Channel 13 - WOKR
Dr Capuano's comments on Mesotherapy
of the term
The 'mesoderm' is
the term used in biology to describe a
'middle layer' of cells and tissues in
the developing embryo. From this layer of
cells develops the deeper layers of the
skin, subcutaneous tissue which is just
beneath the skin, fatty tissues,
tendonous tissues, bony tissues, etc.
on this 'middle layer' is thus
As an ancillary
piece of information, the other layers of
the embryo are the ectoderm and endoderm
.The 'ectoderm' forms, among other
tissues, the brain and outer layer of the
skin. The endoderm forms amoung other
tissues, the linings of the intestines,
bladder and so forth.
As a concept,
treating the 'middle layer' as a method
of practice originated in France in the
early 1950s by Dr.M. Pistor. As a method
of practice, treatments consisting of
multiple injections into the mesodermal
areas, using a combination of medications
or compounds, for various conditions,
using needles was a new idea at that
time. The method of practice has evolved
and become more elaborate with different
nuances such as smaller gauge needles and
injection 'guns' for delivery of
medications and compounds. Most of Europe
has practitioners who are
'mesotherapists'. Their number is
currently estimated in the tens of
My Doctor Uses
For many years
physicians and surgeons in North America,
have been injecting medications into the
mesodermal tissues, but not as a
formalized method of practice. As an
example, in the USA, medical and surgical
practitioners administer steroid
injections into tendons, cysts, muscles,
fascia, etc. Also, in today's day and
age, the use of very fine needles such as
30 and 27 gauge needles is not unusual.
If you look for them, there are
physicians and surgeons in our hemisphere
who of course use techniques that treat
the mesodermal tissues. Which came first
- mesotherapy or your doctor using
needles to treat you injured shoulder ???
As far as I can discern, Mesotherapists
use more medications, more mixtures of
medications, more needles, for more
reasons (indications), more frequently,
and have incorporated the techniques of
mesotheapy into their practice. They
'think' meso tissues - and meso methods.
as a method, involves
- The use of frequent treatments.
- The individual patient understands and
accepts these frequent treatments.
- Injections are the method of delivery
and changing of the 'meso tissues'.
- The materials that are injected are of
a wider variety than is the 'norm' as
practiced in the US.
- Usually more than one compound or
medication will be injected during a
- The concentrations of injected
materials are tailored and titrated
depending on the diagnosis, area to be
treated, severity of problem and so
- Currently, the use of fine bore needles
is a part of mesotherapy.
- An injection 'gun' may be used as part
of 'modern day' mesotherapy.
- Some methods use multiple needles at
use of a fine needle to administer the
correct compound to the correct place at
the correct concentration for the correct
diagnosis at the correct intervals is key
to 'good' practice.
What can happen if
all of the above, or even some of the
above, are not appropriately practiced?
(This is not to say that even if all is
appropriately done, that problems could
not occur !)
As a learned
plastic surgeon colleague from Milan has
stated - "given the.. abuse of this
otherwise fine discipline, I see
"irregularities" and areas of
fibrosis in many patients who have been
abused by these "practitioners"
for years, with the "mirage" of
avoiding liposuction (which they do not
know how to perform ..) I suspect this is
more of a fault to attribute to the
doctor, rather than the technique."
Some say that
treatments with multiple needles do not
'hurt'. As a matter of fact, I never met
a needle that rarely pinched and
have never met a needle that never
pinched ! Needles pinch. Needles hurt -
sometimes certainly ! ('ok' - if you are
'out cold'- have 'nerve problems', etc.,
the above does not pertain !)
Currently mesotherapy is practiced for
the following general categories of
medicine - musculoskeletal problems -
conditions - mesotherapy has usefulness
in conditions such as tendonitis. Doctors
in the USA treat people with tendonitis
using steroid injections as the
'mesotherapists' in Europe treat the
condition. The method of delivery and the
medications used may be somewhat
- cosmetic conditions
for problems such as
'mesotherapy treatments' can be used
alone or with other methods. Combinations
of mesotherapy with other methods of
treatment such as external ultrasound,
canula dissection, tumescence, etc., seem
to have significant potential.
fatty tissue and Lipocontouring
volume of fat can not be removed, at
least not from what I have seen. Small
areas could be treated. I do not see it
as a substitute for liposuction - at
least at this point in time. This method
should not be termed meso-liposuction as
there is no suction.
tissues of the face and elsewhere (meso
of medications, vitamins, minerals, etc.
beneath the skin can be associated with
tightening of the area. To this point
data is inconclusive as to whether
injections alone - will be effective in
lifting and tightening. When combined
with other methods such as ultrasound,
and various forms of subcutaneous
dissection (i.e. surgery), mesotherapy
injections may add to our abilities to
Used correctly and
as noted above, mesotherapy certainly has
applications at its current state of
development. Once more attention is paid
to the field of mesotherapy, there should
be rapid development. This discipline
will meld with other disciplines. Our
goal is to provide longer lasting results
with less invasive procedures, and
mesotherapy can probably help.
Please see our 2004 comments
Pictures of before and after results - Not Dr Capuano's patients.
Capuano, certified by the American Board
of Plastic Surgery, is in private
practice in Rochester, New York.
Operative procedures may be office based
or ambulatory at