Review of injection techniques in body cosmetology

In modern cosmetology, the body widely uses various injection methods:

1. Mesotherapy - allopathic and homeopathic
2. Ozone therapy and oxygen therapy.
3. Reflexology.
4. Homeomeoxymesotherapy.

Mesotherapy is the introduction of pharmacological drugs intradermally into the area of the pathological focus with the goal of creating a "depot" of the drug in the skin with slow peripheral diffusion into the tissues. The main effects develop due to the effect of the introduced substance, the mechanical stimulation of the skin receptors by the needle, the improvement of the microcirculation of blood and lymph circulation in the skin.

The main indications for mesotherapy in body cosmetology:

1. Cellulite (gynoid lipodystrophy).
2. Overweight, obesity.
3. Violation of the venous circulation.
4. Rejuvenation of the bust and décolleté area.
5. Correction of striae.
6. Rejuvenation of the hands.
7. A significant decrease in skin turgor (the so-called "flabby skin").

Contraindications to mesotherapy:

Pharmacological:

• the presence of an allergic reaction to the drug;
• the presence of somatic diseases, which can be complicated after using the pharmaceutical preparation (for example: cholelithiasis with the use of hofitol, autoimmune thyroiditis, gastritis after caffeine application).

Contraindications from the patient:

• pregnancy and lactation;
• fear of injections;
• neuropsychic diseases;
• inflammatory diseases, hematomas and skin integrity disorders in the proposed treatment zone (except for cases of treatment of this pathology);
• tendency to bleeding;
• acute diseases, including viral.

Side effects and complications of mesotherapy:

1. Pain.
2. Erythema.
3. Hematomas
4. Accession of infection with the development of inflammation in the injection zone.
5. Necrosis followed by scarring.
6. Allergic reactions.

Side effects can be caused by the drugs themselves, their wrong combination in the cocktail, the way and depth of administration, and also can depend on the characteristics of the body. Thus, high blood pressure, blood clotting disorders (including due to the use of antiplatelet agents) increase the risk of hematoma.

Some drugs themselves cause bleeding.

Pain occurs with the introduction of acid solutions, protein preparations (enzymes). The occurrence of pain is affected by the technique of injection, the diameter of the needle, the sensitivity of the treated area, the state of the body. Emotional stress, fatigue, hunger, menstruation significantly increase the perception of pain.

Necrosis is due to errors in the combination of drugs in a single syringe, which can be the result of a severe allergic reaction. Vasoconstrictors, adrenaline can provoke local necrosis. The drug should not be in oily solution - the risk of ischemia and thrombosis.

Erythema is often a normal reaction after a mesotherapy session, since most cocktails include vasodilating drugs. The emergence of persistent erythema, accompanied by itching, pain, especially after a few days after the procedure, requires action, since it may be a symptom of an allergic reaction or the development of an inflammatory process.

Purpose and procedure

When choosing a mesopreparation and the technique of cleavage, it is necessary to take into account the distribution of fat tissue in the patient. For example, in the case of a gynoid type, preference is given to use in the area of "breeches" and buttocks of alpha-adrenoblockers. When android - choose drugs that enhance metabolism. The increase in volume is corrected by a deeper introduction, compared with the surface treatment with cellulite.

All information obtained as a result of the examination and questioning of the patient, the planned treatment regimen should be entered on the client's card. The results of the inspection, thermography are recorded in a table and repeated several times per course. In the schematic image of a person, you can specify the location of the "cold" zones, nodes and areas of severe fibrosis (skin retraction and compaction). For each procedure, a protocol is kept, indicating all the drugs used, their number, the ratio in the cocktail, the area to be treated, and a combination with other methods for correcting the figure. It is this control that helps to track the dynamics of treatment, to work out the most acceptable scheme of patient management and confirms the objectivity of the method. In turn, the documentation is necessary in case of conflict situations, insures the specialist against possible claims, and also helps to increase the client's confidence in the cosmetologist.

To reduce the risk of infectious complications, the mesotherapy session should be conducted in a prepared sterile room. All tools and materials that come in contact with the skin should be disposable. Disinfection of the skin is carried out with an antiseptic that does not contain alcohol, since the latter intensifies the duration of bleeding and dry the skin. If the capillary is damaged during the injections, bleeding should be stopped by pressing a dry swab. For the same purpose, use cold cells with a dry surface. To accelerate the resolution of the hematoma help creams containing vitamin K, ascorbic acid, rutin; a good effect gives homeopathic ointment "Traumeel C". To clients prone to bleeding, it is recommended to strengthen the capillaries in advance (ascorutin: 1 tablet 2 times a day, 14 days). After the end of the procedure, the skin is treated with antiseptic, dried. The patient should be given recommendations that will avoid complications during the course of mesotherapy (reminder to the patient):

1. On the day of the session, do not use any cream, no body lotion, or perfume.
2. Do not wear tight clothing to avoid infection.
3. Avoid taking anti coagulants, do not inject during peri-menstruation due to the appearance of hematomas.
4. If you suspect a allergic reaction - the appearance of redness of the itching, swelling - contact your doctor-cosmetologist.

After the session, you should:

1. Avoid exposure to the sun for 48.
2. Do not take a shower, bath, do not visit the sauna, bath during the day.
3. Do not use any cream or body milk for 24 hours.

Basic techniques used in mesotherapy of the body:

1. Microcirculatory technique. Injections are performed along the vascular axes. The drug is administered along the main vessels, paying extra attention to the projection of the regional lymph nodes. Applied at the beginning of treatment for improving lymph and blood circulation, for drainage, removal of pastosity of tissues, with venous insufficiency.
2. Treatment of paravertebral zones and reflex points. Paravertebral zones are trshternymi for enhancing metabolism and pain relief. In the treatment of cellulite and obesity, it is useful to make injections in the sacrum with hormonal disorders, in the reflex points of the gallbladder and stomach with the concomitant pathology in these organs.
3. Classical technique. Processing the entire surface of the problem area.

Basic techniques for working with the body:

1. "Papular" technique. The goal is to create a "depot" of the drug in the dermis. Used for lifting the skin, when processing folds, reflex points
2. Nappage. The technique of superficial injections. Used in the treatment of large areas to reduce pain, combines the effect of the pharmaceutical preparation and reflex stimulation on the skin receptors. 
3. Linear technology. Retrograde introduction of the drug is used in the correction of striae.
4. Infiltration (mesoperfusion). Deep injection of a relatively large volume of the drug is required for the treatment of hard-to-reach areas with poor microcirculation (foci of fibrosis, large cellulite nodules), removal of pain syndrome (muscle strain, sports injuries).
5. The technique of tracer injection is a variant of infiltrating injections. From one injection the needle is injected deeply in different directions. Applied in the treatment of cellulite (deep into the nodes and foci of fibrosis), pronounced subcutaneous fat to enhance lipolysis.

Classification of mesopreparations by effects:

1. Lipolitics:
   • alpha-adrenoblockers - lipogenesis and accumulation of fats in the adipocyte are blocked (lofon, buflomedil, yohimbine);
   • inhibitors of phosphodiesterase, an enzyme regulating lipolysis by reverse conversion of c-AMP to AMP (xanthines, triacs);
   • beta-adrenomimetiki - lipolysis stimulants (algae preparations, yohimbine, graphite).
2. Preparations that enhance the utilization of lipolysis products
   • drugs that enhance the transport of lipolysis products through the adipocyte membrane (mesostabil, phosphatidyl choline);
   • L-carnitine - improves the transport of triglycerides in the mitochondria reduces the concentration of cholesterol in the blood, improves lipid metabolism.
3. Drugs that improve blood flow:
   • alpha-adrenoblockers - block the alpha-adrenoreceptors of the precapillary sphincter, dilate the peripheral vessels (dihydroergotamine, loftone, buflomedil, backgroundiline, sermion, vadilex, minoxidil);
   • angioprotectors (pentoxifylline, trental, dicinone);
   • plant preparations (hofitol, ginkgo biloba, melilotrutin, gamma-melis, horse chestnut) - anti-edema, vasoprotective, lymphokinetic effect. Hofitol also has a diuretic, choleretic, hepatoprotective and hypocholesterolemic effect.
4. Sympatholytics - reduce the formation of acetylcholine, reduce the excitability of peripheral cholinoreactive systems, causing blockade of vegetative ganglia and vasodilation; anesthetics (procaine, lidocaine, mesocaine).
5. Defibrizing preparations:
   • enzymes (lidase).
6. Preparations that improve the structure of the skin:
   • multivitamin preparations (multivitamin oligosol, NSTF-135)
   • oligoelements (Zn, Cu, Se, Mg - antioxidants, Zn, Ni, Co - increase skin tone, regulate pancreas function, Mg is shown in telangiectasias, stabilizes cell membranes, increases muscle tone, regulates enzymatic reactions of the Krebs cycle, carbohydrate metabolism) ;
   • conjouctil (organic silicon) - increases the concentration of AMP in adipocytes and stimulates lipolysis, enhances the synthesis of collagen, elastin and proteoglycans, improves lymphokinetics;  
   • drugs that renew the intercellular matrix and promote the synthesis of collagen and elastin fibers (X-ADN, Placentene, DONA, hyaluronic acid preparations, embryoblasts); 
7. Ready cocktails: homeopathic (lipodystrophin, metabolite chondrodystrophin) and allopathic (intralipo, intracell).

It is more convenient for a beginning mesotherapy to work with ready-made complex preparations. They are distinguished by a balanced composition and pH, which excludes precipitation from the unstable solution, reduces to a minimum possible complications in this connection in the form of necrosis, allergic reactions.

As an example, we present several schemes for treating cellulite. Mesotherapy in complex correction of cellulite is prescribed with the following objectives: improvement of microcirculation, drainage of tissues, reduction of fibrosis, reduction of fat deposits, oxygenation and nutrition of tissues.

Cellulitis I stage, is expressed slightly, puffiness. We choose preparations for strengthening the skin (vitamins, oligoelements) and improving microcirculation (hofitol):

• Hydrosoli polyvitamini 2.0
• Oligosoli Mg 2.0
• Chophitoli 5,0
• Procaini 2% - 2.0.

S. It is recommended that the classical method of splitting is recommended.

Cellulite II stage, "orange peel" is detected locally, fat deposition by the gynoid type. For treatment, we select drugs that improve microcirculation, and alpha-adrenoblockers.

1st syringe:

• Procaini 2% - 2.0
• Esberiveni 2.0

S. Injections along vascular axes.

2nd syringe:

• Aminophyllini 2.0
• Dihydroergotamini 0.3
• Conjoctyli 4,5
• Procaini 2% - 2.0.

S. Classical technique of splintering.

Cellulitis III stage, areas of fibrosis. To improve blood circulation and metabolism in the thickness of fibrous tissue, enzyme preparations will be required. They often give allergic reactions. It is best to use ultrasound therapy in this case. This will soften the foci of fibrosis, "break" cellulite nodules, reduce the number of sessions of mesotherapy. Injection techniques used: tracing injections deep into the nodes, deep injections into the foci of fibrosis, papular - along the vascular axes and paravertebrally, over the problem zone.

1st syringe:

• Mag-2 - 5,0
• Torental 3.0
• Procaini 2% - 2.0.

2nd syringe:

• Hyaluronidasa 5.0
• Procaini 2% - 2.0.

When combining mesotherapy with hardware methods of figure correction, it is important to consider that drugs injected into the skin by injection, retain their activity for about 3-5 days. Any hardware effect increases metabolism in tissues and promotes excretion of pharmaceuticals. Therefore, it is recommended to perform physiotherapeutic treatment on the eve or before the mesotherapy session.

Mesotherapy in the rejuvenation of bust, decollete and hands. The condition of the skin of the chest and hands is one of the reasons that makes it necessary to consult a doctor-cosmetologist. Early signs of aging appear in these areas. Due to photoaging and age-related skin changes.

Indications for mesotherapy bust and decollete:

1. Reduced skin turgor.
2. Strengthening the muscular-fascial corset.
3. Stria.
4. Pigmentation.

Recommended preparations:

1. Preparations of gaaluropeic acid (IAL-SYSTEM, AsNual, X-ADN); glucosaminoglycans (GAG, DONA), embryoblasts, collagen, elastin, ATP, placentene, etc.
2. To strengthen the muscles and lift the breast, use L-carnitine, DMAE Complex, Maslbig, including in combination with hardware techniques (microcurrent lifting, myostimulation, endermological correction, ultrasound therapy, etc.).
3. To correct the stria use the same drugs as to improve skin tone. But the most effective treatment will be "young" stria, having a red color. At this stage, almost complete restoration of the structure of the skin is possible. In other cases, there is a restoration of the synthesis of intercellular substance, increasing the elasticity of the skin in the stretch zone, the disappearance of wrinkles over the rupture in the dermis. A good effect is provided by a combination of mesotherapy with medical chemical peelings, lermabrasion and endermology
4. Pigmentary spots (lentigo) on the decollete is a sign of photoaging of the skin. Remove pigmentation with mesotherapy is impossible, but to prevent photoaging, increase the resistance of the skin to the ultraviolet spectrum can be achieved with antioxidant drugs (multivitamin oligosol, vitamin C, DMAE-complex, IAL-SYSTEM, etc.).

When processing the decollete, it should be borne in mind that the sternum area is very sensitive and is a risk zone for the formation of keloid scars. Propensity to keloids rises during hormonal changes in the body - periods of pregnancy, lactation, menopause. To prevent complications, at work on the decollete use atraumatic needles and technique of microinjection.

Mastopathy is not a contraindication for mesotherapy of the décolleté region, but mammary glands should not be treated with mesopreparations. A good therapeutic effect is provided by ozonotherapy. This method of treatment can soften the fibro-nodular formations, relieve pain. Treatment is conducted in conjunction with a mammologist, under the supervision of ultrasound.

Mesotherapy in the rejuvenation of hands. With age, the skin of the hands is increasingly exposed to aggressive external influences - these are atmospheric factors, and solar irradiation, and the effects of household chemicals. The main complaints that are addressed to the cosmetologist are: dryness, wrinkled skin, pigment spots (lentigo), visible enlarged veins. Mesotherapy gives a strong anti-aging effect on the skin of the hands. But for an optimal result it is good to combine with other cosmetic techniques (photorejuvenation, chemical peelings, plasticizing masks, wraps). Preparations for mesotherapy of hands are the same as for skin rejuvenation. Methods of splitting - classical papular lapping, elaboration of reflex points, along synovial vaginas.

[1], [2], [3]