)Proven to Stimulate collagen synthesis
Hyaluronic acidAmino acidsVitamin COrganic SiliciumFibronectin + Vegetal proteins (Collagen & Elastin)Vitamin A
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Face MesoLift / MesoGlow
Rejuvenation (Complementary)Glycolic acidTaurineXADNMV & MTE
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Major Firming
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.DMAE + Organic Silicium
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MesoGlow Protocols
GlowHA (P)
Silorg (P)
Purascorbol / Vitamin C (P)
Xadenal (C)
Lift (Firming)HA (P)
Silorgamine = Silorg + DMAE (P)
Puretinol / Vitamin A (P)
Taurinox (C)
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MesoGlow/Lift Injection sites & depths 1-2mm
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Face Pigmentation
MesoLighten▼ Melanogenesis
Principals Complementary
GlutathioneKojicVitamin CAzelaic acid
Glycolic acidTretinoin
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MesoLighten Protocols
Kojic acid (P)Azelaic acid (P) Vitamin C (P)Tretinoin (C)
Glutathione (P)Kojic acid (P)Vitamin C (P)Glycolic acid (C)
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MesoLightenInjection sites & depths 1-2mm
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MesoLightenInjection sites & depths 1-2mm
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MesoLightenInjection sites & depths 1-2mm
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MesoLighten
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Body
Localized FatCelluliteStretch marks
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Localized Fat
LipoDissolve = Injection Lipolysis
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Localized Fat IAAL
Injection Lipolysis Mesotherapy
Deep 12mmPPC + DOC (PCDC)Hyaluronidase-Collagenase-
ArtichokeIntermediate 6mm(L-Carnitine-Aminophylline-Yohimbine- Artichoke)
2 - 4 mmL-Carnitine
AminophyllinePentoxifylline
Effective complement
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Phosphatidyl Choline (PPC)
An antioxidant derived from soy lecithin.PPC penetrates the adipocyte , breaks down fat . Dissolved fat is carried through bloodstream and excreted by kidneys and bowel.(P)LipoDissolve + proper diet + Exercise.
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Localized Fat/ Injection Lipolysis
Lipolytic Enhancers:Deoxycholate: Bile salt(P).L-Carnitine: Enhances both lipolysis and fatty acid oxidation(P)Artichoke: Direct lipolytic (P)Aminophylline , Caffeine & Xanthine(P)Hyaluronidase & Collagenase: PPC enhancer Enzymes (C)
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PPC + DOC
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.
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Localized Fat/ Injection Lipolysis
Circulatory Enhancers:Yohimbine:Alpha2-adrenergic Blocker.Aminophylline &Pentoxiphylline: PDEI
Drainage Enhancers:Artichoke:Diuretic and stimulates lymphatic drainage
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Localized Fat/ Injection LipolysisProtocols
Phosphatidylcholine(P)Deoxycholic Acid(P) Vitamin complexAlpha Lipoic AcidAmino Acids
Phosphatidylcholine(P)Deoxycholic Acid (P)TaurineOrganic silicium
Phosphatidylcholine(P)Deoxycholic Acid (P)L-CarnintineAminophyllinePantothenic Acid
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LipoDissolveInjection sites & depths12mm
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LipoDissolve
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LipoDissolveInjection sites & depths12mm
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Cellulite
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”.
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Cellulite
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Cellulite
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Cellulite
Treatment must act in two different ways:on the fat (Lipolytic effect) on circulation (Venotonic effect + Drainage)
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Cellulite
Lipolytic: L- Carnitine + Caffeine .Venostatic: Rutin – Aminophylline –Pentoxiphylline.Drainage: Artichoke.
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Cellulite Protocols
L- CarnitineAminophyllinePentoxiphyllineYohimbineDMAEProcaine
L- CarnitineAminophyllinePentoxiphyllineDMAEVitamin CProcaine
All are Principals
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MesoCelluliteInjection sites & depths 2mm
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MesoCellulite
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Stretch Marks
The connective tissue, including collagen and elastin, becomes increasingly damaged until eventually causing the formation of stretch marks.
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Stretch Marks
Collagen Elastin Stimulating/ Restoring agentsOrganic Silicium / SilorgCentella AsiaticaVegetal proteins + Fibronectin
Firming agentsDMAE + Vitamin CDMAE + Idebenone.
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MesoStretch Marks Protocols
Silorgamine =Silorg + DMAE Centella Asiatica
FibronectinVegetal Proteins
Idebe =Idebenone + DMAE
Vitamin CDMAESilorg
All are Principals
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MesoStretch MarksInjection sites
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Needle size
30/32 G x 4 mm 30/32 G x 6 mm 30/32 G x 12.7 mm
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MesoGuns
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Injection Techniques
PAPULE: 1 to 2mm, with bevel upwardsNAPPAGE: 2 to 4mm, angle of 30° to 60°POINT BY POINT: deep injections, 4 to 12mm
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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.
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MESOPORATION
Mesotherapy ------ Non invasviveNo needles are required.
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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.
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MESOPORATION
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MESOPORATION
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MESOPORATION
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email:[email protected]