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Dr. Amr Ismail MD Consultant Dermatologist Member of American Academy of Aesthetic Medicine MESOTHERAPY in
Dr. Amr Ismail MD Consultant Dermatologist Member of American Academy of Aesthetic Medicine
Dr. Amr Ismail MD
Consultant Dermatologist
Member of American Academy of Aesthetic Medicine

MESOTHERAPY in DERMATOLOGY

email:ahmismai@gmail.com

Definition

A minimally invasive aesthetic procedure employs multiple microinjections of pharmaceutical medications , amino acids , vitamins and others into the mesoderm.

Introduction

Mesotherapy was 1 st described by a French Physician Michael Pistor 1952. In 1987, French Academy of Medicine recognized Mesotherapy as part of traditional medicine.

Skin Structure

Skin Structure

Skin Structure

Embryonic origin

Adult Derivative

Ectoderm

Skin Epidermis Brain Breast Sweat glands

Mesoderm

Fibrous tissue (connective) Cartilage Bone Muscle Fat

Endoderm

Gut

Liver

Lung

Pancreas

Dermis

Connective tissue is often used to describe the extracellular matrix plus the cells found in it, such as fibroblasts, macrophages, and mast cells.

ECM Structure

3 major fiber-forming proteins:

Collagen, elastin, and fibronectin GAG : Hyaluronic acid one of 7. Proteoglycans.

Mesotherapy

Mesotherapy Connective Tissue Shock Therapy

Connective Tissue Shock Therapy

Indications

Hair:

Telogen effluvium Androgenetic Alopecia Face :

Facial rejuvenation (wrinkles + Firming) Facial pigmentation e.g. melasma.

Indications

Body Localised fat areas . Cellulite. Stretch marks.

How To Start

1. Materials & protocols / indication.

2. Injection sites.

3. Injection Depths.

4. Needle size.

5. Machine.

Materials

Classified into :

Principals(Major) Complementary(Minor)

TIP:

Mixture should contain 2-3 principals to achieve satisfactory results(>90%).

Telogen Effluvium Hair Growth Stimulants

Hair

Principals

Complementary

Biotin (Vitamin H/B7) Pantothenic acid (Vitamin B5)

Pyridoxine (Vitamin B6) Zinc + Azelaic acid MV + MTE

AGA Hair Growth Stimulants

5-ARI

Hair

Principals

Complementary

Minoxidil

 

Finasteride

Zinc + Azelaic acid

Dutasteride

MesoHair Protocols

Telogen Effluvium

Androgenetic Alopecia

Biotin (P) Dexenol(P) MV + MTE (C)

Minoxidil(P) / Dutasteride(P) + Biotin(P) Dexenol(P) Zinc + Azelaic (C)

MesoHair Injection sites & depths 1-2mm

MesoHair Injection sites & depths 1-2mm
MesoHair Injection sites & depths 1-2mm

Face MesoLift / MesoGlow

Rejuvenation (Major)

Proven to Stimulate collagen synthesis

Hyaluronic acid Amino acids Vitamin C Organic Silicium Fibronectin + Vegetal proteins (Collagen & Elastin) Vitamin A

Face MesoLift / MesoGlow

Rejuvenation (Complementary)

Glycolic acid Taurine XADN MV & MTE

Major Firming

1.

2.

DMAE :

Potent firming acts quickly and lasts long. Acts in the neuromuscular union, as a precursor of acetylcholine, the neurotransmitter responsible for muscular contraction, increasing the overall tone of the skin. DMAE + Organic Silicium

neurotransmitter responsible for muscular contraction, increasing the overall tone of the skin. DMAE + Organic Silicium
neurotransmitter responsible for muscular contraction, increasing the overall tone of the skin. DMAE + Organic Silicium

MesoGlow Protocols

Glow

Lift (Firming) HA (P)

HA (P)

Silorg (P)

Silorgamine = Silorg + DMAE (P)

Purascorbol / Vitamin C (P)

Puretinol / Vitamin A (P)

Xadenal (C)

Taurinox (C)

MesoGlow/Lift Injection sites & depths 1-2mm

MesoGlow/Lift Injection sites & depths 1-2mm
MesoGlow/Lift Injection sites & depths 1-2mm

Face Pigmentation

MesoLighten Melanogenesis

Principals

Complementary

Glutathione Kojic Vitamin C Azelaic acid

Glycolic acid Tretinoin

MesoLighten Protocols

Kojic acid (P) Azelaic acid (P) Vitamin C (P) Tretinoin (C)

Glutathione (P) Kojic acid (P) Vitamin C (P) Glycolic acid (C)

MesoLighten Injection sites & depths 1-2mm

MesoLighten Injection sites & depths 1-2mm
MesoLighten Injection sites & depths 1-2mm

MesoLighten Injection sites & depths 1-2mm

MesoLighten Injection sites & depths 1-2mm
MesoLighten Injection sites & depths 1-2mm

MesoLighten Injection sites & depths 1-2mm

MesoLighten Injection sites & depths 1-2mm
MesoLighten Injection sites & depths 1-2mm

MesoLighten

MesoLighten

Body

Localized Fat Cellulite Stretch marks

Localized Fat

LipoDissolve = Injection Lipolysis

Localized Fat

IAAL

Injection Lipolysis

Mesotherapy

Deep 12mm PPC + DOC (PCDC)

Hyaluronidase-Collagenase-

Artichoke Intermediate 6mm

(L-Carnitine-Aminophylline-

Yohimbine- Artichoke)

2 - 4 mm L-Carnitine Aminophylline Pentoxifylline

Effective complement

Phosphatidyl Choline (PPC)

An antioxidant derived from soy lecithin. PPC penetrates the adipocyte , breaks down fat . Dissolved fat is carried through bloodstream and excreted by kidneys and bowel.(P) LipoDissolve + proper diet + Exercise.

Localized Fat/ Injection Lipolysis

Lipolytic Enhancers:

Deoxycholate: Bile salt(P). L-Carnitine: Enhances both lipolysis and fatty acid oxidation(P) Artichoke: Direct lipolytic (P) Aminophylline , Caffeine & Xanthine(P) Hyaluronidase & Collagenase: PPC enhancer Enzymes (C)

PPC + DOC

Detergent Effects of Sodium Deoxycholate Are a Major Feature of an Injectable Phosphatidylcholine Formulation Used for Localized Fat Dissolution.

Rotunda AM, Suzuki H, Moy RL, Kolodney MS. Dermatol Surg 2004;30:1001-8. Division of Dermatology, University of California Los Angeles, David Geffen School of Medicine, Los Angeles, California, USA.

Conclusions:

The phosphatidylcholine formula popularly used in subcutaneous injections for fat dissolution works primarily as a detergent causing nonspecific lysis of cell membranes. Our findings suggest that sodium deoxycholate is the major active component responsible for cell lysis.Thus,eliminating unwanted adipose tissue.

Localized Fat/ Injection Lipolysis

Circulatory Enhancers:

Yohimbine:Alpha2-adrenergic Blocker. Aminophylline &Pentoxiphylline: PDEI Drainage Enhancers:

Artichoke:Diuretic and stimulates lymphatic drainage

Localized Fat/ Injection Lipolysis Protocols

Phosphatidylcholine(P) Deoxycholic Acid(P) Vitamin complex Alpha Lipoic Acid Amino Acids

Phosphatidylcholine(P) Deoxycholic Acid (P) Taurine Organic silicium

Phosphatidylcholine(P) Deoxycholic Acid (P) L-Carnintine Aminophylline Pantothenic Acid

LipoDissolve Injection sites & depths12mm

LipoDissolve Injection sites & depths12mm

LipoDissolve

LipoDissolve

LipoDissolve Injection sites & depths12mm

LipoDissolve Injection sites & depths12mm

Cellulite

Aesthetically cellulite is a problem consisting of the visual presentation of weakened and damaged fatty tissue and connective fibrous tissue in the form of bumps and dimples, commonly known as “orange skin”.

Cellulite

Cellulite

Cellulite

Cellulite

Cellulite

Treatment must act in two different ways:

on the fat (Lipolytic effect) on circulation (Venotonic effect + Drainage)

Cellulite

Lipolytic:

L- Carnitine + Caffeine . Venostatic:

Rutin – Aminophylline –Pentoxiphylline. Drainage:

Artichoke.

Cellulite Protocols

L- Carnitine Aminophylline Pentoxiphylline Yohimbine DMAE Procaine

All are Principals

L- Carnitine Aminophylline Pentoxiphylline DMAE Vitamin C Procaine

MesoCellulite Injection sites & depths 2mm

MesoCellulite Injection sites & depths 2mm

MesoCellulite

MesoCellulite

Stretch Marks

The connective tissue, including collagen and elastin, becomes increasingly damaged until eventually causing the formation of stretch marks.

Stretch Marks

Collagen Elastin Stimulating/ Restoring agents

Organic Silicium / Silorg Centella Asiatica Vegetal proteins + Fibronectin

Firming agents DMAE + Vitamin C DMAE + Idebenone.

MesoStretch Marks Protocols

Silorgamine =

Silorg +

DMAE

Centella Asiatica Fibronectin Vegetal Proteins

Idebe = Idebenone + DMAE

Vitamin C DMAE Silorg

All are Principals

MesoStretch Marks Injection sites

MesoStretch Marks Injection sites
MesoStretch Marks Injection sites

Needle size

30/32 G x 4 mm 30/32 G x 6 mm 30/32 G x 12.7 mm

Needle size 30/32 G x 4 mm 30/32 G x 6 mm 30/32 G x 12.7

MesoGuns

MesoGuns
MesoGuns
MesoGuns

Injection Techniques

PAPULE:

1 to 2mm, with bevel upwards NAPPAGE:

2 to 4mm, angle of 30° to 60° POINT BY POINT:

deep injections, 4 to 12mm

Contraindications

Pregnancy, blood thinners, IDDM, cancer patients, AIDS patients, coronary artery heart disease or heart dysfunction, People with arrhythmias, history of blood clots or strokes, autoimmune diseases or organ transplant recipients and skin conditions including: herpes & psoriasis.

MESOPORATION

Mesotherapy ------ Non invasvive No needles are required.

MESOPORATION

A new complex process utilizes the skin's water based "channels" to allow ionic drug solutions to penetrate into the skin, via controlled "electroporation - like" electrical pulses.

MESOPORATION

MESOPORATION

MESOPORATION

MESOPORATION
MESOPORATION

MESOPORATION

MESOPORATION
email:ahmismai@gmail.com
email:ahmismai@gmail.com
email:ahmismai@gmail.com
email:ahmismai@gmail.com
email:ahmismai@gmail.com

email:ahmismai@gmail.com