| BODY CONTOURING | PEER-REVIEW


protocol when using mesotherapy begins with biostimulation with PRP to help connective tissue recovery and microcirculation. The author then introduces different medications depending on the pathology of the individual patient using an automatic electronic mesogun. The five-stage treatment is as follows: ■ Biostimulation PRP as discussed above ■ Reduce lipoedema by using Melilotus plus pentoxifylline and procaine


■ Restore efficient microcirculation by using: » Derivatives of flavonoids, such as rutin or melilotus, which offer particularly beneficial vasculo- protective effects


» Vitamin C, which is essential for neutralising the effect of the free radicals generated in the newly- oxygenated tissue (reperfusion syndrome)


■ Lipolysis using theophylline + carnitine + caffeine + yohimbine + procaine. This helps to: » Inhibit phosphodiesterase » Maintain a high level of cyclic activated protein kinase (AMP)


» Stimulate the natural lipolytic mechanisms of the adipocytes


■ Restructuring and protecting the connective tissue by DMAE to stimulate the regeneration of connective tissue.


Carboxytherapy Carboxytherapy refers to the therapeutic use of carbon dioxide (CO2


or by subcutaneous injection. At the vascular level, CO2


that allows tissue CO2 Carboxytherapy


either transcutaneous or by subcutaneous injection.


refers to the therapeutic use of carbon dioxide (CO2


) in its gaseous state,


■ Slight loss of local adiposity ■ Big improvement to the appearance of the skin so that it appears more compact and elastic


■ Decrease in the dimple effect. The CO2 reverts this


situation when injected in the affected zones through a very thin needle as it: » Produces vasodilatation » Improves the speed of the microcirculation » Ensures the tissue receives more oxygen so the toxins are eliminated


» Reduces the oedema » Favours the lipolysis. Carboxytherapy also provides excellent results for


patients with long-time cellulite, and young patients as a prevention method.


Endermologie Enermologie is a particularly effective treatment in the activation of fibroblasts and the metabolism of the interstitial matrix. It represents a more important basic treatment for different forms of cellulite. Endermologie acts on the skin and subcutaneous


tissue, connective tissue, fat tissue, and the microcirculation both arteriolar, venous and lymphatic and has shown beneficial effects on:39–41 Venous and lymphatic circulation


■ Skin trophicity ■ Fibrosis ■ Adipose tissue (increase the physiology lipolysis).


) in its gaseous state, either transcutaneous increases vascular tone and


produces active microcirculatory vasodilatation due to its direct activity on arteriole smooth muscle cells. In addition, this promotes the Bohr effect, a mechanism to transfer to the lungs and oxygen


present in the lungs to transfer to tissues through the oxyhaemoglobin dissociation curve. When administered through an external route, CO2


promotes this mechanism,


resulting in a higher tissue oxygenation and neoangiogenesis. The effects of C02


are to36–38 :


■ Increase tissue oxygenation ■ Increase flow rate and vasodilatation ■ Clean the ECM ■ Improve the lipolytic effect due to an increase in oxidative process.


Clinical Results The increase of microcirculation improves the metabolism in the connective tissue and help to recover the health of the extracellular matrix. The following are the clinical results:


Radiofrequency The proposed mechanisms for efficacy of radiofrequency in cellulite treatment include thermal injury leading to tightening of dermal fibrous septae, formation of new collagen and collagen remodelling. This should improve the skin’s firmness and elasticity. Please


note that radiofrequency increases the formation of fibrosis and this is not a physiological process.


Figure 5 Mesotherapy application area


Two solutions should be used: one to improve the microcirculation (blue) and another to increase the lipolysis effect (red). The applications should take place in the same day, 2cm apart.


Aminophylline 1cc Caffeine 1cc L carnitine 1cc Yohimbine 1cc Procaine 1cc


Melilotus-Rutin 1cc Pentoxifylline 1cc Vitamin C 1cc Procaine 1cc


prime-journal.com | January/February 2015 ❚


47


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44  |  Page 45  |  Page 46  |  Page 47  |  Page 48  |  Page 49  |  Page 50  |  Page 51  |  Page 52  |  Page 53  |  Page 54  |  Page 55  |  Page 56  |  Page 57  |  Page 58  |  Page 59  |  Page 60  |  Page 61  |  Page 62  |  Page 63  |  Page 64