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Dr. Tarek El Tanbouli MESOTHERAPY. Injection of small doses of medications in the mesoderm with very good effect on treating dermatological lesions (ectoderm)

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Presentation on theme: "Dr. Tarek El Tanbouli MESOTHERAPY. Injection of small doses of medications in the mesoderm with very good effect on treating dermatological lesions (ectoderm)"— Presentation transcript:

1 Dr. Tarek El Tanbouli MESOTHERAPY

2 Injection of small doses of medications in the mesoderm with very good effect on treating dermatological lesions (ectoderm) or even internal lesions as GIT (endermic). Injection of small doses of medications in the mesoderm with very good effect on treating dermatological lesions (ectoderm) or even internal lesions as GIT (endermic). This term is suggested by Dr.Michel Pistor (French doctor 1958). This term is suggested by Dr.Michel Pistor (French doctor 1958). Meso.= Middle; since we are aiming at correct location. Meso.= Middle; since we are aiming at correct location. OR = mean : Intermediary dosage between Allopathic therapy and Homeopathic therapy. OR = mean : Intermediary dosage between Allopathic therapy and Homeopathic therapy.

3 Dr. Tarek El Tanbouli History After many previous studies in Europe started 1793 (Belgium + France) for injecting local anesthetics and histamine to treat musculoskeletal, tendon and Trigeminal pain lesions. After many previous studies in Europe started 1793 (Belgium + France) for injecting local anesthetics and histamine to treat musculoskeletal, tendon and Trigeminal pain lesions. In 1948 Dr. Michel Pistor started pain treatment mainly with local infiltration of Procaine. In 1948 Dr. Michel Pistor started pain treatment mainly with local infiltration of Procaine.

4 Dr. Tarek El Tanbouli History (cont.) In 1958, the name Mesotherapy is suggested for the 1 st time after discovering more injection sites to treat more medical problems. In 1958, the name Mesotherapy is suggested for the 1 st time after discovering more injection sites to treat more medical problems. In 1964 Dr.Pistor founded the French Mesotherapy Society. In 1964 Dr.Pistor founded the French Mesotherapy Society. In st International Mesotherapy Congress. In st International Mesotherapy Congress. and the 1 st Hospital outpatient service for Mesotherapy is created. and the 1 st Hospital outpatient service for Mesotherapy is created creation of University Diploma in Marseille, Bordeaux and Paris creation of University Diploma in Marseille, Bordeaux and Paris.

5 Dr. Tarek El Tanbouli Indications A ) Aesthetic: 1)Lipolysis. 2)Cellulite. 3)Hair loss. 4)Scar. 5)Anti ageing. 6)Meso-Buttox.

6 Dr. Tarek El Tanbouli Indications (cont.) B) Pain: 1)Sports injuries. 2)Chronic inflammatory disorders (Rheumatic, Sacroiliatis, Knee & Shoulder osteoarthritis, etc…) C) Others: G.I.T. disorders,insomnia, tonsilitis … etc

7 Dr. Tarek El Tanbouli Contraindications 1)Pregnant Female. 2)Nursing Female. 3)D.M. ( O.k. if controlled –be sure ) 4)Heart Dis. (arrhythmias ) 5)Children.

8 Dr. Tarek El Tanbouli Instructions After Treatment for 24 hrs. 1.No Exercise. 2.No Massage. 3.No Hot Shower. 4.No Caffeine.

9 Dr. Tarek El Tanbouli Drugs Used

10 Dr. Tarek El Tanbouli A) Lipolytic drugs: 1.PPC 2.Caffeine 3.Aminophylline 4.Yohimbine 5.L – Carnitine 6.Co enzyme A

11 Dr. Tarek El Tanbouli B) Trophic drugs: 1.Silicum = Conjunctyl 2.Vit. C 3.Multivitamins 4.Artichoke 5.Na pyruvate 6.Hyaluronic acid

12 Dr. Tarek El Tanbouli C) Vasodilator drugs: 1.Calcitonin 2.Fonzylane 3.Torental 4.Dicynone D) Local anaesthia Lidocaine Lidocaine

13 Dr. Tarek El Tanbouli Phosphatydilcholine The best lipolytic drug is PPC without any effect on weight loss. The best lipolytic drug is PPC without any effect on weight loss. Either injected pure (Brazil) or diluted with saline Either injected pure (Brazil) or diluted with saline Or in combination e.g.; Lidocaine 2.5 ml Or in combination e.g.; Lidocaine 2.5 ml Saline 2.5 ml Saline 2.5 ml PPC 5 ml PPC 5 ml Aminophylline 5ml Aminophylline 5ml In France PPC is not allowed; so using local anesthetic + Lipolytic drug + Trophic drug + vasodilator drug. In France PPC is not allowed; so using local anesthetic + Lipolytic drug + Trophic drug + vasodilator drug.

14 Dr. Tarek El Tanbouli Phosphatydilcholine (con.) PTC is lecithin from soya beans ( have 2 unsaturated fatty acids = linoleic + alpha linoleic acid) PTC is lecithin from soya beans ( have 2 unsaturated fatty acids = linoleic + alpha linoleic acid) PTC is produced in the body but have saturated fatty acid ( Palmitic + oleic + streaic acid ) in cell membrane of: PTC is produced in the body but have saturated fatty acid ( Palmitic + oleic + streaic acid ) in cell membrane of: Liver cells. Liver cells. Adipocytes. Adipocytes. Lungs of embryo from 4 th month. with more palmitic acid preventing its sticking so allowing inflation + deflation of lungs (stimulate lung surfactant) Lungs of embryo from 4 th month. with more palmitic acid preventing its sticking so allowing inflation + deflation of lungs (stimulate lung surfactant)

15 Dr. Tarek El Tanbouli Phosphatydilcholine (con.) PTC. To be injectable needs: PTC. To be injectable needs: 1)A solvent which is deoxycholic a. ( gallic a.) 2)A preservative which is Benzyl alcohol ( now known as PPC). PPC max. dose in lipolysis = 2500 mg / session (every 4 – 8 w ) PPC max. dose in lipolysis = 2500 mg / session (every 4 – 8 w ) Each area needs 1 – 4 sessions to get the results. (72 % of pt. need 2 session only). Each area needs 1 – 4 sessions to get the results. (72 % of pt. need 2 session only).

16 Dr. Tarek El Tanbouli PPC helps dissolving the double layer of adipocytes producing nano size fat particles. PPC helps dissolving the double layer of adipocytes producing nano size fat particles. At the same time, helps enzymes of mitochondria of adipocytes to break down the triglycerides into mono ( continue for 8 w ). At the same time, helps enzymes of mitochondria of adipocytes to break down the triglycerides into mono ( continue for 8 w ). 99% of dissolved fat transported to liver where metabolized into CO2 + H2O. 99% of dissolved fat transported to liver where metabolized into CO2 + H2O. 1% are transported to kidney. 1% are transported to kidney.

17 Dr. Tarek El Tanbouli Types of injections 1.IED = Intra Epidermic (1 mm depth) 2.IDS = Intra dermal superficial (1-2 mm depth) N = Nappage = multi-pricking technique for cellulite + mesolift N = Nappage = multi-pricking technique for cellulite + mesolift PPP = point by point or papule technique for tonsillitis + insomnia PPP = point by point or papule technique for tonsillitis + insomnia 3.IDP = Intradermal (4 mm depth) for hair loss 3 mm by oblique injection. for hair loss 3 mm by oblique injection. 4.Mesoperfusion ( 5-6 mm depth) 5.IHD = Intra hypodermic (6-13 mm depth) for lipolysis + iliolumbar lig. pain for lipolysis + iliolumbar lig. pain

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22 Cellulite It is lumpy, orange peel, or cottage cheese appearance of skin by strangled fat cells. It is lumpy, orange peel, or cottage cheese appearance of skin by strangled fat cells. Fat cells are held in place by a mesh of collagen fibers in the subcutaneous tissue. Fat cells are held in place by a mesh of collagen fibers in the subcutaneous tissue. If fat cells bloated with water or fat, cellulite appears i.e. fat cells bulge out the mesh of collagen fibers. If fat cells bloated with water or fat, cellulite appears i.e. fat cells bulge out the mesh of collagen fibers.

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26 Factors Causing Cellulite 1.Hereditary 2.Pregnancy 3.Drainage problem (sp. lymphatic ). 4.Obesity

27 Dr. Tarek El Tanbouli Interstitial or extracellar matrix is composed of: 1.Fibroblasts (structural fibrous protein ) 2.Glycosaminoglycans 3.Glycoprotein (adhesive ptn.) 4.Proteoglycans

28 Dr. Tarek El Tanbouli Cellulite appears if interstitial matrix is affected by: 1.Decreased collagen function + production 2.Decreased Elastin 3.Decreased Flow of micro circulation ( due to acidosis + increased free radicals 4.Increased capillary permeability leading to increased free water and then lipedema

29 Dr. Tarek El Tanbouli Cellulite classifications 1.1 st degree = cellulite does not appear if skin is punched. 2.2 nd degree = cellulite only appear if skin is punched but not appear during standing or laying down. 3.3 rd degree = cellulite appear during standing and punching the skin but not on laying down. 4.4 th degree = in all condition.

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31 Treatment of cellulite 1.Decrease lipoedema by Procaine + Benzopirone. 2.Stimulate micro-circulation by Procaine + vit C + penthoxiphylin. 3.Stimulate lipolysis by procaine + PPC ± theophylline ± caffeine ±carnitine ±yohimbin. 4.Stimulate C.T. regeneration by Conjunctyl.

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36 Treatment of Flacidity of Arms and Inner thigh 1.DMAE : Di methyl amino ethanal using 2 – 4 ml (25 mg / ml). 2.Vit.C using 2 ml (222 mg / ml) 3.Procaine using 1 ml (2%) For one thigh or arm. For one thigh or arm. Need 20 treatments with 2 weeks apart by PPP or Nappage injections. Need 20 treatments with 2 weeks apart by PPP or Nappage injections.

37 Dr. Tarek El Tanbouli Complications Complications You have to alert your patients to all side effects: 1 ) Vasovagal Syndrome: Vasovagal Syndrome due to many injections ( ) Vasovagal Syndrome due to many injections ( ) a- Before treatment ask pt. If dizziness or nausea occur to stop injections and give O2 mask for 2-5 min at L /min. If dizziness or nausea occur to stop injections and give O2 mask for 2-5 min at L /min. Ask pt. to stay after injection in the clinic to be sure no loss of consciousness. Ask pt. to stay after injection in the clinic to be sure no loss of consciousness.

38 Dr. Tarek El Tanbouli Complications (cont.) b - Before treatment eat sugary or ptn. diet (more empty stomach more attacks). c - Injection better while lying down more than standing position which may be lethal with loss of consciousness.

39 Dr. Tarek El Tanbouli Complications (cont.) 2.Pain: Dull or burning pain at area of injection which become warm + red, within 5 min, lasts from 10 min. To few days. Dull or burning pain at area of injection which become warm + red, within 5 min, lasts from 10 min. To few days. Not treated by NSAIDs but better with mild narcotics as Hydrocodone or weak opiods e.g. tramal or distalgesic. Not treated by NSAIDs but better with mild narcotics as Hydrocodone or weak opiods e.g. tramal or distalgesic. 3.Nodules: occurred with non expert doctors or increased conc. of PPC. 4.swelling: may start immediately + persist 1 week or more.

40 Dr. Tarek El Tanbouli Complications (cont.) 5.Bruising: persist 1 – 2 weeks so pt. must plan their treatment according to their schedule sp. wedding, swimsuit & modeling photo shoots. 6.Nausea – or + diarrhea: due to cholinergic reaction (sp. aminophylline 250 mg) Treatment: Antiemetic or H2 blocker (Zantac). Treatment: Antiemetic or H2 blocker (Zantac).

41 Dr. Tarek El Tanbouli Complications (cont.) 7. Palpitations: Increased in Hypertensive pt. Give O2 mask + diazepam ( tranquilizer ). Increased in Hypertensive pt. Give O2 mask + diazepam ( tranquilizer ). Occurs with: Occurs with: a) aminophylline if its serum level >20 mg / ml. a) aminophylline if its serum level >20 mg / ml. b) Yohimbine (parasympathomimmetics). b) Yohimbine (parasympathomimmetics). 8.Allergy: Sp. with a) Hyaluronidase b) PPC. Sp. with a) Hyaluronidase b) PPC. Treat as any allergic reactions; Treat as any allergic reactions;

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