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Dr . Hasan Ali Nogay M.D. UNDERWATER and HYPERBARIC MEDICINE SPECIALIST MEDICAL ESTHETICIAN MESOTHERAPIST

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. : +9 0 .242 . 322.00.99 e- mai l : www.drnogay.com. HISTORY OF MESOTHERAPY. 1952 :

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Dr . Hasan Ali Nogay M.D. UNDERWATER and HYPERBARIC MEDICINE SPECIALIST MEDICAL ESTHETICIAN MESOTHERAPIST

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  1. Dr.Hasan Ali Nogay M.D.UNDERWATER and HYPERBARIC MEDICINE SPECIALISTMEDICAL ESTHETICIANMESOTHERAPIST ADDRESS : Demircikara mh. Avni Tolnay Cad. No:46/1, Narenciye Antalya-TÜRKİYE TEL. : +90.242.322.00.99 e-mail : www.drnogay.com

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. 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 SHOULDNOT BE PERFORMED MORE THAN ONCE A WEEK (FROM 2 TO 6 SESSIONS) . AFTER, THE OTHER SESSIONS CAN BE DONEEVERY FIFTEEN DAYS AND “UP KEEP” SESSIONSEVERY MONTH. • IN THE RIGHT SPOT: MESOTHERAPY IS PRACTICED WITH INJECTIONS AT THE SITE OF PAIN ORPATHOLOGY

  7. 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.

  8. 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 • 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. RESPOND WELL TO MESOTHERAPY

  9. 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

  10. TERMINOLOGY RESULTING FROM CONSENSUS OF SCIENTIFIC COMITEEOF 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

  11. 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.

  12. 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).

  13. MESO-SYSTEMMESOTHERAPY 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.

  14. 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.

  15. MEDICATIONS INMESOTHERAPY • 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 VASO-DILATATION 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).

  16. 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.

  17. 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

  18. 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.

  19. 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

  20. 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

  21. 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

  22. 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

  23. 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

  24. CALCITONINE PHARMY II 50 UTand100 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.

  25. 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

  26. 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

  27. 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 4 DH • MELILOTUS 4 DH • CYNARA SCOLYMUS 4 DH : DRAINING ACTION AND ANTIOEDEMA. • FUCUS VESICULOSUS 4 DH : LIPOLYTIC ACTION • ARNICA 4 DH : ANTI-BRUISES ACTION • EXEMPLE OF MIXTURE : • PROCAINE 2 % = 1 ML • FUCUS = 2 ML • MELILOTUS = 2 ML ACTION ON THE VEINS

  28. 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.

  29. 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.

  30. HYPERLIPODYSTROPHY DEEP SUPERFICIAL   GENERALIZED LOCALIZED  FAT STEATOMERY CELLULITE

  31. 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

  32. 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.

  33. 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.

  34. MEDICATIONS IN CELLULITE • STAGE 1 and 2  VASODILATORS MEDICINE DEPTH = 2  4 MM • STAGE 3 TROPHIC MEDICINE DEPTH = 2  4 MM • STAGE 4 LIPOLYTIC MEDICINE  POINT BY POINT 6 MM

  35. 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.

  36. MESOTHERAPY TECHNIQUES IN LIPODYSTROPHY • EPIDERMIC INJECTION : • THE PRODUCT REMAINS IN THE EPIDERM WITH SLOW DIFFUSION ; NO BRUISES. • SUPERFICIAL INTRADERMIC INJECTION : • HALF DELAYED ELIMINATION, ESPECIALLY IN DIFFUSED CELLULITES. • DERMO-HYPODERMIC INJECTION : • AT THE LEVEL OF DEEP FIBROSIS KNOTS. • MIXED OR ALTERNATIVES INJECTIONS.

  37. MEDICATIONSIN CELLULITE MESOTHERAPY VASCULAR ACTION • BENZOPIRONE (COUMARINE) • BUFLOMEDIL • PENTOXIFYLLINE • MELILOTUS • GINKO BILOBA • PROCAINE • LIDOCAINE • CALCITONINE • ETAMSYLATE

  38. MEDICATIONSIN 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

  39. MEDICATIONSIN CELLULITE MESOTHERAPY LIPOLYTIC ACTION • IOIMBINE • TIRATRICOL • AMINOPHYLLINE • EUPHYLLIN • L-CARNITINE • CAFEINE • COENZYME A • LIPOSTABIL

  40. CELLULITE TREATMENT TWO BASIC PRINCIPLES : • MESODRAINING : TREATMENT OF THE CIRCULATION ON VASCULAR AXIS : • LIDOCAINE (MESOCAINE) • ETAMSYLATE (DYCINONE) • BUFLOMEDIL (FONZYLANE) • MESOLYTIC : LOCAL TREATMENT : (SADDLE BAGS, ABDOMEN, HIPS) • LIDOCAINE (MESOCAINE) • SALMON CALCITONINE 100 U • HYDROSOL POLYVITAMINE (HPV BON)

  41. IN LIPODYSTROPHY • STANDARD CLINICAL STAGE (THE MOST FREQUENT) : • MESOCAINE 1 % = 2 ML • CALCITONINE 100 U = 1 ML • FONZYLANE = 2 ML • OLD CELLULITEWITH HARD KNOTS OF FIBROSIS : • MESOCAINE 1 % = 2 ML • CALCITONINE 100 U = 1 ML • HYDROSOL POLYVITAMINE BON = 2 ML • LIPODYSTROPHY WITH IMPORTANT VENO-LYMPHATIC DEFICIENCY : • MESOCAINE 1 % = 1 ML • CALCITONINE = 1 ML • DICYNONE = 3 ML

  42. 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)

  43. CELLULITE TREATMENT TECHNIQUE POINT BY POINT (PPP) NEEDLE 6 MM OR 13 MM • MIXTURES : • PROCAINE 2CC • TRENTAL 2CC • DYCINONE 2CC • SALIN SERUM 2CC • LIDOCAINE 2 CC • TRENTAL 2 CC • DYCINONE 2 CC • CAFEINE 1 CC • ARNICA 1 CC • SALIN SERUM 2 CC NEEDLE 6 MM NEEDLE 13 MM

  44. 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.

  45. 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)

  46. WEIGHT LOSS PHYSICAL EXAM OBSERVE FAT DISTRIBUTION :

  47. 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.

  48. MESOLIFTSKIN • 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.

  49. 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.

  50. MESOLIFTSOLUTIONS • 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)

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