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May 5, 2010

ASAPS 2010: some science on Mesotherapy

One of the most interesting presentations at the recent ASAPS meeting was the long-awaited results of the lipodissolve / mesotherapy study. Dr. V. Leroy Young, who is an extremely careful and thoughtful researcher, presented the findings.

The study used volunteers with a BMI < 30 and without significant skin laxity, who had a series of injections into their abdomen in an attempt to reduce their subcutaneous fat deposits. There was no dieting, no other drugs, lasers or surgery used. The typical grid pattern of injections was used to one-half of the abdomen, with a pre-mixed combination of mesotherapy agents (PPC/DC). The patient had a series of up to four treatments into the same area, at intervals of 8 weeks. This method was chosen to mimic what is done at many mesotherapy clinics. Careful monitoring was done with a multitude of measurements, photos, lab tests, and CT scans - before, during and after the series of injections. By only treating one-half of the abdomen, each patient served as their own control.

There were no significant changes in BMI or skin-fold thickness, and no blood test changes as a result of the treatments.

In reviewing the photos, the before and after "result" photos looked very similar to me. Not much of a change. If there were changes in body shape, I thought that they looked pretty subtle. If I were the patient, I would be pretty disappointed in these results!

There were a couple of CT scans where I could really see a difference in thickness of the fat layer - so something was happening, at least in some patients, some of the time. According to Dr. Young's numbers, there was an average reduction of 7% in the subcutaneous fat thickness.

There were no major adverse effects reported in the mesotherapy study group, but patients' post-op complaints included pain, swelling and nodule formation. Despite that, most of the patients wanted to go ahead and treat the opposite side!

Bottom line: It's good to finally see this kind of non-biased, carefully controlled research being done. Personally, I was not impressed with the changes, but it might have some application for small areas where a little further refinement of a result might be desired following real liposuction. Too early to tell on that idea, though.

When the final report is issued in the Aesthetic Surgery Journal, I will be able to comment on it in more detail.

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