Transcript Mesotherapy nedir?

Dr. Hasan Ali Nogay M.D.
UNDERWATER and HYPERBARIC MEDICINE
SPECIALIST
MEDICAL ESTHETICIAN
MESOTHERAPIST
ADDRESS : Demircikara mh. Avni Tolnay Cad.
No:46/1, Narenciye
Antalya-TÜRKİYE
TEL. : +90.242.322.00.99
e-mail : www.drnogay.com
1
HISTORY OF MESOTHERAPY
1952 :
• Dr PISTOR PERFORMS AN INTRAVENOUS INJECTION OF 10 ml
OF PROCAINE TO AN ASTHMATIC PERSON.
• HIS SHORTNESS OF BREATH DOES NOT IMPROVE, BUT HIS
DEAFNESS DECREASED.
• Dr PISTOR THEN HAS THE SIMPLE BUT BRILLIANT IDEA OF
INJECTING SMALL DOSES OF PROCAIN FROM 3 TO 5 MM
DEEP AROUND THE PATIENT’S EAR.
• THIS THERAPY PROVES TO BE MORE EFFICIENT THAN WHEN
GIVEN SYSTEMICALLY.
2
HISTORY OF MESOTHERAPY
1958
• THE NAME MESOTHERAPY IS SUGGESTED IN THE FRENCH
MEDICAL PRESS.
• FOR Dr PISTOR, HIS TREATMENT MODALITY SEEMED
ACTIVE ON THE MESODERM AND ITS DERIVATES ;
THEREFORE THE TERM “MESO”.
1976
• CONSULTATIONS OF MESOTHERAPY ARE PERFORMEDBY Dr
DALLOZ- BOURGUIGNON IN NECKER’S HOSPITAL (PARIS).
1981
• FIRST MESOTHERAPY CONSULTATION FOR PROFESSIONAL
ATHLETES (INSTIITUT NATIONAL DES SPORTS DE PARIS) Y.
DEMARAIS’SERVICE , PERFORMED BY Dr. J. LE COZ.
3
HISTORY OF MESOTHERAPY
1982
FIRST UNIVERSITY DIPLOMA IN MESOTHERAPY AT THE
FACULTY OF MEDICINE OF PARIS XIII (Dr. M. BICHERON).
1987
• MESOTHERAPY IS OFFICIALLY RECOGNIZED AS PART OF
TRADITIONAL MEDICINE.
1991
• CREATION OF SOCIETE FRANCAISE DE MESOTHERAPIE (1600
MEMBERS).
2002
• MESOTHERAPY IS TAUGHT AT THE FACULTY OF MEDICINE IN
MARSEILLE, BORDEAUX, PARIS.
• FRENCH HEALTH SYSTEM RECOGNIZES THE MESOTHERAPY ACT.
4
HISTORY OF MESOTHERAPY
2003
• DEATH OF Dr MICHEL PISTOR WHO WAS A PASSIONATE
INVENTOR, A POET AND A HUMANIST, DURING HIS WHOLE
LIFE.
2004
• IN FRANCE, APPROXIMATELY 15 000 DOCTORS USE
MESOTHERAPY DAILY AND UP TO 60 000 PERSONS ARE
TREATED BY MESOTHERAPY EVERY DAY.
5
DEFINITIONS OF MESOTHERAPY
DR PISTOR QUOTE :
« A LITTLE, RARELY, IN THE RIGHT SPOT » IS STILL TRUE.
•
A LITTLE: IN MESOTHERAPY, SMALL DOSES OF DRUGS ARE
ADMINISTERED.
MESOTHERAPY GIVES THE OPPORTUNITY OFCOMBINING BETWEEN TWO TO
FIVE DRUGS WITH A SIMPLE INJECTION.
•
RARELY: INITIALLY, MESOTHERAPY SHOULD NOT BE PERFORMED
MORE THAN ONCE A WEEK (FROM 2 TO 6 SESSIONS) .
AFTER, THE OTHER SESSIONS CAN BE DONE EVERY FIFTEEN
DAYS AND “UP KEEP” SESSIONS EVERY MONTH.
•
IN THE RIGHT SPOT: MESOTHERAPY IS PRACTICED WITH
INJECTIONS AT THE SITE OF PAIN OR PATHOLOGY
6
DEFINITIONS OF MESOTHERAPY
MESOTHERAPY IS A MEDICAL TECHNIQUE
• IT CONSISTS OF DERMO-EPIDERMIC INJECTIONS (1 TO 13 MM
DEEP)
• USUALLY OF ALLOPATHIC PRODUCTS VARYING WITH THE
PATHOLOGY TO BE TREATED.
• WITH SMALL DOSES OF DRUGS, WE OBTAIN AN EFFECTIVE
MAXIMALE CONCENTRATION.
• THE SYSTEMIC, GASTRIC AND HEPATIC PASSAGE IS MINIMAL
WHICH RESULTS IN ALMOST ABSOLUTE SAFETY.
7
MESOTHERAPY GENERALITIES
MESOTHERAPY IS A TREATMENT STIMULATING THE MESODERM OR MIDDLE
LAYER OF THE SKIN.
•
CONCERNING AESTHETIC MEDICINE :
– CELLULITE
– WEIGHT LOSS
– BODY SCULPTING
– HAIR LOSS
– FACE AND NECK REJUVENATION
RESPOND WELL TO MESOTHERAPY
•
MESOTHERAPY INVOLVES :
– THE INJECTION OF A CUSTOMIZED MIXTURE WITH EXTREMELY SMALL NEEDLES (GENERALLY 4
TO 6 MM).
– JUST A DROP OF THE SOLUTION : IS PLACED AT EACH INJECTION SITE.
– ONLY INTO THE PROBLEMATIC AREA.
•
THE PROCEDURE :
– IS REALY PAINLESS
– REQUIRES NO PREPARATION OR RECOVERY TIME, NO BANDAGES, NO INTERRUPTION OF THE
DAILY LIFE.
•
SIDE EFFECTS :
– GENERALLY LIMITED TO BRUISING (WHEN DHD TECHNIQUE IS USED WITH A DEPTH OF 10 MM).
– IT IS A SAFE TREATMENT, WHEN PERFORMED BY AN EXPERIENCED CLINICIAN.
8
DIFFERENT TECHNIQUES OF
INJECTION
EPIDERMIC MESOTHERAPY
DERIVATE OF MULTIPRICKING
NO BLEEDING
THE EDGE OF THE NEEDLE DIRECTED UPWARD
MOVEMENT BACKWARD AND FOWARD MOTION IN THE AXE
OF THE NEEDLE
“NAPPAGE” : MULTI-PRICKING
 A THIRD OF THE CONTENTS OF THE SYRINGE IS INJECTED
 THE REST IS LOST
PAPULA
“POINT BY POINT”
 WE PRICK, WE INJECT, WE REMOVE THE NEEDLE
9
TERMINOLOGY RESULTING FROM
CONSENSUS OF SCIENTIFIC COMITEE OF SOCIETE
FRANCAISE DE MESOTHERAPIE (S.F.M.)
• IED : INTRAEPIDERMIC INJECTION : 1 MM
• ID : INTRADERMIC INJECTION : 1 to 4 MM OF DEPTH
• IDS : SUPERFICIAL INTRADERMIC: 1 to 2 MM (NAPPAGE)
• IDP : DEEP INTRADERMIC INJECTION : 3 to 4 MM
• DHP : DERMO HYPODERMIC : 2 to 10 MM
• PPP : POINT BY POINT
: 2 to 4 MM
10
MESOTHERAPY TECHNIQUE
•
NO AGGRESSIVE INJECTION.
•
NO INJECTION DEEPER THAN 10 MM.
•
NO MIXTURE CONTAINING MORE THAN 4 OR 5 DRUGS.
•
A LITTLE, RARELY, IN THE RIGHT SPOT.
•
MATERIAL USED ONLY ONCE.
•
DISINFECTION OF THE INJECTED AREA WITH CHLORHEXIDINE OR BENZYLIC
ALCOHOL.
•
WEARING GLOVES IS RECOMMENDED.
•
A GOOD SESSION MUST BE PAINLESS AND LEAVE MINIMAL OR NO MARKS
AT ALL.
11
MATERIAL USE
• MULTI-INJECTORS AND MULTI-PUNCTURE HAVE BEEN
ABANDONED.
• REPLACED BY THE SIMPLER SINGLE NEEDLE MEASURING 4,
6 OR 13 MM, TO BE USED ONCE ONLY.
• THE NEEDLE IS FASTENED INTO A SYRINGE WHOSE VOLUME
VARIES BETWEEN 2 AND 10 CC.
• THIS MATERIAL CAN EITHER BE USED MANUALLY OR
MOUNTED INTO AN ELECTRONIC OR MECHANICAL INJECTOR
(DHN, PISTOR 3 OR 4, MESO SYSTEM).
12
MESO-SYSTEM
MESOTHERAPY GUN
•
THIS GUN “MESO-SYSTEM” INTEGRATES THE MORE RECENT TECHNOLOGY
APPLIED TO MESOTHERAPY.
•
SPEED AND FREQUENCY OF THE INJECTION ARE CONTROLLED
ELECTRONONICALLY.
•
IT IS CONTROLLED BY MICRO-PROCESSOR AND WE HAVE 8 INJECTION
PROGRAMS.
•
AUTOMATIC PRESSION ADJUSTMENT OF THE SYRINGE, ELECTRONIC
CONTROL OF DEPTH AND DOSE.
•
RECHARGEABLE BATTERY INTEGRATED.
•
AUTONOMY OF 6 HOURS IN CONTINUOUS USE.
•
“MESO-SYSTEM” ACCEPTS ANY KIND OF SYRINGES AND NEEDLES. NO
EXCLUSIVE KIT.
13
SECURITY MEASURES
• BEFORE THE SESSION :
• THROUGH QUESTIONING TO DISCOVER ANY HISTORY
OF ALLERGIES.
• ONGOING TREATMENTS.
• EXISTENCE OF ACUTE OR CHRONIC PATHOLOGY.
• ANTI-COAGULANT TREATMENT.
• THE PATIENT MUST STOP ANY TREATMENT WITH
ASPIRIN OR ANTI-INFLAMMATORY MEDICATION TWO
DAYS BEFORE THE PROCEDURE.
• AFTER THE SESSION :
• NO BATH OR SHOWER.
• NO CREAM AND HYDRATING MILK.
• AVOID THE SUN FOR ONE DAY.
14
MEDICATIONS IN MESOTHERAPY
•
IN GENERAL, BETWEEN TWO AND FIVE DRUGS ARE MIXED AND
INJECTED AT THE SAME TIME.
•
THEIR CHEMICAL AND PHYSICAL COMPATIBILITY HAVE BEEN
TESTED.
•
IN THE BEGINNING, ALMOST ALL MEDICATIONS INJECTED INCLUDED
PROCAÏNE.
•
THIS PRODUCT WAS USED FOR ITS SYMPATHICOLYTIC AND VASODILATATION PROPERTIES.
•
ITS USE, HOWEVER, WAS HIGHLY DEBATED DUE TO ITS HIGH
ALLERGIC RISK BROUGHT BY PARAAMINOBENZOATE.
•
IN FRANCE, PHYSICIANS PRATICING MESOTHERAPY HAVE NEVER
ENCOUNTERED PROCAÏNE-LINKED ANAPHYLACTIC SHOCKS (THE
MINIMUM DOSE INJECTED CAN NOT BE CONSIDERED AGGRESSIVE).
15
DRUGS USED IN
MESOTHERAPY MUST:
• BE APPROVED BY FRENCH DRUG
AGENCY IN ORDER TO BE INJECTED.
• BE PACKAGED IN STERIL AMPULES.
• BE PREPARED JUST BEFORE THE
SESSION.
16
VASODILATORS
DIHYDROERGOTAMINE (D.H.E.)
• PACKAGE : AMPULE OF 2 ML (1 mg)
• INDICATIONS IN USE OF MESOTHERAPY :
– MIGRAINES
– VENO-LYMPHATIC DEFICIENCY
• MESO INJECTION TECHNIQUE :
– IDS.
• CONTRA-INDICATION :
– PREGNANCY
17
VASODILATORS
ETAMSYLATE ( DYCINONE)
• PACKAGE : AMPULE OF 2 ML
• INDICATIONS IN USE OF MESOTHERAPY :
– LOCAL EDEMA AS VEINOTONIC.
• MESO INJECTION TECHNIQUES:
– IED, IDS, IDP, DHD.
• UNDESIRABLE EFFECTS :
– SKIN ALLERGY.
18
PROCAINE
PROCAINE BIOSTABILEX 2 %
•
PACKAGE : AMPULE OF 5 ML (100 mg)
•
VALIDATE INDICATIONS : LOCAL ANESTHESIC
•
INDICATIONS IN USE OF MESOTHERAPY :
– VASODILATOR ACTION
•
CONTRA-INDICATIONS :
– EPILEPSY
– PROCAINE ALLERGY
– PREGNANCY
•
UNDESIRABLE EFFECTS :
– EXCEPTIONNAL ALLERGY
– CARDIO-VASCULAR COLLAPSE
– CONVULSIONS
– CARDIAC ARYTHMIS
19
LIDOCAINE
(WITHOUT PARABEN CONSERVATOR)
:
MESOCAINE
PACKAGE :
 AMPULE OF 5 ML : 0.5 % AND 1 % (25 MG and 50 MG)
INDICATIONS : LOCAL ANESTHESIC
INDICATIONS IN USE OF MESOTHERAPY :
VASODILATOR ACTION
USE WHEN ALLERGIC SUSPICION RISK WITH PROCAINE
UNDESIRALE EFFECTS : RARE ALLERGY
20
VASODILATORS PRODUCTS
BUFLOMEDIL (FONZYLANE)
• PACKAGE : AMPULE OF 5 ML (50 mg)
• INDICATIONS :
– PERIPHERAL VASODILATOR.
• MESO INJECTION TECHNIQUES:
– IED, IDS, IDP, DHD, NAPPAGE, PPP.
• CONTRA-INDICATION :
– EXCEPTIONNAL ALLERGY
21
VASODILATORS PRODUCTS
PENTOXIFYLLINE (TRENTAL)
• PACKAGE : AMPULE OF 5 ML (100 mg)
• INDICATIONS:
– PERIPHERAL VASODILATOR
– ANTI-FREE RADICALS ACTION.
– MESO INJECTION TECHNIQUES: IED, IDS, IDP, DHD,
NAPPAGE, PPP.
• UNDESIRABLE EFFECT :
– SKIN ALLERGY
22
VITAMINS
• VIT A, D3, E, B1, B2, PP, B6, VIT C
(HYDROSOL POLYVITAMIN BON)
• PACKAGE : AMPULE OF 2 ML
• INDICATIONS IN USE OF MESOTHERAPY :
– ANTI FREE RADICALS ACTION.
• MESO INJECTION TECHNIQUES :
– IED, IDS, IDP, DHD.
• CONTRE-INDICATIONS :
 ALLERGY VIT. B1
 HYPERCALCEMIA
 PREGNANCY
23
CALCITONINE PHARMY II
50 UT and 100 UT
PACKAGE :
CIBACALCINE
SALMON CALCITONIN (AMPULE OF 1 ML)
INDICATIONS IN USE OF MESOTHERAPY :
 USED FOR ITS VASOMOTOR PROPERTIES LIKE ANTIOEDEMA AND VASO
MODULATOR.
MESOTHERAPY INJECTION TECHNIQUE : IED, IDS, IDP.
CONTRE-INDICATIONS :
 ALLERGIC TO CALCITONINS.
UNDESIRABLE EFFECTS :
 NAUSEA
 FLUSH
 ITCHING
PARTICULAR OBSERVATIONS :
UNDESIRABLE EFFECTS ARE MORE REDUCED IN MESOTHERAPY, WHEN USING IED
AND IDS TECHNIQUES.
SALMON CALCITONIN IS 25 TO 50 TIMES STRONGER THAN HUMAN CALCITONIN.
24
VITAMIN C
PACKAGE : LAROSCORBINE : AMPULES OF 5 ML
•
VITAMIN C IS A POWERFULL ANTI-OXIDIZING AGENT.
•
ANTI-AGEING EFFECT OF VITAMIN C AND SYNTHESIS OF COLLAGEN
•
TAKES PART IN SYNTHESIS OF ELASTIN.
•
PROTECTS VITAMIN A AGAINST OXIDATION.
•
PROTECTS AGAINST SUN DAMAGE.
•
EXEMPLE OF MIXTURE :
– VITAMIN C
: 3 CC
– PROCAINE
: 1 CC
– SALIN SERUM : 6 CC
25
CONJONCTYL
(ORGANIC SILICIUM AND SALICYLIC ACID)
•
HAS BEEN RE-COMMERCIALED IN FRANCE SINCE JUNE 2004
•
PACKAGE : AMPULES OF 5 ML
•
PROPERTIES :
–
–
•
SILICIUM CONTROLS CELLULAR STIMULATION OF FIBROBLASTS
AND PROMOTES THE REGENERATION OF COLLAGEN AND ELASTIN.
INDICATIONS IN USE OF MESOTHERAPY :
–
–
LIPOLYTIC ACTION
TROPHIC ACTION : THE SKIN IS MORE FIRM, SOFT AND SMOOTH.
•
CONTRE-INDICATIONS : ALLERGY TO SALICYLIC ACID
•
CAN BE INCLUDED IN THE MIXTURES , SUCH AS :
–
–
PROCAINE
: 2 CC
CONJONCTYL : 6 CC
OR :
–
–
–
PROCAINE
: 1 CC
FONZYLANE : 4 CC
CONJONCTYL : 5 CC
26
HOMEOPATHIC DRUGS
WELL TOLERATED WITH MINIMAL RISK.
•
NEVER SIDE EFFECTS.
•
NEVER ALLERGY.
•
WITHOUT CONTRE-INDICATIONS.
•
NO CHIMIC INCOMPATIBILITY BETWEEN HOMEOPATHIC AND ALLOPATHIC
PRODUCTS.
•
INJECTABLE HOMEOPATHIC DRUGS FOR CELLULITE :
–
–
–
–
–
•
HAMAMELIS
MELILOTUS
CYNARA SCOLYMUS
FUCUS VESICULOSUS
ARNICA
4 DH
ACTION ON THE VEINS
4 DH
4 DH : DRAINING ACTION AND ANTIOEDEMA.
4 DH : LIPOLYTIC ACTION
4 DH : ANTI-BRUISES ACTION
EXEMPLE OF MIXTURE :
–
–
–
PROCAINE 2 % = 1 ML
FUCUS
= 2 ML
MELILOTUS
= 2 ML
27
ADVERSE EFFECTS IN
MESOTHERAPY
• NEGLIGABLE NUMBER OF INCIDENTS.
• NO SHOCKS.
• NO SERIOUS ALLERGIC RISK.
• NO RISK OF SKIN INFECTION IF STERILE
TECHNIQUE. (DO NOT REUSE INJECTABLE MATERIAL).
• TO PREVENT SHOCK RISK, USE MESOCAINE.
28
ADVERSE EFFECTS
MOST DISADVANTAGES DUE TO :
• PHYSICIAN LACK OF EXPERIENCE WITH THIS TECHNIQUE
(PAINFUL INJECTIONS, SCRATCHES, BRUISES, TATTOOS).
• INADEQUATE DISINFECTION OR NON STERILIZED MATERIAL
(SKIN INFECTIONS).
• TOO MUCH REPETITIV SESSIONS, DRUGS INJECTED IN
LARGE VOLUME (HEMATOM, CUTANEOUS NODULES).
MINOR ADVERSE REACTIONS :
• LOCAL ALLERGIES, FLUSH WITH VASODILATOR OR
CALCITONIN.
29
HYPERLIPODYSTROPHY
DEEP
SUPERFICIAL


GENERALIZED LOCALIZED

FAT



STEATOMERY CELLULITE
30
CELLULITE CAUSES
•
HEREDITY (PARENTS, SIBLINGS, RACIAL FACTORS).
•
HORMONE EQUILIBRUM
–
–
–
–
–
PREMENSTRUAL SYNDROM
PUBERTY
PREGNANCY
MENOPAUSE
BADLY ADAPTED HORMONAL TREATMENT
•
VENOUS AND LYMPHATIC STATE
•
ROLE OF NERVOUS SYSTEM
•
JOB (PROLONGED STATIONARY JOBS, ON THEIR FEET OR SITTING DOWN ALL DAY)
•
GOOD NUTRITION BALANCE
–
–
•
SUGAR AND FAT EXCESS
INSUFFICIENT WATER INTAKE
NO PHYSICAL EXERCISE
31
CELLULITE
• IT IS CAUSED BY :
– POOR CIRCULATION.
– WEAKENING 0F CONNECTIVE TISSUES.
– LYMPHATIC CONGESTION.
• MESOTHERAPY IS TARGETED TO CORRECT THESE
PROBLEMS BY :
–
–
–
–
IMPROVING CIRCULATION.
STRENGTHENING CONNECTIVE TISSUES.
STIMULATING VENOUS AND LYMPH FLOW.
BREAKING DOWN THE FAT NODULES.
32
CLINICAL CLASSIFICATION
CELLULITE IS CLASSIFIED IN 4 STAGES BASED UPON
ITS APPEARANCE WHILE STANDING, LAYING AND
PINCHING THE SKIN.
• STAGE 1 : APPEARS WHEN YOU PRESS THE SKIN.
• STAGE 2 : APPEARS WHEN THE PATIENT STANDS
UP.
• STAGE 3 : ORANGE SKIN PEEL WHEN THE
PATIENT IS LAYING DOWN.
• STAGE 4 : KNOTS WHEN YOU TOUCH.
33
MEDICATIONS
IN CELLULITE

VASODILATORS
MEDICINE

DEPTH = 2  4 MM
• STAGE 3


TROPHIC MEDICINE
DEPTH = 2  4 MM
• STAGE 4


LIPOLYTIC MEDICINE
• STAGE 1 and 2
POINT BY POINT 6 MM
34
CELLULITE
•
MESOTHERAPY CAN BE USED TO TREAT LOCALIZED FAT DEPOSITS
AND CELLULITE WITH EXCELLENT RESULTS.
•
TODAY, IN FRANCE, WE REGRET THAT THE FOLLOWING DRUGS ARE
NO LONGER AVAILABLE :
•
•
•
•
•
THIOMUCASE
AMINOPHYLLINE
CHOPHYTOL
ESBERIVEN
NOWADAYS, WE USE :
• LOCAL ANESTHETICS (PROCAINE OR LIDOCAINE)
• VASODILATORS (FONZYLANE, TORENTAL) WHICH PLAY AN ACTIVE PART ON
MICROCIRCULATION, AND SOMETIMES ON VENO-LYMPHATIC SYSTEM
(DIHYDROERGOTAMINE, DYCINONE).
• PHYSIOLOGICAL SALIN SERUM..
• LIPOLYTICS (CAFEINE)
• AND SOMETIMES HOMEOPATHIC MEDICINES.
35
MESOTHERAPY TECHNIQUES IN
LIPODYSTROPHY
•
EPIDERMIC INJECTION :
–
•
SUPERFICIAL INTRADERMIC INJECTION :
–
•
HALF DELAYED ELIMINATION, ESPECIALLY IN
DIFFUSED CELLULITES.
DERMO-HYPODERMIC INJECTION :
–
•
THE PRODUCT REMAINS IN THE EPIDERM
WITH SLOW DIFFUSION ; NO BRUISES.
AT THE LEVEL OF DEEP FIBROSIS KNOTS.
MIXED OR ALTERNATIVES INJECTIONS.
36
MEDICATIONS
IN CELLULITE MESOTHERAPY
•
•
•
•
•
•
•
•
•
VASCULAR ACTION
BENZOPIRONE (COUMARINE)
BUFLOMEDIL
PENTOXIFYLLINE
MELILOTUS
GINKO BILOBA
PROCAINE
LIDOCAINE
CALCITONINE
ETAMSYLATE
37
MEDICATIONS
IN CELLULITE MESOTHERAPY
TROPHIC ACTION
•
•
•
•
•
•
•
•
•
•
•
SODIUM PYRUVATE
ALCACHOFA (ARTICHOKE)
CENTELLA ASIATICA
TRISSILINOL (CONJONCTYL)
LISADOS (COLLAGENO, ELASTINA, PLACENTA)
VITAMIN C
HYALURONIC ACID
CHONDROITINE SULFATE
X-ADN
PLACENTEX
POLYVITAMINS
38
MEDICATIONS
IN CELLULITE MESOTHERAPY
LIPOLYTIC ACTION
•
•
•
•
•
•
•
•
IOIMBINE
TIRATRICOL
AMINOPHYLLINE
EUPHYLLIN
L-CARNITINE
CAFEINE
COENZYME A
LIPOSTABIL
39
CELLULITE TREATMENT
TWO BASIC PRINCIPLES :
• MESODRAINING :
TREATMENT OF THE CIRCULATION ON VASCULAR AXIS :
– LIDOCAINE
– ETAMSYLATE
– BUFLOMEDIL
(MESOCAINE)
(DYCINONE)
(FONZYLANE)
• MESOLYTIC :
LOCAL TREATMENT : (SADDLE BAGS, ABDOMEN, HIPS)
LIDOCAINE
(MESOCAINE)
SALMON CALCITONINE 100 U
HYDROSOL POLYVITAMINE (HPV BON)
40
IN LIPODYSTROPHY
• STANDARD CLINICAL STAGE (THE MOST FREQUENT) :
• MESOCAINE 1 %
• CALCITONINE 100 U
• FONZYLANE
= 2 ML
= 1 ML
= 2 ML
• OLD CELLULITE WITH HARD KNOTS OF FIBROSIS :
• MESOCAINE 1 %
• CALCITONINE 100 U
• HYDROSOL POLYVITAMINE BON
= 2 ML
= 1 ML
= 2 ML
• LIPODYSTROPHY WITH IMPORTANT VENO-LYMPHATIC
DEFICIENCY :
• MESOCAINE 1 %
• CALCITONINE
• DICYNONE
= 1 ML
= 1 ML
= 3 ML
41
CELLULITE TREATMENT
• OTHER MIXTURES :
– LIDOCAINE (MESOCAINE)
– SALMON CALCITONINE 100u
– BUFLOMEDIL (FONZYLANE)
• OR:
– LIDOCAINE (MESOCAINE)
– HYDROSOL POLYVITAMINE (HPV BON)
– BUFLOMEDIL (FONZYLANE)
• OR:
LIDOCAINE (MESOCAINE)
CALCITONINE
ETAMSYLATE (DYCINONE)
42
CELLULITE TREATMENT
TECHNIQUE POINT BY POINT (PPP)
NEEDLE 6 MM OR 13 MM
• MIXTURES :




PROCAINE
TRENTAL
DYCINONE
SALIN SERUM
2CC
2CC
2CC
2CC
NEEDLE 6 MM
LIDOCAINE
TRENTAL
DYCINONE
CAFEINE
ARNICA
SALIN SERUM
2 CC
2 CC
2 CC
1 CC
1 CC
2 CC
NEEDLE 13 MM
43
CELLULITE
HOW MANY TREATMENTS ?
• THE NUMBER OF MESOTHERAPY TREATMENTS NEEDED
DEPENDS ON MANY VARIABLES.
• MESOTHERAPY TREATMENTS ARE TYPICALLY GIVEN ONCE
PER WEEK (FOUR AT SIX SESSIONS) TO ACCESS SOME
RESPONSE.
• AS IMPROVEMENT IS SEEN, THE PROCEDURE MAY BE DONE
EVERY TWO WEEKS (FOR EXEMPLE FOUR SESSIONS
DURING TWO MONTHS).
• AND AFTER ONE PER MONTH.
• IN GENERAL, A CHRONIC COMPLAINT LIKE CELLULITE NEEDS
FIFTEEN SESSIONS OF MESOTHERAPY.
44
CELLULITE
THE RESULTS
•
THEY DEPEND ON THE PATIENT’S BODY.
•
MOST OF PERSONS REQUIRES FOUR TO FIVE TREATMENTS TO
BEGIN TO SEE RESULTS.
•
BETWEEN SESSION 4 AND 6 :
 LOCAL CIRCULATION IMPROVED OEDEMA AND HEAVY LEGS FEELING
DECREASED.
 TROPHIC ACTION :
 SKIN MORE SUPPLE AND SMOUTH
 COTTAGE CHEESE APPEARANCE OF THE SKIN IMPROVED.
•
BETWEEN SESSION 8 AND 12 (AFTER 3 OR 4 MONTHS) :
VOLUME OF CELLULITE IS REDUCED
PATIENT’S CLOTHING WILL BECOME LOOSER (LOSING INCHES MORE
THAN WEIGHT)
45
WEIGHT LOSS
PHYSICAL EXAM OBSERVE FAT DISTRIBUTION :
GYNECOID TYPE (PEAR) :
WE USE
(LOWER PART OF THE BODY) OFTEN - DRAINING DRUGS
ASSOCIATED WITH VARICOSE VEINS - VASODILATORS
- STIMULATORS OF VENO
LYMPHATIC CIRCULATION
ANDROID TYPE (APPLE)
(ABDOMEN, UPPER PART OF THE
BODY, CHEST, SHOULDERS ARMS)
WE USE
- DRAINING DRUGS
- VASODILATORS
- LIPOLYTIC DRUGS
46
BODY SCULPTING
• CONTOURING OF THE ABDOMEN, ARMS, LEGS AND HANDS
CAN BE OBTAINED WITH MESOTHERAPY.
• THE MEDICINE PRODUCTS USED TO TIGHTEN SAGGING SKIN
ARE :
–
–
–
–
VASODILATORS
TROPHIC DRUGS
VITAMINS
HYALURONIC ACID
• OTHER AGENTS CAN BE INJECTED TO REMOVE AREAS OF
FAT :
– LIPOLYTICS
• THE RESULT IS A RESTORATION OF A MORE YOUTHFUL AND
ATHLETIC APPEARANCE.
47
MESOLIFT SKIN
•
PHENOTYPIC SKIN CHANGES ARE CAUSED BY AGEING AND
CONDITIONED BY INTRINSIC AND EXTRINSIC FACTORS.
INTRINSIC FACTORS (AGE , SEX, OESTROGENC STATE)
•
HISTOLOGICAL STUDIES CONFIRM THAT THE EPIDERMIS THEN
EXPERIENCES SUBSTANTIAL DENSITY LOSS AND ATROPHY.
•
THE WATER-HOLDING CAPACITY OF THE STRATUM CORNEUM IS
REDUCED, RESULTING IN TISSUE DEHYDRATION.
EXTRINSIC FACTORS (TEMPERATURE VARIATION, WIND, EXPOSURE
TO ABRASIVE PRODUCTS, DRUGS, LIGHT, etc..)
•
THESE FACTORS DETERMINE THE APPEARANCE OF WRINKLES AND
THE LOSS OF SKIN’S TONICITY AND ELASTICITY.
48
MESOLIFT
SKIN AGEING EVOLVES IN THREE PHASES :
PHASE 1 :
 THE SKIN STAYS TONIC
 MODERATE DEHYDRATATION
 NO WRINKLES WHEN FACE IS AT REST (ONLY
APPEAR WHEN SMILING)
PHASE 2 :
 THE SKIN IS WRINKLED
 VISIBLE DRYNESS
 MILD TO MODERATE WRINKLES AT REST
 DERMIC FRACTURE VISIBLE WITH FACIAL
EXPRESSION
PHASE 3 :
 SLACK SKIN
 INTENSE DEHYDRATATION
 ELASTICITY AND TONE LOSS
 SKIN TEXTURE DETERIORATES
 MIDDLE TO SEVERE WRINKLES APPEARING AT REST,
NUMEROUS AND DIFFUSED.
49
MESOLIFT
SOLUTIONS
•
THERE ARE MANY “ANTI-AGEING” TREATMENTS.
•
INDICATIONS WILL DEPEND ON VARIOUS FACTORS SUCH AS THE AREA TO
BE TREATED, STAGE OF AGEING AND SKIN TYPE.
•
MESOLIFT IS PART OF THE OVER ALL MANAGEMENT PROCESS.
•
THIS TECHNIQUE COMBINED WITH HYALURONIC ACID-BASED SOLUTIONS
CAN COMPENSATE POOR-QUALITY OR LOSS OF HYALURONIC ACID.
•
INJECTED INTO THE DERMAL-EPIDERMAL JUNCTION OR THE SUPERFICIAL
DERMIS, EXOGENOUS HYALURONIC ACID RAPIDLY REACHES THE DERMIS.
•
THIS HAS THE FOLLOWING RESULTS :
 RECOLONISATION OF THE EXTRACELLULAR MATRIX
 IMPROVED SKIN HYDRATION AND ELASTICITY
 DISAPPEARANCE OF FINE WRINKLES
 RESULTING IN SKIN BEAUTY (MESOGLOW)
50
MESOLIFT
HYALURONIC ACID
• THE SKIN CONTAINS THE MAIN SUPPLY OF HYALURONIC
ACID WHICH IS A KEY COMPONENT OF THE EXTRACELLULAR
MATRIX.
• ITS HYGROSCOPIC PROPERTIES GIVE IT ITS WATERHOLDING CAPACITY AND GUARANTEE THE HIGH DEGREE OF
HYDRATATION REQUIRED BY SKIN TISSUES.
• IN EFFECT, HYALURONIC ACID ACTS LIKE A MOLECULAR
SPONGE.
• DUE TO INTRINSIC AND EXTRINSIC FACTORS, SKIN LOSES
ITS HYALURONIC ACID.
51
JUVELIFT : THE NEW HYALURONIC
ACID-BASED SOLUTION FOR
MESOLIFT
52
JUVELIFT
• JUVELIFT (CORNEAL)
• IS A SOLUTION OF NON CROSS-LINKED
HYALURONIC ACID OF BIOSYNTHETIC
ORIGIN.
• DESIGNED FOR MESOLIFT TECHNIQUES
APPLIED TO THE FACE, NECK, DECOLLETE
AND BACK OF THE HANDS.
53
JUVELIFT INJECTION
TECHNIQUES
JUVELIFT CAN BE INJECTED INTO AREAS OF THE FACE, NECK, DECOLLETE AND
HANDS WHOSE SKIN HAS LOST ITS TONICITY AND REVEALS FINE LINES.
SEVERAL PUNCTURE TECHNIQUE
THIS TECHNIQUE IS POSSIBLE MANUALLY OR WITH AN INJECTION GUN.
IT CONSISTS OF MICRO INJECTIONS INTO THE DERMAL-EPIDERMAL JUNCTION
OR THE SUPERFICIAL DERMIS OF THE FACE, NECK, DECOLLETE OR THE
BACK OF THE HANDS.
PATIENTS MUST BE WARNED THAT THE EFFECTS OF “PAPULAR” SERIAL
PUNCTURE INJECTIONS MAY STILL BE VISIBLE 2 OR 3 DAYS AFTER THE
SESSION, DEPENDING ON SKIN TYPE.
LINEAR THREADING OR CROSS-HATCHING TECHNIQUE
THIS TECHNIQUE IS MAINLY USED ON LINES IN FRAGILE AREAS OF THE
FACE CAUSED BY FACIAL EXPRESSIONS : CROW’S FEET, SMILE LINES ON
THE CHEEKS AND ORAL COMMISSURES.
IN THIS CASE, JUVELIFT IS INJECTED INTO THE SUPERFICIAL DERMIS USING
THE LINEAR THREADING TECHNIQUE (LINEAR INJECTIONS OR VERTICAL
INJECTIONS FOLLOWED BY HORIZONTAL ONES : CROSS-HATCHING)
54
JUVELIFT
• ADVANTAGES
• 13.5 mg/g OF HYALURONIC ACID, I.E. A CONCENTRATION
1,000 TIMES HIGHER THAN THAT OF THE ENDOGENOUS
HYALURONIC ACID CONCENTRATION IN THE EPIDERMIS AND
200 TIMES HIGHER THAN THAT IN THE DERMIS.
• MOLECULAR WEIGHT OF 2.5.106 Da (the highest on the market)
AT LEAST DOUBLE THAT OF THE SKIN (106 Da).
• THE CONCENTRATION AND THE HIGH MOLECULAR WEIGHT
OF JUVELIFT (CORNEAL) PROVIDE MORE ACTIVE AND
LONGER-LASTING HYDRATION TO PREVENT AND COMBAT
SKIN AGEING.
• SKIN TONICITY IS ENHANCED.
55
JUVELIFT
• TOLERANCE :
HYALURONIC ACID IS ALREADY USED IN A VARIETY OF
THERAPEUTIC INDICATIONS SUCH AS OPTHALMOLOGY,
RHEUMATOLOGY AND DENTISTRY.
• IN DERMATOLOGY, IT IS USED AS A FILLER FOR SKIN
DEPRESSIONS.
• JUVELIFT :
IS STERILE, NON-PYROGENIC, NON-IRRITATING,NONCYTOTOXIC, FREE OF TISSUE REACTION.
HAS BEEN USED IN OTHER INDICATIONS FOR 8 YEARS
56
JUVELIFT
TREATMENT
• THE CHOICE OF THERAPEUTIC PROTOCOL WILL DEPEND ON
THE STAGE OF AGEING.
• SEVERAL SESSIONS MAY BE REQUIRED TO ACHIEVE THE
DESIRED EFFECT.
• INJECTION SCHEDULE FOR EACH INDIVIDUAL PATIENT.
• A MINIMUM INTERVAL OF TWO WEEKS SHOULD BE
OBSERVED BETWEEN SESSIONS.
• THIS TREATMENT MAY BE SUPPLEMENTED BY INJECTION OF
WRINKLE FILLERS.
57
REVITACARE
BIO-REVITALISATION
PRODUCT PRESENTATION
• 4 ML : NON RETICULATED HYALURONIC ACID
– BIOTECHNOLOGY ( NON ANIMAL)
– BIO-COMPATIBLE
– BIO-DEGRADABLE
• 10 ML : BIOLOGIC STERIL SOLUTION WITH
VITAMINS
– VITAMINS A, E, C.
– VITAMIN D.
– VITAMINS B1, B2, B3, B4, B5, B6.
58
REVITACARE
BIO-REVITALISATION
PROPERTIES
• HYALURONIC ACID :
– HYDRATATING : SPECIFIC CAPACITY TO CREATE WATER
MOLECULE HELPING DERM TO FIRMESS AND ELASTICITY.
– RESTRUCTURING : KEY ROLE IN ORGANIZING EXTRA CELLULAR
MATRIX.
– FIBROLAST STIMULATION : FORERUNNER OF COLLAGEN AND
ELASTIN.
– ANTI-FREE RADICAL EFFECT : MAIN PROTECTION BY
ELIMINATING NOXIOUS SKIN COMPONENTS.
• POLYVITAMINS :
– A,E,C : ANTI-OXIDIZING ACTION
– D : ESSENTIAL FOR CALCIUM SYNTHESIS
– VITAMINS B GROUP (B1,B2,B3,B4,B5,B6) : THESE VITAMINS ARE
ESSENTIAL FOR A WELL BALANCED SKIN.
59
REVITACARE
BIO-REVITALISATION
THE BENEFITS OF REVITACARE BIO-REVITALISATION ARE NUMEROUS :
•
SKIN IS MORE :
–
–
–
–
–
SUPPLE
FIRM
SMOOTH
HEALTHY
BRIGHT
•
BIO-REVITALISATION CAN BE USED COMPLEMENTARY TO
WRINKLES FILLING, BOTOX SESSION, AFTER A PEELING TO
OPTIMISATE THE RESULTS.
•
•
TECHNIQUES OF USE :
SEVERAL TECHNIQUES CAN BE USED, EITHER SEPARATLY OR
GENERALLY JOINTLY DURING THE SAME SESSION OF TREATMENT :
– THE MULTIPUNCTURE
– THE NAPPAGE
60
MESOLIFT RESULTS
• YOUR SKIN IS FIRM, SMOOTH AND
HEALTHY.
• YOU HAVE A YOUNGER GLOW.
• YOU LOOK GOOD.
61
MESO BOTOX
BOTOX INJECTIONS WITH MESOTHERAPY
•
THE BOTOX IS DILUTED WITH PHYSIOLOGICAL SERUM (10 CC) OR
COMBINED WITH AN ANESTHESIC (9 CC OF SALIN SERUM + 1 CC OF
ADRENALISED XYLOCAINE 2 %).
•
BOTOX DILUTION DEPENDS ON THE AREAS TO BE INJECTED ON THE FACE.
•
A DETAILED EXAMINATION OF THE PATIENT‘S FACE IS NEEDED.
•
NOTING AND TRACING FACIAL POINTS, LINES AND WRINKLES
(DERMATOLOGICAL PENCIL).
•
MESOTHERAPY BOTOX INJECTIONS INCLUDE SMALL DERMAL PAPULAS.
•
INTRADERMAL INJECTIONS ARE REPEATED AND A SMALL AMOUNT OF
PRODUCT (MORE OR LESS DILUTED) IS INJECTED ALONG THE LINES
TRACED WITH PENCIL.
62
MESO BOTOX
•
THE PRACTITIONER MUST INJECT THE RIGHT DOSE OF BOTOX TO
AVOID A MASK-LIFE EFFECT.
•
IT IS NECESSARY TO CHECK THE EFFECTS OF BOTOX SESSION
AFTER TWO WEEKS.
•
THE TREATMENT’S ORIGINALITY IS THE SUPERFICIAL ACTION
ALONG THE FACIAL MUSCLES.
•
THESE MUSCLES ARE FINE, TINY AND OFTEN INTRICATELY LINKED.
•
VIA THESE MORE SUPERFICIAL INJECTIONS, THE THERAPIST
ACTS ON THE MUSCLE’S FIBERS TO ACHIEVE AN OVERALL
RELAXED EFFECT.
•
THE FACE LOOKS MORE SERENE.
63
HAIR LOSS
MESOTHERAPY
•
ALOPECIA AFFECTS BOTH MEN AND WOMEN.
•
THE LOSS OF HAIR RESULTS FROM :
–
–
–
–
•
THE MESOTHERAPY PROTOCOL FOR HAIR GROWTH INVOLVES USE OF A
COMBINATION OF PRODUCTS SUCH AS :
–
–
–
–
–
–
•
POOR SCALP BLOOD FLOW
NUTRITIONAL DEFICIENCIES
EXCESSIVE ANDROGENS (ANDROGENIC ALOPECIA)
MECANICAL ALOPECIA BY TRACTION
BIOTIN
BEPANTHENE (DEXAPANTHENOL)
VITAMIN C
MULTI-VITAMINS (NCTF 135)
SILICIA
VASODILATORS
IN SOME COUNTRIES :
–
–
FINASTRIDE (PROPECIA)
PLACENTEX
64
HAIR LOSS
MESOTHERAPY
•
3 OR 4 DRUGS WILL BE MIXED AND THE QUANTITY TO BE INJECTED
WILL NOT EXCEED 2.5 CM³.
•
INJECTIONS ARE PERFORMED AT THE LEVEL OF THE SCALP WITH
A 2.5 CM³ SYRINGE USING A 4 MM NEEDLE.
•
THE TECHNIQUE OFTEN ASSOCIATES DEEP INTRADERMAL IDP IN
CONTINOUS INJECTION WITH SUPERFICIAL INTRADERMALS, MULTIPRICKING.
•
FOR ACUTE HAIR LOSS :
– ONE SESSION EVERY WEEK DURING THE FIRST MONTH
– ONE SESSION EVERY TWO WEEKS DURING THE TWO MONTHS AFTER
– ONCE A MONTH , REACHING A TOTAL OF 12 TO 15 SESSIONS.
•
FOR CHRONIC HAIR LOSS :
– EVERY 3 WEEKS.
65
SCARS
ON THE MORPHOLOGIC LEVEL, 3 TYPES OF SCARS CAN BE
DIFFERENTIATED :
→ KELOID SCARS :
• CLASSICALY, DERMATOLOGISTS PROPOSE DOING CORTICOID
INFILTRATIONS.
• IN MESOTHERAPY, THE PROCEDURE USED FOR INJECTION WILL
CONSIST OF :
– A DILUTED CORTICOID
– WITH A 4 MM NEEDLE VERY USEFUL FOR THESE SCARS.
→ HYPERTROPHIC SCARS :
• FOR THIS TYPE OF SCAR, GENERALLY FIBROUS, WE SUGGEST
• USING :
– A DILUTED ANTI-INFLAMMATORY ASSOCIATED WITH AN ANTIEDEMA
– WITH A 4 MM NEEDLE AT THE LEVEL OF THE SCAR, EVERY 2 OR 3 MM.
– SESSIONS WILL BE PERFORMED EVERY 2 OR 3 WEEKS.
66
SCARS
→ FLAT SCARS :
• FOR THE NON AESTHETIC FLAT SCARS, WE SUGGEST :
– A NAPPAGE TECHNIQUE IN SUPERFICIAL INTRADERMAL
– THE MIXTURE GENERALLY USED ASSOCIATE PROCAIN AND VITAMINS
AND VASODILATORS.
OTHER MEDICINE PRODUCTS
•
PLACENTEX (ITALY) HAS SHOWN ITS QUALITY IN BLIND TEST
STUDIES FOR HEALING PHENOMENA.
•
IN BRAZIL, PRACTITIONNERS ARE USING “LISADOS”, “COLLAGEN”,
“ELASTIN” OR “PLACENTA”.
•
IN THE CASE OF DARK SCARS, ASCORBIC ACID (VITAMIN C) HAS
PROVED HELPFUL TO LIGHTEN THE SCAR.
67