Long before mesotherapy was used in cosmetic dermatology, it gained recognition in pain management, sports medicine, and rheumatology. In the aesthetic arena, it had few indications and unimpressive results and was used mainly to treat cellulite. However, as the demand for more effective noninvasive cosmetic surgery treatments grows, the popularity of mesotherapy continues to increase nationwide. The latest spike in popularity is due to 2 newly created applications. One is the mesolift, also known as mesoglow, which consists of injecting a mixture of vitamins, minerals, and hyaluronic acid into the skin. The other is the injection of phosphatidylcholine and enzymes (collagenase and hyaluronidase) to treat fat deposits for body sculpting. Thus, US fascination with mesotherapy has been limited to its aesthetic applications. When mesotherapy was introduced to the United States, the procedure was much less aggressive in terms of the ingredients used and the volume of those ingredients as a result of heavy French influence. However, US physicians quickly adopted their own methods and variations on the procedure, and the approach changed radically because of a major difference in the mentality, habits, and expectations between the markets. Today, mesotherapy in the United States has products and protocols that are original and much more efficient. For once, innovation in aesthetic medicine, which usually travels from east to west, is now crossing the Atlantic in the opposite direction. In this article, we will explain some of these products and protocols.
Before proceeding, it is important to mention that there have been no controlled studies of mesotherapy to date, although one is reported to be under way in the United States. Physicians rely mostly on anecdotal experience until the results of such studies are published. Therefore, although it is true that there has been no systematic evaluation of toxicity, there are no reports of such adverse events despite the wide use of mesotherapy today. However, this does not necessarily mean that mesotherapy is completely safe, and dermatologists must keep in mind that no aesthetic treatment should in any way endanger a patient’s health—“first, do no harm.”