Dr.

Michel Pistor 1952 Non surgical relatively painless technique that is used worldwide with a broad range of indications (rheumatology, sports, vasc. Diseases, pain relief, .) It is a technique of using microinjections of conventional or homeopathic compounds (A.A., vitamins, minerals,.) to deliver a healing or corrective treatment to a specific area.

Dr. Michel Pistor (1924-2003) performed clinical research and founded the field of mesotherapy. Multi-national research in intradermal therapy culminated with Pistor's work from 1948 to 1952 in human mesotherapy treatments. The French press coined the term Mesotherapy in 1958. The French Academy of Medicine recognized Mesotherapy as a Specialty of Medicine in 1987. Popular throughout European countries and South America, mesotherapy is practiced by approximately 18,000 physicians worldwide.

Definition:
(From Greek mesos, "middle", and therapy from Greek therapeia, "to treat medically") It is a non-surgical cosmetic medicine treatment.

Mesotherapy employs multiple injections of pharmaceutical and homeopathic medications, plant extracts, vitamins, and other ingredients into the subcutaneous fat.

Mesolift (mesoglow) Mesobotox Mesohair Mesocellulite Mesomelasma

Mesostriae Mesofat

Body

Face

Double chin

Eyepad fats

Polyvitamins, antioxidants, H. A.

Activate cell metabolism

Repair age related skin damage

Mechanism of action
1.Activation of fibroblast activity 2.Replace loss of H.A. 3.Improve cellular metab. & circulation Tardy supply of nutrients NB: inactive circulation
Acc. of waste products

1.Right drug 2.Right dose 3.Right location

Compound Vitamins Vitamin A Vitamin B Vitamin C Vitamin D Vitamin E Vitamin K Amino acids Minerals (sodium, potassium, calcium and magnesium) Coenzymes Nucleic acids

Characteristics Regulates keratinocyte activity, promotes collagen synthesis Regulate the biological balance of the skin Stimulates collagen synthesis, inhibits melanin synthesis, is an antioxidant Takes care of essential calcium synthesis and cell membrane stability Generates ant-radical activity and improves the microcirculation Provides an important substance in skin microcirculation Promote protein construction Provide ionic balance

Serve as biochemical catalysts Synthesize proteins

1.Intraepidermal (0.5-1 mm) the most superficial 2.Papular technique (dermoepidermal J.) 3.Nappage (2-4mm) (30-60 ) One syringe to inject several times continuously into dermis 4.Point by point Single injection (1-2 cm apart) micropapules

1.Once/week 4 ws Once/2ws 2 months Once/month 2 months 2.One ttt/14 d 2 months 3.One ttt / 6-8 ws 3 months Maintenance every 3-6 months

1.Pregnancy 2.Insulin dependent diabetes 3.History of strokes 4.History of recent cancer 5.Thromboembolic phenomenon 6.Medications (warfarin, heparin, NSAI)

1.No needle cutting, no operative intervention

2.Low dose usage, precise location

3.No complication to any part of body

4.Time release absorption

The most important is NOT the technique

(Manual-gun-nappage-point by point )

but the transepidermal penetration: Why not simply rub the product topically on the skin surface ?

No Needle Mesotherapy

Interwaved Modulated Radiofrequency (IMRF)

Alternative to traditional mesotherapy No needle No pain Reliable Efficient

Electronic impulses

High frequency Low intensity

Permeabilising cellular membranes (altering membrane potential) Electroporation of lipids bilayer (biological stress)

Advantages over other transdermal transport techniques or systems:

There is no electronic contact with the patients. So there is no risk of chemical burns, pain or inflammation. It is not invasive It has no return electrode (ground plate) It is not contraindicated in prosthesis There is no molecular ionization of the transported substances

Advantages over other transdermal transport techniques or systems (cont.):

It is valid for ionic, non-ionic and lipidic substances The speed of transcutaneous penetration of the hydrolipid products is approximately 1 gram per 60 seconds It does not require any conductor gel It has no secondary effects Practical, transportable and easy to handle It introduces substances of any molecular weight

Indicated in:
Obesity Cellulite Flaccidity Facial treatments Stretch marks
Electroporation by radiofrequency is a very reliable techniques which can be adapted to multiple therapies and opens up the way to numerous possibilities.

Contra indications
Patients with pace makers Pregnant women Severe acne Epileptic patients

Phosphatidyl choline

Deoxycholate

Rittes PG. Dermatol Surg. 2001. 27:391-392. Improvement of lower lid bulging due to prominent fat pads (250mg/5mL) Hexsel D. J Drugs Dermatol. 2003. 2(5):511-518. Improvement of adipose deposits following liposuction (250mg/5mL) Rotunda AM. Dermatol Surg. 2004. 30(7):1001-1008. Active component detergent effect ofsodium deoxycholate.

Localized fat deposits are areas where fat is accumulated and does not disappear with diet and exercise. They are found at the face, jowl, neck, arm, abdomen, back, thigh and hip areas.
They can be aggravated by the aging process, hormonal changes, poor dietary habits, lack of exercise and slow metabolism conditions.

Fat cells are metabolically active and are well supplied by blood vessels.

The fatty acids come from 3 main sources:

1. 2. 3.

Dietary fats. Fat produced in the liver. Excess blood glucose. There are two types of fat; Brown fat and white fat. A fifth to a quarter of adult body weight is made from white adipose tissue.

Brown fat assist in burning energy / calories, generates heat and appears as small lipid droplets. White fat is the conventional type of fat which stores energy and is full of lipid droplets. White fat is always beneath the skin and is the cause of obesity. Adipose tissue is the largest storehouse of energy in the body (in the form of triglycerides) and makes up 15-20% of the body weight in men and 20-25% of body weight in women. Men are more likely to get "potbellies" because their fat is stored around the abdomen, whereas women tend to get heavier hips, thighs and rear ends.

Hormones cause the deposition of fat in specific areas of the body. Aging process slows down metabolic rate, allowing fatty tissue deposits. Poor dietary habits and sedentary lifestyle.
Genetic.

Patients with small localized fat deposits.

Patients not suitable for operations. Patients aware of mesotherapy.

Phosphatidylcholine.
Na deoxycholate. Caffeine. Vitamins and anti-oxidants. Ma huang herb ( ephedra).

L-carnitine.

3-6 sessions at 2-4 weeks interval. 250mg of phosphatidylcholine (250mg/5mL) injected into effected area. Patient can be seated or lying down Better to measure diameter of area to be treated before session. Anesthesia ( optional and local ). Sterilization with alcohol swap. Multiple injections with a 10 -12 mm long needle ( to reach subcutis).

Injections given at 1-2cm. Interval.

Takes from 10-15 min.

All patients asked to follow a natural healthy diet.

Lots of water is used to flush toxins that are eliminated from the body along with dissolved fat. Exercise is needed to circulate the medications used, with either walking or another form of aerobic activity, three times a week. Local anti-inflammatory may be used twice daily for bruising, irritation and discomfort e.g. reparil gel.

Bruising. Redness, irritation and itching over the injected area which may last to 3 days post session. Edema : Traumatic from injection. Lipolysis. Post-inflammatory hyperpigmentation.

Hematoma formation.
Patient dissatisfaction.

Pregnancy. Lactation. Diabetes mellitus. Bleeding tendency. Psychic patient. Children. Generalized obesity. Targeting weight reduction.

What to Expect :

2-4 cm decrease in the diameter of the injected part 2 weeks after the session. No weight loss.
Right patient selection . Optimum results.

Surgical Procedure Removes fat cells Cannot be used where cellulite is 2 weeks down time Wear restrictive garments for weeks Weight gain back in extratreated sites. Significant bruising and pain Causes scarring Takes up to 3 months to see results Causes loose and weak skin places

Non-invasive procedure Removes fat from cells Used wherever there is cellulite No down time Wear loose clothing after treatment Weight gain back where it was
Minimal bruising and Reduces scarring Results seen in weeks. Tightens and strengthens skin .

pain

Phosphatidyl choline has been recently tried with variable results.

L-carntitine aslo has been tried .

Cellulite is an accumulation of fat, fluid, and toxins trapped in a hardened network of connective tissue fibers that hold down the skin causing the "dimpling" effect. The fat cells inflate, causing a rippling and puckering of the skin, commonly referred to as orange peel skin.

Lymphatic and venous circulation are poor in these areas.

Mesotherapy is used to cause an increase in venous and lymphatic flow, as well as elimination of fat and dimpling in the area.
The medications used in Mesotherapy destroy the connective tissue bands and melt the trapped fat, creating a smooth, dimple-free appearance.

Patient who is seeking treatment for cellulite

Possibly overweight, but not obese Not interested in surgery Wants a fast, easy, procedure that shows good results

Treatments will depend on how much cellulite and dimpling the patient has in the problem area. Treatment can last 15-45 minutes.
Involves injecting several small amounts of medications and vitamins into the middle layer of skin.

Optional anesthesia.

Isoproterenol (-Agonist) Hyaluronidase, collagenase Ephedrine (Sympathomimetic amine) Calcium pyruvate (Krebs cycle metabolite) Carnitine (amino acid derivative) Ma huang herb ( ephedra) Fat burner; is inhibited for systemic use in USA. Gingko biloba extract platelet aggregation factor inhibitor, endothelium derived relaxing factor . Artichoke ( circulatory stimulator)

Improved blood flow to the treated area.

Dissolves excess fat deposits. Removes fibrotic, hardened connective tissue. Improved lymphatic drainage. No downtime.

No downtime procedure. The treatment is permanent and the results are measurable as long as patients do not gain more than fifteen pounds.

Most people will require from 6-10 sessions to achieve results at 1-2 weeks intervals.
Dieting and exercise will help to maintain one's results over the long term. In 4 weeks, a patient's skin appears significantly smoother. Most patients lose anywhere from 2-4 inches where their cellulite is treated.

Injection-Lipolysis

NETWORK

Injection-Lipolysis

NETWORK-Lipolysis
Europe An international association of physicians in North America all fields with at present exceeding 2900 Asia physicians Africa from 64 countries applying Lipolysis injections South America according to the NETWORKs method. Australia/ Oceania

World Map, Robinson Projection

Injection-Lipolysis

Definition

Definition of Injection Lipolysis

Lipolysis is used for the Reduction of small localized fat deposits by destroying the adipocytes structure.

It is performed by subcutaneous injections with a solution of polyenyl-

Injection-Lipolysis

vs Mesotherapy

Terms

Lipolysis vs. Mesotherapy Lipolysis:

SUBcutaneous injections, depth 6 mm 12 mm subcutaneously injected into fatty tissue!
Only to dissolve fat! Aesthetic use!

Mesotherapy:
INTRAcutaneous injections, depth 1 mm 4 mm intracutaneously injected to cure hundreds of diseases by injecting small amounts of a variety of mostly homeopathic substances (200 different agents and more are known).
Injection-Lipolysis and Mesotherapy (Dr. Michel Pistor, France 1952) are entirely different techniques!

PC in

Aesthetic medicine

1988

2004

Italy 1988 First official aesthetic introduction on the 5th International Meeting of Mesotherapy in Paris, first treatment of Xanthelasmas (light-yellow fat cholesterol deposits of eyelids) in Italy by Sergio Maggiori M.D. Brasilia 1995 First treatment of lower eye fat pads (Dermatologist Patricia Rittes M.D., Brazil) Europe 2001 First experimental and clinical studies beginning Europe 2002 First case reports by Franz Hasengschwandtner M.D. (Austria) and beginning of treatments Europe 2003 Foundation of NETWORK-Lipolysis Development of a standardised training concept Europe 2004 Establishment of research groups. Development of a new treatment protocol

PC in

Aesthetic medicine

2004

2006

Worldwide 2004 Establishment of worldwide NETWORK-Representative 1. International Lipolysis-Congress and NETWORK member meeting, FFM Worldwide 2005 Foundation of ISL International Society of Lipolysistherapy Websites for patient information in 8 languages Publishing 2nd NETWORK-Lipolysis Report 2004 Studien-Kooperation mit der Ruhruniversitt, Bochum 1. International Lipolysis Convention in Salzburg, Austria 2. International Lipolysis Congress and NETWORK member meeting in Paris Europe 2006: Third party liability insurance for NETWORK-Members in EU, Norw. & CH Start Scientific NETWORK-Compound Study, University of Regensburg, GER 1. International Scientific Symposium on Injection-Lipolysis, Vienna 3. International Lipolysis Congress and NETWORK member meeting in Vienna

PC in

Aesthetic medicine

2007

2010

Worldwide 2007 Study of Lipoma treatment by member Dr. Bechara, Ruhr-University, Bochum 1. M.A.S.T.E.R.-Conference 2007 and NETWORK member meeting in Paris 1. NETWORK Austral-Asean Lipolysis member conference in Sydney Worldwide 2008 12 Compound Pharmacy (EU, AUS, USA, CAN, MEX, EGY, ISR, SA, KUW, LEB, VRC, Dubai) produce standardized NETWORK Compound in high quality 1. National German NETWORK member meeting Worldwide 2009 rd party liability insurance for NETWORK-Members Expanding 3 worldwide (except USA) 2. M.A.S.T.E.R.-Conference 2009 FAT and NETWORK member meeting Introduction of the new NETWORK Compound Mixture Worldwide 2010 Introduction of the new NETWORK Pain & Side Effect Management

Used dosages in application of PC

PC - DC

Dosages

Lipolysis Colitis Ulcerosa Bipolar depression Atherosclerosis Fat embolism

2.5 6

Lipolysis 8 weeks subcutanous Intravenous daily in gr. Oral daily in gr. 15 15

2.5

4.5
0 5 10 15 20 25 30

PC - DC

Composition

Biochemistry and Function

Phosphatidylcholine (PC) / Lecithine is an essential phospholipid LIPIDES ( Fatty acids and derivates )
and classificated in 2 groups

STORAGE-LIPIDE Triglycerides

LIPIDE and Glycolipide

MEMBRANEPhospholipide

PC - DC

Composition

Phospholipids
Phosphatidylcholine is an essential Phospholipid (in literature also mentioned as EPL), which is specially high concentrated in membrans of adipocytes and Hepatocytes.

Sphingomyelin (70/30 %), another important phospholipid, is highly concentrated in nerves and brain. It has a different composition in comparison with PC, being esterified with Ceramid-1-phospate to long chained fatty acids.

This leads to a resistance of nerve tissue

against the detergent effect of medications

PC - DC

Function

Cell membrane destruction

If we speak of injectable PPC we always have Phosphatidylcholine (5 %) Deoxycholate (2,44 %) Benzyl alcohol as 3 basic components:
PC
Bile acid as solvent preservative

DC

PC - DC

Function

Emulsion Lipases - Metabolism

bursting of the adipocytes membrane - The deoxycholate in PC/DC liquifies and dissolves the plasma membrane. emulsification of fat by detergent effect of the active ingredients and transportation into the liver by HDL particles and by micelle formation. It follows a partial degradation by a cascade of enzymes (hormone sensitive lipase, triglyceride-, diglyceride-, monoglyceride-lipase), and a further metabolism/catabolism in the liver, among others by oxidation in the mitochondria (in citric acid cycle).

The lipolytic process

- a hypothesis

PC/DC - lecithine
The lipolytic process
Adipocytes before and after treatment with PCDC solution (University of California Los Angeles, Division of
Dermatology, in vitro) Publication: Adam Rotunda, Dermatol. Surg 2004;30:1001-1008

The lipolytic process

- a hypothesis

In vivo lysis of adipocytes

10 days after lipolysis
Photos: Dr. Hasengschwandtner

The lipolytic process

- a hypothesis

The most important steps in dissolving the subcutaneous fat!

Metabolism

Transportation into the liver Emulsification

Membran destruction

Adipocytes

PC injection

The lipolytic process

proven by science

Dissolving the subcutaneous fat

1.

bursting of the adipocytes membrane -The deoxycholate in PCDC liquifies and dissolves the plasma membrane. emulsification of fat by detergent effect of the active ingredients and

2.

3.
4.

breakdown the fat through enzym cascade

transportation into the liver by HDL particles and by micelle formation. It follows a partial degradation by a cascade of enzymes (hormone sensitive lipase, triglyceride-, diglyceride, monoglyceride-lipase) a further metabolism/catabolism in the liver, among others by - oxidation in the mitochondria (in citric acid cycle). The final products of degradation are C02, H2O and energy.

5.

NETWORK Study

Univ. Regensburg

Cell Damaging Effects of Na-DC propidium-jodid-stain ( DNA intercalator for the stain of necrotic cells) (Univ. Regensburg)

Control
4h
Scale bar: 20

1% Triton X
4h

Na-DC 0.01 mg/ml

Na-DC 0.05 mg/ml

Na-DC 0.1 mg/ml

4 4 Effect @ h 0.05 mg/ml,h Lipolysis 4 h 12,5g

NETWORK Study

Univ. Regensburg

Cell Viability after Treatment with Na-DC

120

MTT-Assay: = Thiazolyl blue tetrazolium bromid quantitative photometrical determination of cell number and metabolicactivity The amount of form is proportional to number of living cells
100 80 60

Cell viability [%]

40
20 0

Na-DC [mg/ml]

Viability decreases @ 0.5 mg/ml (Univ. Regensburg)

PC - DC Safety

Safety for patients and physicians

Do not use PC of inferior quality!

10 different PC raw materials (Soy, chicken eggs, synthetics) different qualities for injectable PC Only high quality Soy lecithine is successful in lipolysis PC is produced in different countries sometimes raw material quality is wrong sometimes the PC/DC ratio is wrong. some products contain only 30% of the necessary PC concentration. NETWORK led laboratory tests of most common PC products. Some contain a too high concentration of Lyso-PC Most products are not to be uses successfully for subcutaneous lipolysis.

NETWORK recommends only 2 commercial products: Lipobean (S.Korea), Essentiale N (Ukraine licensed from Germany).

Comparison Products

Lyso-PC
Toxic over a concentration of 9% High concentrations of Lyso-PC result from wrong production procedure NWL-1 content: < 3.0 % Lyso-PC Some products have Lyso-PC concentrations of of over 17%

PC - DC

Comparison

PC products by lab comparison

Product name Lipostabil PPC concentration (mg) 254 Lyso-PC concentration 5,71 %

NWL 1 Formula magistralis

Dermastabilon BCN Phosphatidylcholin Inno-Med Mesoline Toscani Phosphocol

259 228 Not Lipolysis suitable

76 77 78 82 110

1,51 % 4,84 % > 9% = toxic

9,21 % 12,26 % 8,92 % 9,70 % 8,18 %

PC/DC

Benefit/risk ratio

Benefit / Risk ratio

Significant increase of side-effects

High concentration DC

Less
PC
Significant decrease of effects

High concentration Lyso-PC

Patient selection

Criteria

Psychological components

The treatment successful or not?

Patient selection

Criteria

Different types of fat tissue

Excellent to treat: Soft fat = pudding fat You must see it with your fingertips! Less successfully to be treated: Firm, tough fat, it contains a lot of binding tissue

Patient selection

Criteria

Pearls
Most important: The pre selection of patients

Don't let yourself be persuaded by the demands of patients to do non-promising treatments. Patients often are very challenging! Pre-select carefully if suitable and do not promise too much Results of facial procedures often are very satisfying Sometimes the treatment of inner thighs is more important than the lateral parts of the thighs. Be aware that good results with saddlebags can only be achieved if they consist of soft and gentle fat. Very tight and substantial rubbery fat-tissue is stubborn and has a less good prognosis Treat obese persons only with respect to the fact that lipolysis can only be an additional help for their weight-problem. Cooperation with an plastic surgeon has proven to be very satisfying for both parties.

Patient selection

Criteria

Treatment combinations
Patient selection selection possibilities
Combination Lipolysis and Liposuction Lipolysis before Liposuction ca. 10 days Lipolysis after Liposuction corrections Combination Lipolysis and Diet Lipolysis during weight reduction

Patient information

NETWORK files

Patient information
1.
2. 3.

Patients must be informed very precisely

Patient information about therapy Anamnesis sheet: patients have to fill out the form accurately. Risk information: record the individual information by hand made signatures or grafics Precaution
1.

4.

2.

14 days befor treatment patient should stop using blood thinning medication Body treatment: patient should wear width clothes on day of treatmet 3. Woman: Do not treat during menses because of higher pain level.

5.

After care

Contra indication

Absolute
Minors or children Pregnant women; Nursing Mothers Diabetics with microangiopathy or patients with other perfusion
disturbances.

Certain autoimmune diseases

(Scleroderma, Pemphigus vulgaris, systemic lupus erythematosis, dermatomyositis Not contraindicated are: Rheumatic illnesses and thyroiditis Hashimoto

Severe liver diseases (cirrhosis, carcinoma)

Contra indication

Relative

Renal diseases
(short-chain fatty acids are eliminated via the kidneys)

Lipodystrophy Disturbances of blood coagulation Inflammatory connective tissue diseases

(Polymyositis, Dermatomyositis)

Acute infections and chronic infection risk

(Tuberculosis, HIV patients - clinical study: bull-necked HIV patient)

Severe allergy history

Side effects

1-7

Local irritations
days
Redness
Itching Swelling

Miscellaneous

Sensitivity to the touch - up to 3 weeks Nodules

(deep Haematomas sometimes appear as nodules not disappearing for longer period of time. Rather rare occure fibromas if injected too deep.

Up

to 2 weeks
Pain in the treated area
Haematoma (bruises)

Necessity of thorough Patient Information

Hyperpigmentation up to 3 month

Side effects

post injection

Hyperpigmentation after injections may occur

Hyperpigmentation occurs quite rarely and disappears commonly after three months. Laser treatment is contra identicated

Side effects Exceptions

Rare Reactions
Exceptions All facial treatments may be accompanied by obvious swelling and uncomfortable sensations (oedema and erythema); they may last for up to one week (cheeks; double chin; neck) Rare Reactions Infections which can appear after any injections (never seen) Slight cholinergic reactions Increased stool frequency or mild diarrhoea Circulatory problems for a short time after injections hypovolaemia, low BP (night time collapse) Intermenstrual menorrhoea (fatty tissue is a high oestrogen accumulator)

Side effects

After 24 hours

Jowels and double chin (neck)

Before 24 hours after injections after 8 weeks. Photos: Dr. Hasengschwandtner (A)
Pat.6711

Before

24 hours after first injections

After 8 weeks

Side effects Attention!!

Inject with special care

Lipolysis post Liposuction: the areas coult be altered fibrous with insufficient blood flow. Danger of necrosis on areas with less micro circulation.
Beware of injecting into tendons, ligaments and bursae f.e. around knee and tendo Achillis.

Decontaminate skin thoroughly before

Documentation

Lipolysis-Report 2010
How satisfied are your patients after the treatment?
90%

80%

70%

60%

50%

40%

30%

20%

10% 84% 0% satisfied less satisfied 16%

Experienced users reduce the rate of less satisfied patients from 16% at the beginning to less than 3%, even 0%.

Circumference measuring by tape

Documentation Measurements

Use always identical reference points (navel or floor example 3 cm below navel) Use NETWORK measuring tape to measure always with same pressure Measure after patient has exhaled 6cm over navel
6cm over navel
7cm below navel 7cm below navel

Documentation Measurements

Caliper - Skin fold measuring

Measure always identical skin folds

Documentation Measurements

Ultrasound Fat measurement

Each imaging ultrasound device can be used for fat measurements. Such measurements are very accurate when done properly

Documentation Photography

Information about making aesthetic photos

Photographic picture series in the aesthetic medicine are showing a change in a temporal interval. The change of the body contour The change of the skin structure

Treatment

Possibilities

lower belly
2 treatments, no weight loss reduction of lower belly of 9 cm,
Photos: Dr. Hasengschwandtner (A)
Pat. 5686

Before

After 2 treatments

Treatment

Possibilities

Cheeks, jowls, chin, neck

One treatment session NO WEIGHT LOSS Photos: Dr. Palmer (GB)
NETWORK Representative in UK

Before

After 1 treatment

Treatment

Possibilities

Example of skin retraction

after one session of lipolysis, injection of network-compound in jowels, chin, neck
Photos: Dr. Hasengschwandtner (A)

Before

After 1 treatment

Treatment

Possibilities

lower belly, 46 y.
2 treatments, from 101 to 93 cm (measured 5 cm below navel)
Photos: Dr. Hasengschwandtner (A)
Pat. 5975

Before

After 2 treatments

Treatment

Possibilities

Saddel bags 29 y.
One Treatment, -4 cm each side
Photos: Dr. Hasengschwandtner (A)

Before

6 weeks after 1 treatment

Treatment Intervals

NETWORK recommendation

Time distance between the treatments should be at least 8 weeks ( this is scientifically proven).

Multiple regions minimal 8 weeks

Treat multiple regions at the same time only within the 100ml dosage.

Treatment Intervals

Ultrasonography
Dr. W. Norek /A

first picture: immediately after injection second picture: 4 weeks later

Treatment Intervals

Ultrasonography
Dr. W. Norek / A

Six and eight weeks after first injection process is active over a period of 8-10 weeks!

Treatment Intervals

NETWORK experience
If the patient has a normal metabolism : The melting process starts from the first day on, first visible results are to be seen from the 10th day on. The main melting process takes place between between week 4 and 6 After 8 weeks the process is usually completed.

Treatment

Injection depth

NETWORK protocol
Body: 10 - 12 mm Face: 4 - 6 mm Melt the fat always from above downwards.
Injection depth10-12 mm

22,3mm

21,8mm

Treatment

A case study

Our estimation
Normally you can expect a reduction of ca. 3-4 cm after 1 treatment at a normal fatty belly!

Treatment expiry

Overview

Treatment course
1. 2. 3. 4. 5.

6.
7.

Patient information Photodocumentation Measuring and weight Mark treatment region Preparing the Compound Treatment After care (PSM)

Regions & Dosages

Regions

Face

Face
Regions

Successful

Injection-Lipolysis

double chin
Photos: Dr. Mark Palmer, GB
NETWORK representative vor UK members

Before therapy

After 1 treatment

Successful

Injection-Lipolysis

Double chin
One treatment
Photos: Dr. Kai Rezai (GER)

Before

After 1 treatment

Successful

Injection-Lipolysis

chin, flabby cheeks, neck, 60yrs

One treatment
Photos: Dr. Hasengschwandtner (A)
Pat. 6464

Before

After 1 treatment

Successful

Injection-Lipolysis

jowls and double chin, 42yrs

One treatment
Photos: Dr. Hasengschwandtner (A)
Pat. 5117

Before

After1 treatment

Successful

Injection-Lipolysis

axillary fold & upper arms

Photos: Dr. Sierra, Chile

Before

Final result

Injection-Lipolysis

axillary fold and triceps region, 38 yrs

Successful

One treatment
Photos: Dr. Hasengschwandtner (A) Pat. 5515

Before

After one treatment

Successful

Injection-Lipolysis

58yrs, Dorsal fat & skin laxity

Only one treatment on Feb. 19th
Photos: Dr. Hasengschwandtner

19. February
18. March

3. May
15. June

Successful

Injection-Lipolysis

Back-rolls, 34 yrs
One treatment
Photos: Dr. Hasengschwandtner (A)
Pat. 5086

Before

After one treatment

Successful

Injection-Lipolysis

Lovehandles, 24yrs
One treatment, 20 ml compound on each side, 89 cm to 85 cm
Photos: Dr. Hasengschwandtner (A)
Pat. 6218

Before

After one treatment

Successful

Injection-Lipolysis

Lovehandles, 34yrs
2 treatment sessions Photos: Dr. Sierra, Chile

Before

After 2 treatments

Successful

Injection-Lipolysis

belly & lovehandles

Photos: Dr. Holzmller (A)

Before

7 weeks after Treatment

Successful

Injection-Lipolysis

abdomen, 23yrs
Patient wanted to have a washboard belly, without doing exercises
Photos: Dr. Hasengschwandtner (A)
Pat. 5071

Before

9 weeks after 1st treatment

15 weeks after 2nd treatment

Successful

Injection-Lipolysis

abdomen, 51yrs
one treatment session, no weight loss
Photos: Dr. Hasengschwandtner (A)

Before

After one treatment

Successful

Injection-Lipolysis

abdomen
One treatment session, no weight loss
Photos: Dr. Hasengschwandtner (A)

Before

After one treatment

Successful

Injection-Lipolysis

28yrs, lower abdomen,

One Treatment, from 91 to 84 cm (3 cm below navel), weight loss -1 kg
Photos: Dr. Hasengschwandtner
Pat. 5529

Before

After one treatment

Injection-Lipolysis

Upper and lower abdomen, 51yrs

Successful

one treatment, upper reduced from 83 to 76 cm, lower from 93 to 88 cm, iliac crest 1 shot; -0.5 kg, control picture after one year right hand side.
Photos: Dr. Hasengschwandtner (A)
Pat. 5845

Successful

Injection-Lipolysis

Lower abdomen
Photos: Dr Mark Palmer, UK
NETWORK representative for UK members

Before

After one treatment

Successful

Injection-Lipolysis

abdomen
two treatments, weight loss kg reduction of lower belly from 101 to 92 cm
Photos: Dr. Hasengschwandtner (A)
Pat. 5190

Before

After one treatment

Successful

Injection-Lipolysis

inner thighs, gluteal fold, 34yrs

two sessions, no weight loss
Photos: Dr. Hasengschwandtner (A)
Pat. 5546

Before

After 2 treatments

Successful

Injection-Lipolysis

gluteal-banana, cellulite, 52yrs

one treatment, right side
Photos: Dr. Hasengschwandtner (A)
Pat.5968

Before

After one treatment

Successful

Injection-Lipolysis

Inner thighs
2 treatments, Photos: Mark Palmer MD, UK

Before Skin contact on inner thighs

After 1st treatment

After 2nd treatment Still a small gap on inner thighs when knees are in contact

Successful

Injection-Lipolysis

36yrs, Iliac Crest

One Treatment, -9 cm
Photos: Dr. Hasengschwandtner
Pat. 6106

Before

After one treatment

Successful

Injection-Lipolysis

Saddle bags
Five treatments, -14 cm each, -5kg Dr. Thierry Marechal (Paris, F)
NETWORK representative for French members

Before

After 5 treatments

Successful

Cellulite-Treatment

Cellulite-Therapy
Photos: Prof. Nour El-Din, Egypt
NETWORK representative for Egypt members

Successful

Cellulite-Treatment

Cellulite-Therapy
Photos: Prof. Nour El-Din, Egypt
NETWORK representative for Egypt members

Successful

Injection-Lipolysis

Male breast
2 treatments third injection only on right side planned
Photos: Dr. Hasengschwandtner (A)
Pat. 5329

Before

After 2nd treatment

Successful

Injection-Lipolysis

unilateral lipomasty, 31yrs

Young man, examination of all blood values as recommended, eventually mammography, one session,
Photos: Dr. Hasengschwandtner (A)
Pat 4803

Before

After 1st treatment

Successful

Injection-Lipolysis

Lipomastia, 56yrs
one treatment, 15 ml each side
Photos: Dr. Hasengschwandtner (A)
Pat. 5010

Before

9 weeks afster 1st treatment

Successful

Injection-Lipolysis

68yrs, Lipoma
Two sessions, 10ml pure PCDC each
Photos: Dr. Hasengschwandtner
Pat. 4920

before

2 weeks after 1st treatment

11 weeks after 2nd treatment

23 weeks after 1st treatment

Medical indication

Lipoma

two treatments, Photos: Dr. Hasengschwandtner (A)

Pat. 5783

Lipoma, 47yrs

Med. Indikation

Lipoma

Madelungs deformity
Photos: Dr. Hasengschwandtner (A)

one treatment, buffalo hump,

Pat. 6024

Supporting

Combi therapies

After the swelling is gone (after 3. day)

Lymphatic drainage
Endermology treatment

Combi therapies

during & after

During and after the treatment

After Thermage Filler Botulinumtoxin A

During Radio frequency Mesotherapy Ultrasound

Combi therapies

Injection-Lipolysis

40yrs, cheeks, jowls, chin After 2 Lipolysis sessions on cheek, nasolabial fold, jowls, chin, 1 session with Botox glabella, lateral eyelid, Restylane on lips, 1 session Mesolift in face and neck with hyaluronic acid. Photos: Dr.
Hasengschwandtner (A)

Successful

Injection-Lipolysis

44yrs, 1 lipolysis on jowls and nasolabial fold, filler in cheeks and malar
region

(In jowls 3 shots each side with 0.5ml compound, in nasolabial fold only 2 shots of 0.2ml each side, 1ml Hyacorp on each side in malar region and 1ml each side in cheeks, Azzalure in front.)
Photos: Dr. Hasengschwandtner (A)

Before

After finishing the combinationtreatment

After care

PSM-Management

The NETWORK PSM During the treatment Pain &anaesthesis for special cases Side effect Management Local
Direct after the Treatment

Ultrasound after treatment AfterCare Gel AfterCare Gel Degozym (Bromelain & Papain combination)

Up to 7 or 14 days after the treatment

Up to 10 days after the treatment

After care

PSM-Management

Local anaesthetics

Pain & side effect management

In certain cases, f.i. if you treat painful areas likes jowls, triceps region or very small fat pads, you can add 1ml of Xylocain or Lidocain (2% - without vasoconstrictor) to the compound.

1ml anaesthetic mixed in the syringe with 10ml PC/compound solution brings

After care

Patient-Information

References for patients

Patient should wear extent clothes for body treatments After treatment: 30 min. relaxing in the practice During 1st day Drink a lot of water! Avoid sun or solarium during first week to avoid hyperpigmentation Use sunblocker durig 1st month if you have sun exposition

Actual discussion

Studies

Studies pro and contra

Pro Uni Regensburg 1

(09) (09)

Prof. Gpferich, Dr. Blunk, Silvan Klein, Prof. Dr. Prantl

Uni Regensburg 2 Uni Bochum

(06-09)

Neutral Dr. Schuller-Petrovich (A)

Prof. Dr. Prantl

5 Publicationen

Dr. Hoffmann, Dr. Bechara

Contra Pig Poster Brasil

(05)

US Study of ASAPS(10)

Only 1x shown on a congress (Brasilia)

Leroy Young, MD, American Society of Aesthetic & Plastic Surgery, FDA agreed, with NETWORK Compound

Dr. Kopera (A)

(08)

Actual discussion

NETWORK

Injection-Lipolysis in 2009
ISAPS survey in 2009 with plastic surgeons (30,817) in 25 Top-countries:

17,1 Mio aesthetic treatment 8,5 Mio invasive treatment 8,6 Mio non-invasive treatment 2,8 Mio Botulinum treatment 1,6 Mio Liposuction 65.486 Lipolysis treatment

USA reports 12,448 Lipolysis treatments by plastic surgoens. Place 1.

German plastic surgeons reports 6,516 Lipolysis treatments gemeldeten NETWORK member reports additional more than 100,000 Lipolysis treatments by dermatologist and general practioners in 2009.

Actual discussion

NETWORK

the worlds largest Lipolysis Community

Discuss your ideas and results with experts and members inside of NETWORK Lipolysis. Together we will develope the lipolysis therapy continuously:

NETWORK LIPOLYSIS -

on member congresses (MASTER-Conference) on Aesthetic-Holidays inside the member chat room by hotline to Dr. Franz Hasengschwandtner
Medical and Scientific Director of NETWORK-Lipolysis

Workshop

Many thanks

The Vision

Many thanks for your attention!

Thank You