MESOTHERAPY

By : dr. Pita M. Asriri

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History
1952: dr. Michel Pistor used Procaine

injections behind the ear for

loss.

hearing

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History
1958: The first press publication about

Pistors experiments and the

Mesotherapy
1964: SFM (Societe Francaise

used of term
Mesotherapy)

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1976:

The first Mesotherapy

International congress
1982: The International

Society of Mesotherapy
1987: Mesotherapy as a

part of traditional
medicine in French
Academy of Medicine

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History
2004: Mesotherapys booming in USA
2005: Mesotherapy in Indonesia
Over 25,000 physicians worldwide today use

mesotherapy .

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MESOTHERAPY
What is Mesotherapy?

Multiple injections of microdoses of active medications

onto the epidermis or into the dermis (embryologically
derived from the mesoderm) of the skin, at relatively
infrequent but regular intervals.

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Skin test

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Dr. Pistor defined Mesotherapy as ..

To bring the right product (medicine),

in the right amount,
to the right place..

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Why Mesotherapy?
Cause it Works!
Characteristics:
Simple technique
Locoregional
Minimum secondary effects
Minimum doses
Economics
Very Effective

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Advantages
Good for mild moderate aging (figures 1.6 and 1.7)
Easy to perform
Low pain
No Necessity for a skin test
Limited side effect
No downtime or a recovery time
Can be performed on every skin phototype

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Indications
AESTHETIC
Mesoglow
Mesolift
Mesolipo/sculpting
Mesomelasma
Mesocellulite
Mesostretchmark
Mesoalopecia
Mesobotox

NON-AESTHETIC
Dermatology
Gastroenterology
Neurology
Gynecology
Sport medicine
Ear ,nose, & throat
Urology
Vascular disease
Traumatology &
Rheumatology
Others: presbyopia, mouth
sores,
etc

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Areas of aplication
Face (cheeks, chin, forehead)
Neck
Low neckline
Back of hands
Abdomen
Arm and legs (inner surface)

Contra Indications
Allergy (especially to the injection ingridients )
History of hyperthropic scars
Bleeding abnormallities and or oral anticoagulant therapy
Pregnancy /breast feeding
Autoimmune disordes (lupus, scloderma)
Epilepsy
Diabetes
Herpes simplex virus type 1 (HSV-1) infections

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Bacterial infections
Inflammatory skin disordes (acute phase)

Note : HSV-1 infection are acontraindications if present in

the active phase in order to avoid reccurences in those
patients suffering from cold sores, oral prophylaxis with
valacyclovir is mandatory (500mg twice daily for 5 days)
A single dose of famciclovir (1500mg) can also be used

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Technique
Manual mesotherapy needles
Mesogun
Dermaroller

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Injection Rules:

The right needle

& the right drugs
for the right site.

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Frequency
1x/ week for 1 month (4x)
1x/ 2weeks for 1 month
1x/ month every 3 months

Or
1 session / week during 2
months

1 session / month
Can vary according to skin condition, lifestyle,
Reaction to thetreatment, desire for quiker result

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Mesotherapy Cocktail
The cocktail is made of revitalizing subtances in a sterile biological solution supplied in a 5ml bottle (NTCF 13.5)

Vitamins
It is a easy understand that there is no problem because these vitamins are

injected directly into the dermis atrophy.

The vitamin b complex vitamin B1 (thiamine),B2 (riboplavin),B3 (Niacin), B5
(pantothenate), B6 (pyridoxine), B9 (folic acid) and B12 (cyanocobalamin) are
coenzymes in several metabolic processes that have to scavenges free
radicals
Vitamin C stimulates collagen synthetis and inhibits melanin (acting together
with vitamin E )
Vitamin E is a strong antioxidant because of its anti free radical activity
Vitamin K has an effect on the microcirculation
Also important are vitamins D, H (biotin) b10 and I (innositol)

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Amino Acids
The cocktail contains 24 amino acids, which are stable water
soluble and part of the structure of proteins . They build Polypeptides
Which from the matrix of the cellular architecture or repair the protein
the structure of tissue that has been damaged by photoaging, smoking
or other causes.

Minerals
Sodium, potassium, calcium and magnesium act as catalysts of
numerous cell function.

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For Mesosculpt
Phospatidylcholine
This antioxidant is derived from natural soy lecithin
It alters the metabolism of fatty subtances such as cholestrol and tryglycerides in the body
It is an excellent fat burner

L Carnitine
This is required for fatty acids to be delivered into cells where the fat can be burned as a source

of fuel
Diet and exercise along with L Carnitine will maximaze fat removal

Caffeine
This alkaloid increase the blood flow and stimulates fat cells where the fat cells to release fat

into the blood stream to be burned by the body metabolism

It acts to drain the fat cells
It thightens and tones the skin

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Aminophyline
This stimulates the release of fat into the bloodstream
Its effectiveness is similar to that of caffeine
However it is less stable and must be kept in a cool place and used quickly
It allows beta receptors to burn the fat more effeciently

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DMAE (dimethylamine ethanol)

This is commonly used in topical formulas for anti aging
It acts at the neuromuscular junction as a precursor of acetylcholine, the neotransmitter responsible
for a muscular contraction increasing the overall tone of the skin
Alpha-lipoic acid
This is a powerfull anti oxidant

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Asian Centella
This helps in strengthening the cappilaries and veins and in so doing assist with better blood
circulation
Its stops the formation of fibers that trap fat cells in cellulite and improves the flexibility of the
coonective tissue
Glycolid Acid
This is the most commonly used AHA
It works by stimulating new growth of skin and collagen and by decreasing the bonds that hold
dead skin cells to the surface

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Hyaluronic Acid
This Natural subtances is found in all living organism
It is indicated for the treatment of aged and dehydrated skin
A nonstabilized from is used in mesotherapy
It is used for tissue hydration, lubrication, and smoothness and for softening and decreassing
wrinkles of the face, neck and scalp
Vitamin C

This players a role in collagen formation

It is a key immune systems nutrient

It has potent Activity againts free radicals

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For Mesoglow
Gluthatione a powerful antioxidant
SOD (superoxide dismutase) prevents melasma
Vitamin C an antioxidant
Argireline : helps wrinkle reduction

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Injection Techniques

Papule

Nappage

Point by Point

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Mesotherapy injection techniques

From the surface to the deeper layers:

Injection technique Depth Abbreviation

1. Epidermal
< 1 mmIED
2. Papule
1 mm
N/A
3. Nappage
2-4 mm
IDP
4. Point by point
4 mm
PPP
5. Mesoperfusion > 4mm N/A
6. Mixed
variable
N/A

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Abbreviations used for injection techniques

Abbreviation
Technique
I.E.D.
Intra Epi Dermal
I.D.S.
Intra Dermal Superficial
I.D.P.
Intra Dermal Profound
I.H.D.
Intra Hypo Dermal
P.P.P.
Point by point
S.C.
Subcutaneous
Mixed
The use of more than one
technique within one
session at one
body region

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EPIDERMAL
Applied onto or into the epidermis, no bleeding,

simple, painless, allows to expand areas.

Technique: manual or mesogun
Needle: special needle for mesotherapy

30 G 4mm

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Manual intra epidermal

Manual epidermal

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Parkinsons hand
Parkinson hands

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PAPULE : IDS
Definition: Injection applied

where epidermis meets the

dermis. Depth 1-2 mm, the
epidermis usually lifted from the
basal layer
Bevel upwards
Material : needle 27-30 G , 4mm
Indication: wrinkles, mesobotox

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Papule technique
Papule technique

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Nappage
Definition:

2-4 injections per second, every 2-4 mm, under

continuous visual control, 30-60 degrees, needle
penetration 2-4mm.
Material: needle 30 G 4mm
0,01-0,02 cc per injection.

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Manual nappage IDS

Manual nappage

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Point by point (PBP)

Definition: precise and single injection into the deep

dermis
Material: needle 30 G ,4 mm - 6 mm
Indication : stage 3-4 cellulite, fibro-sclerous cellulite

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PPP technique on belly

PPP technique

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Injection Application Technique

multipuncture

coating

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Injection application Techniques

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Mesotherapy Needle Roller(MTS)

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How it works?
Step One The Microneedles of the
dermaroller penetrate the epidermis and
dermis layer of skin

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Step 2 The derma roller needles will leave

micro channels into the skin. These channels
improve the penetration of therapeutic active
ingredients such as mesotherapy products.
These channels closed within hour. The
epidermis remains intact

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Step 3 The post traumatic response of the

skin is to produce collagen and elastin. These
bulk up the thickness, creating great looking,
firmer and healthier looking skin.

Indication
Cellulite treatment
Skin rejuvenation : improving skin thickness & tone,

reducing wrinkle
Reduce pigmentation
Scars : post acne, stretch marks
Hair Loss

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Contraindication
Disease of healing
History of keloid
Uncontrolled diabetes
Pregnancy / Nursing

Transcellular Route
Normal creaming

With derma roller

No more than 0,3% can penetrate

the skin surface

up to 40 times can be infiltrated

through the stratum corneum

Confocal laser pictures taken by the Uiversity of Marburg/Germany

Procedure
Cleaning the area of treatment
Once ready to roll, apply a numbing agent.
Rolling the Dermaroller in different directions, with slight

pressure

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Apply an antibacterial cream to protect from any

possible infection if needed

Applying a vitamin rich moisturizer after use

Slight reddening of the area may occur after

treatment. This will fade quickly but dependant on

the method, it may last for up to 24 hours. Staying
out of the sun for this period or using a sunblock

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Short healing period

Ideally,1 device per session
Less expensive than big investment machinary
Can be safely combined with other treatment. Ex.

Chemical peeling

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This patients lost 7 inches from her abdomen, back, &

hips undergoing 10 treatments.

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Mesolipo

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Meso Non Needle-Electroporesis

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To avoid hematoma / bleeding

Do not perform mesotherapy during a patients menstrual period.
Do no let the patient take aspirin or a nonsteridal anti inflammatory drug (NSAID) for a

few day after the procedure.

Inject the product slowly, to avoid the high preasure breaking vessel walls.
Apply antibiotic cream after each session.

To avoid pain, in sensitive patient :

Pinch or strech the skin during the injections.
Change the needle several time during each treatment.
Choose products containing lidocaine or apply emla cream 1 hour before treatment.
Talk the with patient a lot during the session.

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The frequency of treatment varies, depending on :

Type of medicine to be used
Age of patient
Degree of sun exposure
Race of patient
Hereditary of factors

The frequency schedules are :

Every 2 weeks for 6-8 visits
Every week 7 10 visits
Every month, with no time a limits

The expected outcome are :

Generally plumper and clearer skin
Fewer wrinkles
Complexion events out in color
Skin becomes radiant & glowing, looking younger, rested & revitalized

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THANK YOU

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Skinnic Aqua Skin Whitening

Komposisi ampul cair Skinnic Aqua Skin Whitening:
L-Ascorbic Acid 500mg
Beta-Hydroxy Acid 250mg
Alpha Lipoic Acid 500mg
Copper Peptide 50mg
Retinol 10mg
Hyaluronic Acid 10mg
Selenium 10mg

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Komposisi Lyophilized Powder:

Kojic Acid 500mg
L-Glutathione 300mg
Alpha-Hydroxy Acid 100mg
Collagen Extract 375mg

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Manfaat produk: pemutihan kulit, mencegah penuaan

dini, dan meremajakan baik pada lapisan kulit luar

maupun organ dalam
L-Ascorbic Acid
Merangsang pembentukan kolagen pada seluruh jaringan tubuh
Menyehatkan kulit dan menyegarkan badan

Beta Hydroxy Acid

Menstimulasi perbaikan kulit
Mencegah dan mengurangi jerawat
Alpha Lipoic Acid
Memberikan perlindungan terhadap radikal bebas
Membantu meningkatkan manfaat antioksidan lain
Mendaur ulang fungsi antioksidan lain khususnya Vitamin C dan E

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Retinol
Menstimulasi regenerasi sel kulit
Mengencangkan kulit
Memudarkan garis halus dan keriput
Hyaluronic Acid
Menjaga kelembaban dan kekenyalan kulit
Mencegah penuaan dini

Cooper peptide
Merangsang regenerasi kulit
Meningkatkan produksi kolagen dan elastin
Mengencangkan, menghaluskan dan melembutkan kulit
Mengikat dan membuang kolagen dan elastin yang rusak pada
kulit dan jaringan parut

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Selenium
Mencegah kerusakan gen (antioksidan)
Menguatkan sistem kekebalan tubuh
Mencegah kangker dan penyakit kardiovascular
Menguatkan jantung dan pembuluh darah
Memperlancar aliran darah ke otak
Kojic Acid
Memudarkan pigmentasi dan bintik-bintik penuaan
Merupakan senyawa terbaik untuk memutihkan kulit
Menghambat sintesa melanin yang merupakan awal proses

penggelapan kulit

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L-Glutathione
Merupakan antioksidan utama dalam tubuh manusia yang
sebagian besar ditemukan dalam hati
Merupakan antioksidan kuat untuk untuk menangkal radikal bebas
penyebab gangguan fungsi organ dalam dan kulit
Mendetoxsifikasi senyawa residual (seperti Parasetamol) di dalam
hati
Alpha Hydroxy Acid
Menstimulasi perbaikan kulit
Menghilangkan garis-garis halus pada wajah

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Collagen Extract
Menjaga kelembaban kulit
Menghaluskan dan mengencangkan kulit
Rekomendasi dosis:
Campurkan 1 ampul cair dengan 1 ampul bubuk Skinnic Aqua Skin
Whitening dan aplikasikan 1x seminggu secara intravena (6)
Instruksi Penyimpanan:
Hindarkan dari panas dan sinar matahari langsung
Jauhkan dari jangkauan anak-anak
Simpan di tempat sejuk dan kering dibawah 28 derajat celcius

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Glutax
Kandungan Glutax 3G:
Glutathione 3000mg
Asam Askorbat (High Grade) 1500mg
Alpha Lipoic Acid 200mg
Kolagen 350mg
Kandungan Glutax 5G:
Glutathione 5000mg
Asam Askorbat (High Grade) 1500mg
Alpha Lipoic Acid 200mg
Kolagen 350mg

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Kegunaan
Memutihkan kulit.
Dengan alpha lipoic acid untuk meningkatkan efektifitas glutathione

Dosis dan pemakaian:

Suntikkan 1 set Glutax setiap minggu selama 2 bulan (tergantung
metabolisme tubuh Anda). Dosis kemudian dapat dikurangi menjadi 1
suntikan setiap 2 minggu untuk pemeliharaan.

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Tidak Cocok Untuk:

Wanita Menyusui.
Aplikasi pada masa menstruasi.
Alergi dengan Vitamin (jenis apapun).
Wanita hamil.
Pasien dengan masalah kardiovaskular.

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Kojic Acid Whitening

Isi Dalam Box Kojic Acid :
6 ampul Pelarut
6 vial bubuk Kojic Acid 1000mg
Manfaatnya sebagai inhibitor melanin khusus
mampu mencerahkan titik-titik pigmen dan warna
menghilangkan bintik-bintik flex, bintik-bintik penuaan, dan
menyembuhkan jerawat.
menetralkan radikal bebas, memperkuat aktivitas sel, dan mencegah
degenerasi sel.

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Rekomendasi dosis dan administrasi Kojic Acid:

Kojic acid diadministrasikan secara intravena (IV), 2x seminggu (6)

Kojic Acid tidak dirokemendasikan untuk:

Wanita hamil & menyusui
Wanita pada periode menstruasi
Alergi terhadap vitamin (jenis apapun)
Pasien dengan masalah kardiovaskular

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Biocell CRP
Kandungan tiap set Biocell CRP:
Hyaluronic Acid 300mg
Hydrolized Vit C 1250mg
L-Glutathione 900mg
Manfaat Biocell CRP:
Peremajaan Kulit
Pemutihan Kulit
Anti Aging

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Dosis dan administrasi Biocell CRP:

Campur Hyaluronic Acid, Vitamin C, dan Glutathione, masing-masing
satu ampul. Disuntikkan secara i.m., i.v., atau S.C., sekali seminggu

Instruksi Penyimpanan Biocell CRP:

Simpan dibawah 30c, hindarkan dari paparan cahaya

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Liponsaure/Lipostabil/mesostabyl
Phospatidylcholine
disuntikkan sub cutan ke timbunan lemak lokal
merangsang produksi dan meningkatkan aktivitas insulin

sehingga mempromosikan pembakaran lemak.

Disebut juga Lipodissolve
Dengan metode lipodissolve, PPC memecah molekul
kolesterol dan asam lemak lainnyameningkatkan
kelarutan lemak pada timbunan lemak.
Phosphatidylcholine mampu menembus lapisan kulit dan
mengemulsi lapisan lemak di bawahnya, membuat
mereka lebih mudah larut ke air diekskresikan keluar
bersama kotoran dan urin.

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Menurut Journal Bedah Estetik, dosis aman maksimum

dari PC adalah 10 ml per sesi dengan sekitar 0,1-0.5 cc

disuntikkan pada setiap suntikan mikro.
PRAKTEK
Max drop 10 cc
Ambil 1 cc
Suntik jarak 1,5 cm
Lengan 0,5cc masing2 kanan dan kiri
Perut 1 cc
Paha dalam 1cc masing2 kanan dan kiri

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MRS Body 5%
Administrasi ~ dgn injeksi PPC
Kandungan tiap vial MRS body 5%:
Plateled Derived Growth Factor(PDGF) 1 mg/L
Insulin-like Growth Factor(IGF-1) 1 mg/L
Phosphatidylcholine 50 g/L
L-Carnitine(Vit.B ) 10 g/L
Triamcinolone 0,5 g/L
Sodium Hyaluronate 0,5 g/L
Multi Vitamin 0,5 g/L

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Riboflavin
Riboflavin diperlukan untuk memproses asam amino dan

lemak.
Riboflavin juga mengaktifkan Vitamin B6, asam folat, dan
membantu mengubah karbohidrat menjadi ATP
Riboflavin juga bertindak sebagai antioksidan.
Karena riboflavin meningkatkan efisiensi energi
mitokondria, riboflavin akan meningkatkan metabolisme
lemak dan mengurangi penyimpanan lemak.

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Manfaat Lain Riboflavin B2 :

Meningkatkan efektifitas L-carnitine sebagai agen pembakaran
lemak
Mengontrol kelebihan berat badan
Mengatur tingkat energi dan meningkatkan metabolisme
Mengontrol kadar gula pada periode diet
Meningkatkan perbaikan dan pertumbuhan jaringan
Memberikan nutrisi bagi kulit, kuku dan mata.
Petunjuk pemakaian:
Gunakan1 ampul bersama dengan 1 ampul L-carnitine dan 1
ampul prolene, disuntikkan secara sub cutan, mengikuti jadwal
suntik L-carnitine (umumnya 2x seminggu).

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L-carnitin
L-carnitine adalah sejenis asam amino yang disintesis di

ginjal dan hati.

L-carnitine terebentuk dari asam amino essensial yaitu
tysine dan methionline.
Fungsi utama dari L-carnitine adalah untuk transportasi '
asam lemak rantai panjang seperti glukosa, lemak,
karbohidrat dan protein.
L-carnitine mentransport asam lemak yang tersimpan
dalam penyimpanan antar membran dan lemak dari
makanan yang kita makan untuk kemudian mengubahnya
menjadi energi.

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Administrasi L-Carnitine
Suntikkan 1 ampul L-carnitine secara subkutan (dengan

campuran Prokain Kafein dan Riboflavin B2) dua kali

seminggu.
Karena sifat L-carnitine yang hanya meningkatkan
pembakaran bukan menghancurkan lemak, imbangi
pemakaian dengan olahraga teratur agar mencapai hasil
yang diinginkan. (5)

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Procaine Caffeine
Kandungan per ampul Procaine caffeine:
30mg Caffeine
40mg Procaine HCl
Administrasi mengikuti L-carnitin

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Acne

Inj Zinc Gluconas

Intra Vena 1 Ampul 1-2 kali seminggu

Satu seri terapi 10 Ampul
Mekanisme Kerja : Anti Inflamasi

KOMPOSISI
Zincum Gluconiucum 3 ml, Acidum
Citricum 671 mg

Triamcinolon
Untuk acne nodulokistik
Sediaan 10 mg/ml
1 sesi butuh 1 mg (max 0,1 cc)jadi masukkan 0,1 cc ditambah

0,9 cc NaCl
Bila ingin peeling, tunggu 3 hari post injeksi agar tidak dekok
Maximal 4x/tahun (4x0,1cc) boleh diulang paling cepat 4 minggu
Bukan disuntikkan ke dalam lesi melainkan ke pinggir lesi
Bila acne terlalu banyak, cari yg paling parah, 1 lesi 1 strip 0,01
Tidak boleh disuntikan ditempat yg inflamasi
Lateral 1-2 mm ditempat yang tidak inflamasi
Interaksi obat : Lidocain
Efek Samping : Scar Hipotropic

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Gerovital
Fungsi Gerovital H3:
Mengencangkan payudara dan merapatkan otot kewanitaan.
Meremajakan dan mengencangkan kulit.
Mengembalikan kekenyalan kulit. (5x5)

Gerovital

Komposisi gerovital
Procaine Hydrochloride 0.1000 mg
Benzoid Acid 0.0060 g

PENGGUNAAN :
1 minggu 2x
IM