Mesotherapy photoIt's a revolutionary phenomenon that's sweeping through the medical spa industry. Singer Roberta Flack calls it "a gift from God," and its fans, including models and actresses flocking for treatment, though not necessarily publicly avowing it, feel the same. It's mesotherapy (pronounced mez-o-therapy)—a treatment started more than 50 years ago in France by Dr. Michel Pistor which dissolves fat and gets rid of your cellulite.

Any women's magazine editor will tell you that when the words "thinner thighs" or "how to get rid of cellulite" appear on their covers, magazines fly off the newsstands.
While many techniques, potions and formulas have claimed to treat cellulite, mesotherapy really works, even though there are still naysayers who say nothing changes cellulite.

How do I know it works? Because, as a professional consultant to the industry, I want all my clients to have cutting edge treatments and technology in their medical spas, so I tried the treatment with the renowned Dr. Lionel Bissoon at The Bissoon Institute for Mesotherapy in Palm Beach, FL.

Mesotherapy is a series of injections of a "cocktail" of nutraceuticals, FDA-approved off-label pharmaceuticals, vitamins, minerals, amino acids and homeopathic formulas under the mesoderm or middle layer of the skin—hence its name. Dr. Pistor developed it primarily to reduce cellulite, but it has proved to be of use in weight loss and is sometimes used in conjunction with liposuction for such areas as thighs, stomach, arms and even the neck, face and hands. The French even use it for rheumatism, fibromyalgia and sports injuries, and it has been found to be effective in treating migraine and constipation.
Dr. Bissoon is an osteopath who founded The Institute and the American Board of Mesotherapy. He is one of the foremost mesotherapy practitioners in the U.S. and the one credited with popularizing its treatment here. I met him several times at anti-aging conferences at which we were both panelists. The more I heard about it, the more I knew I had to know it if was something that should be on the menus of my clients' spas.

I'm a vegetarian, and I work out with a personal trainer, but like many women, I still had cellulite on my thighs. I just didn't feel comfortable wearing shorts any more because I didn't like the way my thighs looked. My physician husband was skeptical of the treatment, but now admits that my thighs are at least a third better after my first three treatments.

Dr. Bissoon says there are three factors that cause cellulite: poor circulation, defective connective tissues and enlarged fat cells. He estimates that 90% of women have cellulite, and that it can actually be caused by too-tight elastic in your underwear. "It's all oriented in the panty line," says. "Thongs became a popular fashion item, but women don't understand that there are actually benefits to wearing them. They are practicing prevention of cellulite at an early age and don't even realize it."

When Dr. Bissoon started doing mesotherapy in 1999 after training with French practitioner Jacques Le Coz, there were only a handful of "mesotherapists". As word of mouth spread throughout the industry about its efficacy, he started teaching others how to administer and formulate the treatment, and now holds training seminars in Florida, Beverly Hills and New York City.

According to Leslie Fischer, the executive director of the Institute, the real explosion of interest has been over the past two years. "We went from training three doctors to training more than 100 from all parts of the country, and we've had numerous requests from Asia and Australia" said Fischer. They have also retrained many doctors who learned the therapy at other courses or in France, and offer private training to doctors.

Why has it been around so long and is only now just taking off? Mainly, it's because the French never did research on it, says Fischer. "They just said it worked, and of course, people asked, where are the studies?" So, in addition to training the art of mesotherapy, The Bissoon Institute has been funding research, under the direction of Dr. Frank Greenway, for the past year-and-a-half to prove the science behind the treatment. Dr. Bissoon's book, The Cellulite Cure, which will be published in May, will reveal findings of that research, as well as the complete story of the treatment, how it works and include before and after photos that show what a difference it can make.

There are many in the medical profession who are anxiously awaiting those results. Dr. David Friedman, a world-renowned laser treatment physician who resides in Israel, is one. He took a mesotherapy course in Canada and had positive results with the six patients he has treated so far, but he is taking a cautious approach.

"Real science is the foundation of any medical procedure," he says. "However, I am most interested in seeing placebo-controlled, double-blind studies. This, to my knowledge, is lacking. I don't think that the side-effect portion of the equation has been adequately fleshed out. What are the short-term and long-term systemic effects and the short-term cutaneous effects?"

Peter Fodor, M.D., president of the American Society for Aesthetic Plastic Surgery (ASAPS), writing in a 2003 "Cellulite Update" press release, said, "Currently, there are no peer-reviewed articles or scientific studies to back up claims that mesotherapy improves the appearance of cellulite." He added, "Although some treatments may provide temporary improvement in the dimpled appearance of cellulite, to date there is no proven, permanent "cure" for cellulite." That update was two years ago, and, again, one of the reasons that Dr. Bissoon is funding research. Whether the research will be accepted by organizations such as ASAPS remains to be seen, since it is not independent research.

Dr. Bissoon took what he learned in France and refined and improved it. He sometimes uses 100 to 200 injections per square inch of dimpled skin in 30 to 40-minute sessions. This mass attack on cellulite with the specialized formula dissolves the fat cells, breaks down the connective tissue which, in a sense, cradles that fat in those uneven dimple-like dents, and then repairs the connective tissue and releases growth factors directly into the affected area to heal it and restore and maintain the skin's elasticity.
"Several medicines may be used," said Dr. Bissoon. "One is aminophylline, which breaks down the fat. We also use an enzyme called hyaluronidase for the connective tissue repair, melilocus, a homeopathic medicine made from sweet clover, which increases circulation. Cynara scolymus is a homeopathic artichoke-based medicine which also helps with circulation. Some add Vitamin C. I use multi-vitamins."

One of the most important aspects of the treatment is learning to "diagnose" the severity and compound the right formula for each patient. Says Dr. Bissoon, "I teach [those in the course] to examine and evaluate the problem. I teach them how to pick the right solutions for the different aspects of cellulite: cottage cheese skin vs. ridges. Some women have loose skin or saddlebags around the knees. You have to look at the whole picture and plan. For instance, there's a certain solution for loose skin in the neck, another for the abdomen. It's a hands-on strategy."

Like so many advances in the medical spa industry, there is already new state-of-the-art technology being tested as the delivery system for the treatment, one using lasers that will be good news to "needle-phobics." Dr. Gallo is one of nine physicians taking part in that study (see sidebar).
There is much to make mesotherapy appealing and revolutionary:

- Few side effects. The most common is minor bruising and itching. I did experience the former. Even though most of the ingredients are natural, all patients at The Bissoon Institute are tested with the formula 24 hours before a prescribed treatment. This is a MUST for any facility adding mesotherapy to its treatment menu. Dr. Bissoon says he can count on one hand the number of patients who were allergic to the formula. The beauty of concocting an individual formula for each patient is the ability to determine what may be causing an allergic reaction, and try to eliminate that from the treatment.

- It's noninvasive. There is no cutting, just injections. No general or local anesthesia is required. Of course, this depends on your pain threshold, too. Some use a topical numbing or anesthesia cream, and I have to admit, that next time I would ask for that to reduce the sting of the injections.

- There's no recovery time. The minor bruising does not curtail any activity, which is not true of something a little more invasive, such as liposuction.

- It's long-lasting. Though it may take several treatments to erase the cellulite, you may only need one touch-up treatment per year—about the same as liposuction.

- It's multifunctional. As previously mentioned, it is being used to spot-reduce fat, even on hands and eye-fat pads, and has proved especially helpful in smoothing out liposuction dents. In addition to skin rejuvenation, it's also been used to treat alopecia. And no doubt, more uses for it will keep popping up.

Consultations for mesotherapy usually cost $500. The treatment itself, depending on where you live and the area you are having treated, can vary from $300 to $750 per session.

There are rarely areas that cannot be treated. Different formulas, as well as different injection techniques are used for each. And once you are cellulite free, as long as you maintain a healthy diet, you should remain cellulite-free, with just that annual "tune-up" treatment.

As a medical spa business professional, I am extremely excited about mesotherapy. I predict it will turn out to be the Botox of this decade. And this revolution is just beginning.

Please contact: Cheryl Whitman at [email protected] for further information on Beautiful Forever.