Mesotherapy is a method of introducing medications into the body through microinjections of the mesoderm of the skin. It originated in 1952 in Paris, France, by Michel Pistor, MD.. Jacque Le Coz, MD and Dr. Pistor worked to improve the methodology, and the Academy of French Medicine recognized it as a “standard of care” along with other traditional medicine in 1986. It is used for a large variety of illnesses, including tendonitis, eczema, scars, and sports injuries, in addition to cellulite stages 1-3, treatment of alopecia and hair loss, and facial rejuvenation treatments. The depth of treatment is 0.5mm-6mm deep (called Nappage technique). When the depth is 6-12mm (the Point Per Point technique) and reserve fat is treated, it is called Lipotherapy. Combining meso- and lipo-therapy, we can use deoxycholate and phosphatidyl choline to permanently reduce the amount of fat to a treated area, and tighten the skin.
Possible Risks and Side Effects
Potential risks and side effects can include, but are not limited to:
- Over correction
- Under correction
- Skin necrosis, and
- Delayed hypersensitivity
I have read of the possible risks and and side effects of treatment, and consent to move forward with treatment.
Guarantee of Treatment
I understand that no guarantees as to the amount of improvement can be made, and that diet and exercise can affect the outcome. I understand that Mesotherapy and Lipotherapy have a goal of decreasing inches and permanent spot fat reduction, and that its primary goal is not to reduce weight. I acknowledge that I have had the opportunity to discuss all questions regarding this treatment with Pure Cosmetics and that they have been answered satisfactorily. My signature will constitute a full and final release of any legal responsibility resulting from the administration of mesotherapy and/or lipotherapy, as well as any other medical treatment that may be needed as a result thereof.
To my knowledge, I am not pregnant, and not breastfeeding, and will notify Pure Cosmetics immediately if I think I have become pregnant or become pregnant during the course of treatments.
I understand that adjunctive procedures, such as microdermabrasion, use of sunblock products, prescription skin care regimens, and facials performed by experienced Estheticians may enhance the outcome, health and appearance of the skin treated with Mesolipotherapy.
I understand and consent to the taking of photos of my body and face before, during and after the course of treatment(s) for medical record keeping.