COSMETIC

Effectiveness of Mesotherapy on Body Contouring

Seung Ha Park, M.D., Ph.D.
Deok Woo Kim, M.D.
Min Ah Lee, M.D.
Sang Chul Yoo, M.D.
Seung Chul Rhee, M.D.
Sang Hwan Koo, M.D., Ph.D.
Geun Hye Seol, R.N.
Eun Young Cho, A.N.
Seoul, South Korea
Background: Despite the increasing interest in mesotherapy as an alternative
method for body contouring, there are few reports of its safety, efficacy, and
mechanism of action. A clinical examination was performed to evaluate the
efficacy of mesotherapy for body contouring.
Methods: Twenty women were enrolled in this prospective, case-controlled
study over a 12-week period. The authors injected a mixed solution (i.e., am-
inophylline, buflomedil, and lidocaine) into the superficial dermis of the medial
aspect of one thigh weekly using a mechanical delivery gun. There was no
treatment to the other thigh. The change in the fat level was evaluated by
measuring the girth of the thighs and by computed tomographic scanning. The
lipid profiles were checked to determine the effect of mesotherapy on lipid
metabolism, and questionnaires were used to determine the satisfaction rate of
the patients.
Results: The loss of thigh girth on the treated side was not significantly different
from that of the untreated side. The computed tomographic scans showed no
statistically significant difference in the cross-sectional area or thickness of the
fat layer between each group. There were no statistically significant changes in
the lipid profiles except for the triglyceride level. A questionnaire asking about
the effect of mesotherapy indicated poor patient satisfaction.
Conclusion: Mesotherapy is not an effective alternative treatment modality for
body contouring. (Plast. Reconstr. Surg. 121: 179e, 2008.)

M
esotherapy is a recently introduced treat-
ment that involves the delivery of phar-
macologic drugs or substances into the
mesoderm, which is the layer of fat or connective
tissue under the skin.1 Mesotherapy using differ-
ent substances has been advocated by some to
treat a variety of conditions as varied as chronic
pain, psoriasis, cellulite, weight loss, and local obe-
sity control. In particular, mesotherapy has been
advocated by some doctors or physicians and used
as a nonsurgical alternative to liposuction for sev-
eral years. The pharmacologic drugs or substances
most frequently injected for body contouring are
phosphatidylcholine, isoproterenol, aminophyl-
line, caffeine, L-carnitine, buflomedil, calcitonin,
and others. Despite the number of anecdotal re-
ports and data suggesting that the components of
From the Department of Plastic and Reconstructive Surgery,
Korea University Medical Center.
Received for publication November 7, 2006; accepted Jan-
uary 24, 2007.
Presented at the 60th Congress of the Korean Society of Plastic
and Reconstructive Surgeons and the 24th Congress of the
Korean Society of Aesthetic Plastic Surgeons, in Busan, Ko-
rea, May 25, 2006.
Copyright ©2008 by the American Society of Plastic Surgeons
DOI: 10.1097/01.prs.0000304611.71480.0a
traditional mesotherapy formulations might be ef-
fective, there have been no peer-reviewed clinical
trials that have critically evaluated the efficacy of
these localized injections for body contouring.2
Therefore, this study performed clinical trials to
determine the effect of mesotherapy on body con-
touring.
PATIENTS AND METHODS
This randomized, prospective, clinical trial
was carried out on volunteers who had localized
obesity but no cellulite on their thighs and were
younger than 40 years (range, 22 to 40 years).
Twenty female patients were enrolled in this study.
All the volunteers provided written informed con-
sent and accepted the possibility of side or adverse
effects, including infections, pain, and unreliable
or ineffective result associated with the procedure.
This study was approved and granted by the uni-
versity research committee (institutional review
board) in December of 2005. The study was also
Disclosure: None of the authors has a financial
interest in any of the products, devices, or drugs
mentioned in this article.

www.PRSJournal.com 179e

carried out in accordance with the International
Conference of Harmonization good clinical prac-
tice guidelines.
Sample Preparation
One of the medial thighs of each patient was
selected randomly for mesotherapy, with no in-
tervention being performed on the other. A 5-ml
solution containing 2 ml of aminophylline (25
mg/ml), 1 ml of 1% lidocaine, and 2 ml of bu-
flomedil (10 mg/ml) was prepared. Before the
procedure, the patient received an ice massage to
reduce the level of pain. An imaginary straight line
connecting the symphysis pubis to the medial mar-
gin of the patella was drawn, and a 10 ⫻ 10-cm area
was made, in which the center was the point di-
viding the line by two-thirds. The solution was
injected into the superficial dermis every 2 to 4
mm2 using a mechanical delivery gun for meso-
therapy (Pistor4; MI-Medical, Chanac, France). The
treatment was repeated in the same thigh at every
week for 3 months (Figs. 1 and 2).
Assessment of the Effectiveness of Mesotherapy
on Body Contouring
The patients were monitored every month to
measure the girth of both thighs. In addition, the
body fat composition was analyzed (InBody 4.0;
Biospace, Seoul, Korea), and blood was sampled
Fig. 1. A 10 ⫻ 10-cm square was drawn (arrow) on the medial thigh, and mesotherapy was
performed with a mesogun. Photographs obtained before treatment (left) and 3 months after the
mesotherapy (right).
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Plastic and Reconstructive Surgery • April 2008
every month to determine the lipid profile during
the follow-up. The girth of both thighs was mea-
sured at the upper, middle, and lower third por-
tions using a measuring tape, and the average was
calculated to two decimal places and rounded off
to one decimal place. To eliminate any interob-
server difference, the same nurse, who was blinded
to this study, measured the girth of the thigh be-
fore treatment. The circumference of the un-
treated thigh of each patient was also measured.
Computed tomography was performed on 10 of
the 20 patients before and 1 to 2 weeks after the
end of the clinical trial. The change in the amount
of fat was measured by calculating the cross-sec-
tional area of the total fat and the thickness of the
fat layer from the medial margin of the adductor
longus muscle to the skin. At the same time, the
changes in the blood lipid profiles such as triglyc-
eride, low-density lipoprotein cholesterol, high-
density lipoprotein cholesterol, total cholesterol,
phospholipid, total lipid, and free fatty acid were
also checked. A questionnaire was given to the
subjects to inquire about their experience with
mesotherapy. Two women did not answer the
questionnaire and 18 women replied as to how
much they were satisfied with the final results. This
was presented in the form of a Likert-type scale
ranging from 1 (extremely dissatisfied) to 5 (ex-
tremely satisfied). The women were also asked
Volume 121, Number 4 • Mesotherapy for Body Contouring
Fig. 2. Computed tomographic scans of both thighs for measuring the cross-sectional areas and thick-
ness of fat.
whether they would recommend mesotherapy to
others.
Statistical Analysis
All the data were coded in a standardized for-
mat and analyzed using SPSS version 12.0 (SPSS,
Inc., Chicago, Ill.) The descriptive statistics given
are the mean and SD. The statistical significance
for the changes in the girth of the thigh, the cross-
sectional areas of the fat layer, and the thickness
between the treated and control sides was evalu-
ated using the Wilcoxon signed rank test. A com-
parison of the blood lipid profiles between pre-
treatment and posttreatment sample was also
performed using the Wilcoxon signed rank test.
The reported p values were two-sided, and a value
of p ⬍ 0.05 was considered significant.
RESULTS
Change in Girth of the Thigh
Although the measurements were obtained on
the fourth, eighth, and twelfth weeks during the
follow-up period, only the latest measurements are
reported because the measurements taken at the
fourth and eighth weeks were similar to those
taken before treatment. There was little change in
body weight and the amount of body fat observed
in the subjects throughout the study (Table 1).
Although not statistically significant, there was a
0.6-cm decrease in the girth of the thigh in the
treated areas and a 0.3-cm decrease on the con-
tralateral side (Table 2).
Cross-Sectional Area and Thickness of the
Fat Layer
The computed tomographic evaluation pro-
vided more detailed information about the effect
of mesotherapy. The cross-sectional areas of the
treated thigh decreased by 3.8 cm2 (average),
whereas that of the contralateral side decreased by
2.5 cm2 (average). The thickness of the fat layer
decreased by 0.03 cm on the treated area and
increased by 0.05 cm on the contralateral side.
However, there were no statistically significant dif-
ferences in either of the cross-sectional areas or
the thickness of the fat layer (Tables 3 and 4).
Blood Lipid Profile
There were some patterns in the decrease in
the amount of low-density lipoprotein choles-
terol, total cholesterol, total lipid, free fatty acid,
and triglyceride. However, among these, only
the change in the triglyceride level was signifi-
cant. (p ⫽ 0.04) (Table 5).
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 Plastic and Reconstructive Surgery • April 2008

Table 1. Patient Summary and Thigh Girth Measurement before and after Mesotherapy
Before Treatment After Treatment

Circumference* Circumference

Sex/Age BW BFP Treated Untreated BW BFP Treated Untreated

Patient (yr) (kg) (%) (cm) (cm) (kg) (%) (cm) (cm)
1 F/35 58.8 28.2 41.3 54.6 59.1 28.2 55.0 54.9
2 F/31 65.1 33.2 63.3 61.5 65.7 32.9 62.5 61.7
3 F/39 62.3 34.5 57.5 55.8 61.7 35.3 55.2 55.4
4 F/22 58.4 34.0 54.4 54.2 59.1 33.5 55.6 55.1
5 F/34 57.1 36.6 52.5 51.7 57.9 38.1 51.6 52.9
6 F/39 61.3 33.9 54.9 54.2 61.8 32.7 54.3 55.4
7 F/23 70.4 34.4 58.5 57.4 72.3 35.7 57.1 55.6
8 F/35 58.8 32.7 51.9 51.7 58.3 33.1 54.2 53.0
9 F/30 75.1 43.7 58.9 59.5 68.5 38.0 55.2 53.4
10 F/35 57.5 30.3 52.0 50.6 58.7 33.1 53.5 51.7
11 F/26 61.2 30.8 56.2 57.0 61.2 32.1 56.6 57.4
12 F/40 68.5 37.5 56.8 55.9 64.2 35.9 54.5 53.8
13 F/24 57.1 32.3 56.4 56.4 56.9 31.7 56.3 55.6
14 F/25 61.7 61.0 60.4 61.4 58.5 43.5 58.4 59.0
15 F/29 80.4 44.1 64.5 62.5 83.8 42.3 63.9 64.1
16 F/26 51.6 27.4 50.5 51.7 51.5 24.9 49.2 51.9
17 F/31 66.6 34.0 57.6 55.9 67.7 34.6 57.6 56.9
18 F/24 72.1 38.0 61.6 59.9 70.2 36.0 59.7 60.2
19 F/37 55.7 30.1 53.1 51.7 55.6 33.3 53.9 52.3
20 F/27 47.4 29.5 50.8 51.9 48.0 30.0 49.6 50.5
Average F/31 62.4 35.3 56.3 55.8 62.0 34.2 55.7 55.5
BW, body weight; BFP, body fat percentage.
*Average values of upper, middle, and lower circumference of thigh.

Table 2. Changes in Thigh Girth after Mesotherapy
(n ⴝ 20)*
Thigh Girth
Before After
Treatment Treatment
Thigh (cm) (cm) Change†
Treated side 56.3 ⫾ 4.1 55.7 ⫾ 3.7 –0.6 ⫾ 1.5 0.380
Untreated side 55.8 ⫾ 3.7 55.5 ⫾ 3.5 –0.3 ⫾ 1.8
*Values are reported as a mean ⫾ SD.
†Calculated by the girth of the thigh after treatment minus the
pretreatment value.
‡Obtained by using the Wilcoxon signed rank test to compare the
change in girth of the treated side with that of the untreated side.
Questionnaire
Regarding the level of satisfaction with the
effect of mesotherapy, all of the patients answered
with a Likert-type scale as either 4 (very dissatis-
fied) or 5 (extremely dissatisfied). Eighty-nine per-
cent of patients confessed that they had been at-
tempting to quit the treatment before the end of
the experiment. The reasons for attempting to
quit the therapy during the treatment course were
pain (56 percent) and the negative expectation
regarding the effect of mesotherapy (44 percent).
In terms of the subjective scales regarding the
effectiveness of mesotherapy, all of the patients
expressed negative thoughts about mesotherapy.
They regarded mesotherapy as being not so ef-
fective (67 percent) or ineffective (33 percent) in
reducing the girth of the thigh. There were no
volunteers who wanted the same treatment on the
contralateral side of their thigh, and none would
recommend this treatment to others as a body
p‡
contouring procedure.
DISCUSSION
There are a large number of protocols or treat-
ment formulas used in mesotherapy. Because each
protocol differs from doctor to doctor, it is not
possible to test the effect of each formula as a
standard protocol for injection lipolysis. The pro-
posed current cocktail formulas or protocols for
lipolysis can be found at web sites such as http://
www.mesotherapyworldwide.com/images/pdf/
ACSM_Body_contouring_pg142-143.pdf (e.g.,
phosphatidylcholine, hyaluronidase, aminophyl-
line, artichoke extract, collagenase, melliotis,
L-carnitine, pentoxifylline, buflomedil, and oth-
ers). Although there are few reports on the effec-
tiveness of each formula used in injection lipolysis,
aminophylline and buflomedil are common in-
gredients in mesotherapy used for lipolysis, irre-
spective of the addition of other pharmacologic
agents.
In adipocytes, the effects of catecholamines
and the mechanisms that mediate them have been

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Volume 121, Number 4 • Mesotherapy for Body Contouring

Table 3. Cross-Sectional Fat Area Measured by Computed Tomography and a Comparison of the Changes after
Mesotherapy between the Treated and Untreated Control (n ⴝ 10)*
Mean Fat Area (mm2)

Thigh Before Treatment† After Treatment† Change‡ p§

Treated side 15,121.3 ⫾ 3010.5 14,742.0 ⫾ 2816.6 –379.3 ⫾ 1244.0 0.285
Untreated side 15,006.4 ⫾ 2868.5 14,756.2 ⫾ 2996.1 –250.2 ⫾ 1243.0
*Ten patients were chosen randomly using a table of random sampling digits.
†Values are reported as the mean ⫾ SD.
‡Calculated by the girth of the thigh after treatment minus the pretreatment value.
§Obtained by using the Wilcoxon signed rank test to compare the change in girth of the treated side with that of the untreated side.

Table 4. Fat Thickness Measured by Computed Tomography and a Comparison of the Changes after
Mesotherapy between the Treated and Untreated Control (n ⴝ 10)*
Thigh Girth (cm)

Thigh Before Treatment† After Treatment† Change‡ p§

Treated side 2.66 ⫾ 0.57 2.63 ⫾ 0.63 –0.03 ⫾ 0.24 0.474
Untreated side 2.68 ⫾ 0.52 2.73 ⫾ 0.67 0.05 ⫾ 0.36
*Ten patients were chosen randomly using the table of random sampling digits.
†Values are mean ⫾ SD.
‡Calculated by girth of the thigh after treatment minus the pretreatment value.
§Obtained by using the Wilcoxon signed rank test to compare the change in the girth of the treated side with that of the untreated side.

Table 5. Changes of Lipid Profiles after Mesotherapy (n ⴝ 20)

Before Treatment After Treatment Change
Lipid (mg/dl) (mg/dl)* (mg/dl) p†
Total cholesterol 179 ⫾ 28.0 168.8 ⫾ 22.5 –7.1 ⫾ 14.8 0.206
HDL cholesterol 65.9 ⫾ 12.6 66.0 ⫾ 13.3 0.1 ⫾ 6.5 0.779
LDL cholesterol 107.4 ⫾ 17.0 99.0 ⫾ 15.7 –8.4 ⫾ 11.1 0.068
Total lipid 604.6 ⫾ 82.4 582.0 ⫾ 62.0 –22.6 ⫾ 40.8 0.123
Phospholipid 195.1 ⫾ 31.8 196.9 ⫾ 20.2 1.8 ⫾ 20.4 1.0
Triglyceride 78.6 ⫾ 17.2 68.4 ⫾ 19.5 –10.3 ⫾ 11.2 0.042*
Free fatty acid 155.0 ⫾ 22.8 148.0 ⫾ 25.7 –7.0 ⫾ 15.6 0.183
HDL, high-density lipoprotein; LDL, low-density lipoprotein.
*Blood sampling was carried out on all the patients at every monthly visit for the mesotherapy treatment and 1 to 2 weeks after the end of
the clinical trial. Time-series analysis showed that the lipid profiles had no statistical patterns or significance among the acquired samples. The
last result of lipid profiles is described.
†Lipid profiles of pretreatment and posttreatment samples were compared by using the Wilcoxon signed ranked test. The results show a
significant difference (p ⬍ 0.05).

examined extensively. Lipolysis is signaled by ␤-ad-
renergics. An antilipolytic signal is transduced by
␣2-adrenergics.3 Therefore, compounds that pro-
mote ␤-adrenergic activation and ␣2-adrenergic
inhibition might increase the rate of lipolysis in fat
cells.1
Aminophylline and buflomedil were used as
pharmacologic drugs in this clinical trial because
they are commonly used in mesotherapy by gen-
eral practitioners. Although the mechanism of
mesotherapy has been suggested to be a mixed
mechanism involving mesolipolysis, mesodrain-
age, and mesodissolution, the former is consid-
ered to involve xanthine derivatives and ␣2-adren-
ergics by inhibiting phosphodiesterase, increasing
the intracellular cyclic adenosine monophosphate
level, which in turn, activates the hydrolysis of adi-
pose tissue triglycerides.4 The latter drug used in this
study, buflomedil hydrochloride, is a vasoactive drug
that is considered to have a lipolytic or mesodrainge
effect by inhibiting the ␣-adrenoceptors.5 However,
there is some controversy regarding the effect of
aminophylline. There was an experimental report
demonstrating an increase in the plasma free fatty
acid with an intravenous aminophylline injection.4
Greenway et al. reported that after administering
a 10% aminophylline ointment with a calorie-
restricted diet, the patient’s weight decreased by
3.3 ⫾ 2.2 kg and the thigh girth was decreased by
0.77 ⫾ 0.66 cm (p ⬍ 0.001 by analysis of variance).6
However, Kim et al.7 reported no fat-reducing ef-
fect after a subcutaneous injection of aminophyl-

183e

line to the abdomen in a rat model. Nevertheless,
there are many practitioners who use aminophyl-
line empirically either orally or through the sub-
cutaneous route to control obesity, without pro-
viding any reliable data.
There are several radiographic methods for
measuring the subcutaneous fat thickness.8 –11 Sei-
dell et al.12 reported that the subcutaneous adi-
pose-tissue areas measured by magnetic resonance
imaging are almost identical to those obtained by
computed tomography. In contrast, they showed
that movement artifacts are a larger problem with
magnetic resonance imaging than with computed
tomography. Accordingly, considering cost-effec-
tiveness, computed tomography was used for the
fat thickness measurement, even though there are
some disadvantages of exposures to radiation and
scarce presence of the beam-hardening effect.
Although there is a preliminary report contra-
dictory to this result,13 there was no body contouring
observed in this study. There were no statistically
significant changes in thigh girth, cross-sectional
area, or laboratory values for the lipid profile except
for a decrease in the triglyceride level in the blood,
which might be an indirect effect of the method
of aminophylline absorption into the systemic
circulation.14
Some mesotherapists suggest that mesotherapy
for local obesity has little effect without a calo-
rie-restricted diet and an adjuvant exercise
program.15 In addition, some insist that the mech-
anism for the effect of mesotherapy is too com-
plex. However, it is unclear whether any positive
result for mesotherapy with a calorie-controlled
diet and exercise program is attributable to the
mesotherapy itself or to the other components of
the treatment. The authors believe that medical
practice should not be based on an uncertainty
principle. Some may insist that the present study
was inaccurate because mesotherapy depends on
the therapeutic skill of the clinician. However,
practitioner-based bias did not occur because a
consistent power and depth were achieved in this
study using a mechanical delivery gun. Neverthe-
less, the relatively small sample size might have
affected the statistical power of the data. Although
use of an appropriate statistical methodology does
not fully overcome this limitation, use of the Wil-
coxon signed rank test, which is a nonparametric
test, reflects the study’s characteristic at least in
part. There was a nonspecific decreasing pattern
of average thigh girth or lipid profile, but this is
believed to be a temporary disuse phenomenon or
the result of the systemic absorption of the phar-
macologic agents. Moreover, there were six cases
184e
Plastic and Reconstructive Surgery • April 2008
(30 percent) whose thigh circumference actually
increased after mesotherapy.
It is possible that abdominal fat is different
from thigh fat. Matarasso and Pfeifer1 showed that
adipocytes in the thigh regions contain more ␣2-
receptors. Therefore, fat in this area is believed
to be more resistant to lipolysis. However, one
experimental study, in which aminophylline was
injected into the subcutaneous tissue of the ab-
domen, also concluded that a subcutaneous in-
jection of aminophylline is not effective in reduc-
ing the amount of regional and systemic fat.
Another possible limitation is that this study was
not a double-blind or true case-control study.
However, the authors believe such a study may not
be adequate because it may add a new confound-
ing factor: the possibility of inflammation-medi-
ated fat necrosis or resorption if a placebo is in-
jected into the skin.16
Mesotherapy, in general, is classified accord-
ing to the depth of the injection into the epider-
mic, intradermic superficial, and intradermic lay-
ers. The intradermic superficial method, using a
mechanical delivery gun, was adopted for meso-
therapy, which is known to produce only slight
pain during the procedure.15 However, most pa-
tients (56 percent) experienced severe pain dur-
ing the procedure, even though lidocaine had
been added to the solution and a cold massage was
performed before the procedure. Accordingly, it
is believed that the pain developed as a result of
the mesotherapy itself and was not caused by the
surgeons. Therefore, a topical anesthetic cream
might be helpful before these procedures.
There are no clinical reports demonstrating
the effectiveness of mesotherapy for body con-
touring in the Korean or English literature. The
U.S. Food and Drug Administration has not ap-
proved the subcutaneous use of the medications
commonly used in mesotherapy. Moreover, there
are many reports showing unexpected infections
or adverse reactions to mesotherapy.17–21 Rohrich22
reported that the physician’s duty is to provide pa-
tients with safe, proven methods of medical care; this
is a statement with which the authors absolutely
agree. Therefore, more clinical trials will be needed
to demonstrate the effectiveness of mesotherapy.
CONCLUSIONS
Although there are a few reports showing that
mesotherapy is partially effective for some medical
conditions,23,24 there is a recent report showing
that mesotherapy does not provide any significant
benefit.25 Mesotherapy was not found to be an
effective treatment modality for controlling local
Volume 121, Number 4 • Mesotherapy for Body Contouring
obesity or for body contouring. Mesotherapy is not
recommended for body contouring because most
patients were unsatisfied with mesotherapy, and its
efficacy was not demonstrated experimentally.
However, additional study of a larger population
is needed.
Seung Ha Park, M.D.
Department of Plastic and Reconstructive Surgery
Korea University Medical Center
126-1, Anam-Dong, Sungbuk-Gu
Seoul 136-705, South Korea
shp98@korea.ac.kr
ACKNOWLEDGMENT
Funding for this project was provided by the Korean
Association of Clinical Plastic Surgeons.
REFERENCES
1. Matarasso, A., and Pfeifer, T. M. Mesotherapy for body con-
touring. Plast. Reconstr. Surg. 115: 1420, 2005.
2. Rotunda, A. M., and Kolodney, M. S. Mesotherapy and phos-
phatidylcholine injection: Historical clarification and review.
Dermatol. Surg. 32: 465, 2006.
3. Bernlohr, D. A., Jenkins, A. E., and Bennaars, A. A. Adipose
tissue and lipid metabolism. In G. Bernardi, D. E. Vance, and
J. E. Vance (Eds.), Biochemistry of Lipids, Lipoproteins and Mem-
branes, 4th Ed. Amsterdam: Elsevier, 2002. P. 275.
4. Zanaboni, L., Bonfiglioli, D., Sommariva, D., D’Adda, D., and
Fasoli, A. Increase in lipolysis and decrease in plasma-heparin
lipoprotein lipase activity and alpha 1 lipoprotein level after
aminophylline in man. Eur. J. Clin. Pharmacol. 19: 349, 1981.
5. Clissold, S. P., Lynch, S., and Sorkin, E. M. Buflomedil: A
review of its pharmacodynamic and pharmacokinetics prop-
erties and therapeutic efficacy in peripheral and cerebral
vascular disease. Drugs 33: 430, 1987.
6. Greenway, F. L., Bray, G. A., and Heber, D. Topical fat re-
duction. Obes. Res. 3: 561S, 1995.
7. Kim, H. K., Kim, Y. W., and Kim, H. J. The evaluation of the
effect of aminophylline injection to subcutaneous fat reduc-
tion (in Korean). Korean Soc. Aesthetic Plast. Surg. 9: 17, 2003.
8. Koda, M., Senda, M., Kamba, M., Kimura, K., and Murawaki, Y.
Sonographic subcutaneous and visceral fat indices represent
the distribution of body fat volume. Abdom. Imaging 32: 387,
2006.
9. Tokunaga, K., Matsuzawa, Y., Ishikawa, K., et al. A novel
technique for the determination of body fat by computed
tomography. Int. J. Obes. 7: 437, 1983.
10. Borkan, G. A., Gerzof, S. G., Robbins, A. H., et al. Assessment
of abdominal fat content by computed tomography. Am.
J. Clin. Nutr. 36: 172, 1982.
11. Weits, T., van der Beek, E. J., Wedel, M., et al. Computed
tomography measurement of abdominal fat deposition in
relation to anthropometry. Int. J. Obes. 12: 217, 1988.
12. Seidell, J. C., Bakker, C. J., and van der Kooy, K. Imaging
techniques for measuring adipose-tissue distribution: A com-
parison between computed tomography and 1.5-T magnetic
resonance. Am. J. Clin. Nutr. 51: 953, 1990.
13. Salas, A. P., and Asaadi, M. Aesthetic application of meso-
therapy: A preliminary report (Abstract). Presented at the An-
nual Meeting of the American Society for Aesthetic Plastic Sur-
gery, Vancouver, British Columbia, Canada, April 17, 2004.
14. Hughes, T. A., Stentz, F., Gettys, T., and Smith, S. R. Combining
beta-adrenergic and peroxisome proliferator-activated recep-
tor gamma stimulation improves lipoprotein composition in
healthy moderately obese subjects. Metabolism 55: 26, 2006.
15. Park, Y. Y. Cellulite and Aesthetic Mesotherapy. Seoul: Hanmi
Medical Publishing, 2004. P. 134.
16. Rose, P. T., and Morgan, M. Histological changes associated
with mesotherapy for fat dissolution. J. Cosmet. Laser Ther. 7:
17, 2005.
17. Centers for Disease Control and Prevention. Outbreak of
mesotherapy-associated skin reactions: District of Columbia
area, January-February 2005. M.M.W.R. Morb. Mortal. Wkly.
Rep. 54: 1127, 2005.
18. Rivera-Olivero, I. A., Guevara, A., Escalona, A., et al. Soft-
tissue infections due to non-tuberculous mycobacteria fol-
lowing mesotherapy: What is the price of beauty. Enferm.
Infecc. Microbiol. Clin. 24: 302, 2006.
19. Brandão, C., Fernandes, N., Mesquita, N., et al. Abdominal
haematoma: A mesotherapy complication. Acta Derm. Vene-
reol. 85: 446, 2005.
20. Rosina, P., Chieregato, C., Miccolis, D., et al. Psoriasis and
side-effects of mesotherapy. Int. J. Dermatol. 40: 581, 2001.
21. Tennstedt, D., and Lachapelle, J. M. Cutaneous adverse ef-
fects of mesotherapy. Ann. Dermatol. Venereol. 124: 192, 1997.
22. Rohrich, R. J. Mesotherapy: What is it? Does it work? Plast.
Reconstr. Surg. 115: 1425, 2005.
23. Monticone, M., Barbarino, A., Testi, C., et al. Symptomatic
efficacy of stabilizing treatment versus laser therapy for
sub-acute low back pain with positive tests for sacroiliac
dysfunction: A randomized clinical controlled trial with 1
year follow-up. Eura. Medicophys. 40: 263, 2004.
24. Soncini, G., and Costantino, C. The treatment of pathologic
calcification of shoulder tendons with E.D.T.A. bisodium salt by
mesotherapy. Acta Biomed. Ateneo Parmense 69: 133, 1998.
25. Amin, S. P., Phelps, R.G., and Goldberg, D. J. Mesotherapy for
facial skin rejuvenation: A clinical, histologic, and electron mi-
croscopic evaluation. Dermatol. Surg. 32: 1467, 2006.
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