Mesotherapy and Phosphatidylcholine Injections

Historical Clarification and Review

ROTUNDA, ADAM M MD^*; KOLODNEY, MICHAEL S MD, PhD^†

^*Department of Dermatology, University of Southern California School of Medicine, Los Angeles, California

^†Department of Medicine, Division of Dermatology, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California

Address correspondence and reprint requests to: Adam M. Rotunda, MD, Bennett Surgery Center, Suite 570, 1301 20th Street, Santa Monica, CA 90404-2053, or e-mail:[email protected].

Acknowledgment We would like to thank Drs. Jacques Le Coz and Raja Bhupathy for their editorial assistance and Dr. Maria Teresa Ochoa for her assistance with translation.

Adam M. Rotunda, MD and Michael S. Kolodney, MD, PhD have indicated no significant interest with commercial supporters.

Dermatologic Surgery32(4):p 465-480, April 2006.

Abstract

BACKGROUND

Mesotherapy was originally conceived in Europe as a method of utilizing cutaneous injections containing a mixture of compounds for the treatment of local medical and cosmetic conditions. Although mesotherapy was traditionally employed for pain relief, its cosmetic applications, particularly fat and cellulite removal, have recently received attention in the United States. Another treatment for localized fat reduction, which was popularized in Brazil and uses injections of phosphatidylcholine, has been erroneously considered synonymous with mesotherapy. Despite their attraction as purported “fat-dissolving” injections, the safety and efficacy of these novel cosmetic treatments remain ambiguous to most patients and physicians.

OBJECTIVE

To distinguish mesotherapy from phosphatidylcholine injections by reviewing their history and the relevant experimental or clinical findings.

METHODS

A comprehensive search of Medline indexed literature and conference proceedings.

RESULTS

All the published studies evaluating the clinical efficacy of traditional mesotherapy currently originate from Europe. These reports focus primarily on musculoskeletal pain and vascular disease, rather than cosmetic applications. Although experimental data suggest that a number of traditional mesotherapy ingredients may theoretically reduce fat, these effects have not been supported in peer-reviewed studies. An increasing number of reports demonstrate that subcutaneous injections of a formula containing phosphatidylcholine combined with its emulsifier, deoxycholate, are effective in removing small collections of adipose tissue. Cell lysis, resulting from the detergent action of deoxycholate, may account for this clinical effect.

CONCLUSIONS

Mesotherapy is distinct from a method of treating adipose tissue with subcutaneous injections of deoxycholate alone or in combination with phosphatidylcholine. Additional clinical and experimental studies are necessary to more definitively establish the safety and efficacy of these treatments.