Critics say mesotherapy offers slim chance

By Maria Puente, USA TODAY

Call it "hope in a needle." Mesotherapy, the latest fat-melting fad, is a half-century-old technique from France that involves hundreds of injections and is touted as an alternative to liposuction.

"It's more than hope in a bottle," says Marion Shapiro, a retired emergency room doctor in New York who has started a new career as a "mesotherapist," injecting people with a cocktail of plant extracts, vitamins and medications (such as a drug for treating asthma). The concoction is supposed to stimulate fat cells to shed fat.

"Our results are not surgical, there are fewer complications and less downtime, and that's why mesotherapy is going to become more popular than liposuction," Shapiro says.

It's called mesotherapy because the injections go under the skin and are absorbed by the mesodermal, or middle, layer. Then, you're supposed to shed weight the same way you do when you diet and exercise, excreting fat in waste. But you can still regain the weight.

Singer Roberta Flack is the most famous celebrity to endorse the procedure. She told ABC's 20/20 last year that she lost 40 pounds after a year of treatment, although she also dieted and exercised.

Mesotherapy was developed in France in 1952 and has long been popular with the European rich and famous. But it never caught on in the USA, where medical skepticism about its efficacy and safety is widespread. Among other concerns, some of the drugs involved are intended to treat something entirely different.

Flack's doctor, Lionel Bissoon, learned the specialty in France five years ago and is now the leading advocate here. He says the procedure can be used as a delivery system for more than fighting fat. "We can treat migraine headaches, back pain, constipation, sports-medicine injuries, arthritis."

But many dermatologists and plastic surgeons are alarmed about the growing profile of mesotherapy. "No one says exactly what they put into the (syringe)," says Naomi Lawrence, a derma-surgeon at the University of Medicine and Dentistry of New Jersey. "One drug they often use, phosphatidylcholin, is unpredictable and causes extreme inflammation and swelling where injected. It is not a benign drug."

Even Brazil, which is less strict than the USA in drug approvals, has banned the drug for these purposes.

If there were studies that proved to dermatologists that this procedure works, "we'd all be using it," she says. "If we had something that could (really) melt fat away, it'd be great."

But Bissoon cites a 1994-95 study on "topical fat reduction" by UCLA researchers that concluded women who had the injections did lose weight even without diet or exercise. Shapiro says 95% of the 1,000 patients she has treated in the past six months have responded to the therapy, and 85% are happy with the results.

"About 100 people a year die of liposuction," Bissoon says. "We have had no deaths, no strokes, no heart attacks. The biggest side effect is bruising."

Mesotherapy is not cheap: Each session costs an average of $500, and 10 to 15 sessions are recommended, for a total price tag similar to liposuction.