Cosmetic Medicine | Dr. Enrique Etxeberria, Plastic Surgery in Bilbao


Cosmetic Medicine - Mesotherapy - Mesotherapy


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Mesotherapy consists in the intradermal infiltration of biological solutions which stimulate the synthesis of collagen, hydrate the dermis and maintain the natural equilibrium of the skin.
At facial level they seek to generate a more youthful and jovial appearance of our skin.
At corporal level we can address our action towards:
- hydrating an area (for example the back of the hands, cleavage,…)
- accumulations of localised fat
- cellulitis


Mesotherapy is a technique invented in 1952 by the French doctor Michel Pistor, which consists in treating the affected areas with microinjections of conventional or homeopathic medications, vitamins, minerals or aminoacids.
The name comes from the layer of skin into which the substances are injected, derived from the embryonic mesoderm.
In 1987, the French Academy of Medicine recognised Mesotherapy as part of conventional medicine.  The International Society of Mesotherapy covers 14 countries of Europe and South America.
It also has applications in the field of cosmetic medicine, being used as a treatment for reducing cellulitis, localise adiposities and wrinkles, this latter being known as mesolifting. Likewise, Mesotherapy is used to treat other afflictions and as a cosmetic treatment in different procedures: for example, scars, acne, psoriasis, vitiligo, freckles, flaccidity, stretch marks, hair loss, metabolic fat disorder, localised fat, diseases of the peripheral vascular system and ulcers of the leg.


It is indicated for hydrating, toning and revitalising the face as well as the cleavage, neck and hands.  With this technique, increased hydration and luminosity is achieved in these treated areas.
Depending on the pathology being treated, the type of medication will be selected, which when injected will have much more direct action.  Due to the characteristics of the tissue into which it is applied, the medication will remain active within the specific area where it was deposited, without entering the general circulation or interacting with other organs. By so doing, more results are achieved with lower doses, a benefit which means the treatment has fewer adverse effects, compared with what it could have if the medication were introduced into the organism by other means, for example, orally.
Mesotherapy is used nowadays principally for the treatment of skin afflictions and for cosmetic improvement, in cases such as:
- Scars
- Acne
- Psoriasis
- Vitiligo
- Freckles
- Flaccidity
- Stretch marks
- Facial ageing
- Hair loss
- Cellulitis
- Metabolic fat disorder
- Localised fat


Traditional mesotherapy can be applied with different treatments, amongst which of note is homeopathic mesotherapy, which is based on the fact that its origins lie in pure and simple substances from the vegetable, animal and mineral kingdoms.
There is also virtual or needle-free mesotherapy, which seeks the same objectives as mesotherapy with needles but without the use of injections. Virtual mesotherapy uses electrical impulses or radiofrequency to pursue the same objectives. Amongst its advantages are that it is totally painless.
As a genera rule, if mesotherapy is applied correctly and by a specialist, it is a treatment which barely has side effects, although some bruising may appear.


In mesotherapy, the following treatments can be distinguished:
Sequential Meso-perfusion (or slow mesotherapy): in this case, needles are used which enter a depth which varies between 2 and 13 millimetres and which is characterised by a short injection time, which varies between 1 and 5 seconds, followed by a more extensive pause, of 10 to 50 seconds, which make up the “injection sequence”.  The time required for a session of slow mesotherapy varies between 5 and 45 minutes.  This difference will vary depending on the areas treated and the technical capabilities of the apparatus used.
Manual mesotherapy: injections which are applied manually.
Mesotherapy with apparatus of assisted injection
Meso-dissolution: to dissolve localised fat and for the treatment of cellulitis.
Mesoglow: for the treatment of facial ageing, a selection of medications are applied to the face, neck and cleavage to achieve the effect of tightening the skin.
Mesopeeling: consists in introducing medications which produce an exfoliation of the skin in order to improve the appearance of the skin, treat skin spots, fine lines, dilated pores and scars.
Mesolifting: in those cases where the skin is thinner, flatter, dehydrated, and in which transformations in nutrition or in micro-circulation can be seen.
Homeopathic mesotherapy: Homeopathic medications have no active chemical ingredients but rather have their origin in pure and simple substances from the vegetable, animal and mineral kingdoms.
Allopathic mesotherapy: uses chemically active medications from traditional medicine.


Prior to a session of mesotherapy, you can eat and drink normally, but there are some aspects that must be taken into consideration. Prior to the first session it is very advisable to speak with your surgeon to ensure you are fully informed about the protocol and the possibility of having an allergic reaction to some of the medications used.
Before leaving home, you must remove from your skin any fragrances, make-up or any cosmetics, in order to thereby guarantee a safe, comfortable and effective treatment.
You should never attend a mesotherapy session if you are ill.  Your surgeon must always be made aware if the patient is not feeling well.  If you feel cold or are experiencing cold symptoms such as fever, cough, vomiting, headache, diarrhoea or general malaise of the body prior to undergoing mesotherapy, it is advisable to cancel the session and postpone it to another day.
For his part, the doctor must comply with basic hygiene standards prior to the session and adequately disinfect the skin.  To avoid bacteria which may have unwanted effects, all materials should be sterilised. The vials must be opened just before their use and both the professional as well as the medical assistant who will be in contact with the patient must correctly wash their hands with liquid soap, antiseptic soap and alcohol gel.
Prior to each microtherapy session, the correct antisepsis of the entire skin surrounding the area to be treated must be undertaken. This antisepsis must be carried out by a responsible doctor who will have to hand cotton wool impregnated with alcohol in order to properly disinfect the area.
You must avoid taking salicylic acid during the week prior to the mesotherapy session.


Normally a session lasts some 15 minutes. In very sensitive people, local anaesthetic cream is applied. After the mesotherapy session, a decongestant mask is applied for a few minutes.


It is advisable to refrain from any significant physical exercise during the first 24 hours, as well as refrain from exposing yourself to any source of sun or heat.


Three sessions are performed, separated by 21 days between each of them. This process is repeated every 3 to 6 months depending on the medical criteria.