1. Mesotherapy Workshop Alta A. Smit, MD

2. Dr. Alta Smit_Mesotherapy_Speakers' Training 2006 Mesotherapy pharmacology Pharmacokinetics Route of administration Intradermal Intradermal Time of absorption Very slow Very slow Up to 7 days Up to 7 days

3. Mesotherapy Materials and methods

4. Dr. Alta Smit_Mesotherapy_Speakers' Training 2006 Mesotherapy: Materials and methods Manual technique 1, 3, 5 and 10 cc measured ring syringe 1, 3, 5 and 10 cc measured ring syringe Needles: 27 or 30 gauge, ½ inch Needles: 27 or 30 gauge, ½ inch Advantages AdvantagesPractical Works in difficult areas Lebel needles Disadvantages More costly Imprecise dose Painful

5. Dr. Alta Smit_Mesotherapy_Speakers' Training 2006 Mesotherapy: Materials and methods Assisted technique French Pistor Gun French Pistor Gun Needles: 27 or 30 gauge, ½ inch Needles: 27 or 30 gauge, ½ inch Advantages: Advantages:Adjustable Precise dose Disadvantages DisadvantagesPainful

6. Dr. Alta Smit_Mesotherapy_Speakers' Training 2006 Mesotherapy: Materials and methods Quantity 0.3-0.5 cc per injection 0.3-0.5 cc per injectionDistance Every 2 cm Every 2 cm Acupuncture points Acupuncture pointsFrequency 1 to 2 times a week for 10 weeks 1 to 2 times a week for 10 weeksMaintenance Monthly Additional therapies Massages Manual lymph drainage

7. Dr. Alta Smit_Mesotherapy_Speakers' Training 2006 Anti-aging mesotherapy Lebel needle 30 gauge, 4 mm 30 gauge, 4 mm Perpendicular to skin Perpendicular to skin Intradermal Intradermal

8. Dr. Alta Smit_Mesotherapy_Speakers' Training 2006 Anti-aging mesotherapy Needles: 27 or 30 gauge, ½ inch Incorrect injection for skin Perpendicular to skin Goes to sub- cutaneous cellular tissue (hypodermis)

9. Dr. Alta Smit_Mesotherapy_Speakers' Training 2006 Anti-aging mesotherapy Needles: 27 or 30 gauge, ½ inch Correct injection 45-degree angle Intradermal

10. Mesotherapy Facial Refresh

11. Dr. Alta Smit_Mesotherapy_Speakers' Training 2006 Anti-aging mesotherapy Glavella Insulin syringe Insulin syringe Four units per point Four units per point Placenta compositum Cerebrum compositum

12. Dr. Alta Smit_Mesotherapy_Speakers' Training 2006 Anti-aging mesotherapy Front lines Insulin syringe Insulin syringe Three units per point Three units per point Cerebrum compositum

13. Dr. Alta Smit_Mesotherapy_Speakers' Training 2006 Anti-aging mesotherapy Crows feet Insulin syringe Insulin syringe Three units per point Three units per point Placenta compositum Cerebrum compositum

14. Dr. Alta Smit_Mesotherapy_Speakers' Training 2006 Anti-aging mesotherapy Eyebrows Insulin syringe Insulin syringe Two units per point Two units per point Placenta compositum Cerebrum compositum

15. Dr. Alta Smit_Mesotherapy_Speakers' Training 2006 Anti-aging mesotherapy Lower eyelids Insulin syringe Insulin syringe Two units per point Two units per point Placenta compositum

16. Dr. Alta Smit_Mesotherapy_Speakers' Training 2006 Anti-aging mesotherapy Upper nose Insulin syringe Insulin syringe Three units per point Three units per point Placenta compositum

17. Dr. Alta Smit_Mesotherapy_Speakers' Training 2006 Anti-aging mesotherapy Perioral Insulin syringe Insulin syringe Two units per point Two units per point Placenta compositum Cerebrum compositum

18. Dr. Alta Smit_Mesotherapy_Speakers' Training 2006 Anti-aging mesotherapy Lower jaw Insulin syringe Insulin syringe Three units per point Three units per point Placenta compositum

19. Dr. Alta Smit_Mesotherapy_Speakers' Training 2006 Anti-aging mesotherapy Neck Insulin syringe Insulin syringe Two units per point Two units per point Placenta compositum

20. Dr. Alta Smit_Mesotherapy_Speakers' Training 2006 Mesotherapy: Materials and methods Cranial application Hair loss Hair lossSelenium-Homaccord Alopecia Alopecia Cutis compositum Dandruff DandruffGraphites-Homaccord

21. Dr. Alta Smit_Mesotherapy_Speakers' Training 2006 Mesotherapy: Materials and methods Abdominal application Overweight Overweight Hepar compositum Thyreoidea compositum

22. Dr. Alta Smit_Mesotherapy_Speakers' Training 2006 Weight control program Obesity Treatment Strumeel drops Thyreoidea compositum Chakra point Hepar compositum ST 36 Lymphomyosot SP 6

23. Dr. Alta Smit_Mesotherapy_Speakers' Training 2006 Weight control program Endocrine classification Hypophysis Apple shaped Thick trunk Thin extremities Treatment Placenta compositum Glavella ST 23, 25, 27

24. Dr. Alta Smit_Mesotherapy_Speakers' Training 2006 Weight control program Endocrine classification Pancreas Pear shaped Increased abdominal fat Treatment Syzygium compositum drops Hepar compositum Solar plexus LIV 13 ST 25, 36

25. Dr. Alta Smit_Mesotherapy_Speakers' Training 2006 Weight control program Endocrine classification Ovaries/testicles Lower extremity fat Treatment Ovarium compositum ST 29 SP 6

26. Dr. Alta Smit_Mesotherapy_Speakers' Training 2006 Mesotherapy physiopathology Lymphodystrophy Interstitial edema Water retention Venous stasis Lymphatic stasis

27. Dr. Alta Smit_Mesotherapy_Speakers' Training 2006 Mesotherapy physiopathology Lipodystrophy Grade I Lymph edematous state “Orange peel” look Breakdown of connective fibers Reduction of cutaneous elasticity

28. Dr. Alta Smit_Mesotherapy_Speakers' Training 2006 Mesotherapy physiopathology Lipodystrophy Grade II Micronodular state Superficial skin retractions Look of “rice granules” Production of non-elastic fibrous elements

29. Dr. Alta Smit_Mesotherapy_Speakers' Training 2006 Mesotherapy physiopathology Lipodystrophy Grade III Grade III Macronodular state Macronodular state Deep retractions of “hollow” skin Deep retractions of “hollow” skin Proliferative phase Proliferative phase Collagenic degeneration Lobular partitions

30. Dr. Alta Smit_Mesotherapy_Speakers' Training 2006 Mesotherapy physiopathology Lipodystrophy Grade IV Grade IV Macronodular state Macronodular state Deep skin retraction Deep skin retraction Flaccidity Flaccidity Fibrous phase Fibrous phase Adhesion of connective fibers Cellular and vascular compression

31. Dr. Alta Smit_Mesotherapy_Speakers' Training 2006 Mesotherapy: Materials and methods Gluteal application Fat burner Fat burner Thyreoidea compositum Firming Firming Placenta compositum

32. Treatment of indurated (hard) cellulite Vascular system Aesculus-Injeel 1 ampoule (1.1 ml) alternating with Hamamelis-Injeel ampoules (1.1 ml) One week Aesculus, 1 week Hamamelis Hamamelis-Homaccord 1 ampoule (1.1 ml) Vipera berus-Injeel 1 ampoule (1.1 ml) Drainage of the connective tissue +Lymphomyosot 1 ampoule (1.1 ml) + Coenzyme compositum 1 ampoule (2.2 ml) +Thuja-Injeel 1 ampoule (1.1 ml) Ubichinon compositum 1 ampoule (2.2 ml) Berberis-Homaccord 1 ampoule (1.1 ml) Hormonal system +Hormeel 1 ampoule (1.1 ml) Ovarium compositum 1 ampoule (1.1 ml) Hypophysis suis-Injeel 1 ampoule (1.1 ml) Lipolysis + Fucus vesiculosus-Injeel 1 ampoule (1.1 ml) +Graphites-Injeel Adeps suillus-Injeel 1 ampoule (1.1 ml) Graphites-Homaccord Grippe Nosode-Injeel 1 ampoule (1.1 ml) Total 9.9 ml Primary medication Secondary medication

33. Treatment of soft cellulite Vascular system Aesculus-Injeel 1 ampoule (1.1 ml) + Placenta compositum 1 ampoule (2.2 ml ) Hamamelis-Homaccord 1 ampoule (1.1ml) Vipera berus-Injeel 1 ampoule (1.1 ml) Drainage of the connective tissue +Lymphomyosot 1 ampoule (1.1 ml) + Ubichinon compositum 1 ampoule (1.1 ml) +Thuja-Injeel Berberis-Homaccord Hormonal system +Hormeel 1 ampoule (1.1 ml) Ovarium compositum 1 ampoule (2.2 ml) Lipolysis +Graphites-Injeel 1 ampoule (1.1 ml) Fucus vesiculosus-Injeel 1 ampoule (1.1 ml) Firming effect + Cutis suis-Injeel 1 ampoule (1.1 ml) Funiculus umbilicalis suis-Injeel 1 ampoule (1.1ml) Embryo totalis suis-Injeel 1 ampoule (1.1 ml) Primary medication Secondary medication

34. Dr. Alta Smit_Mesotherapy_Speakers' Training 2006 Mesotherapy: Materials and methods Legs application Lymphodistrophy LymphodistrophyLymphomyosot Lipodystrophy Lipodystrophy Thyreoidea compositum Melilotus-Homaccord Venous congestion Venous congestionHamamelis-Homaccord Firming Firming Placenta compositum

35. Dr. Alta Smit_Mesotherapy_Speakers' Training 2006 Mesotherapy complications AllergiesItchingRashEcchymosisHematomasInfectionIntoxication Vagal reaction Skin atrophy NecrosisHyperpigmentationHypopigmentationErythema

36. Dr. Alta Smit_Mesotherapy_Speakers' Training 2006 Mesotherapy Contraindications: Allergy to medications Allergy to medications Dermal lesions Dermal lesions Debilitated patients Debilitated patients Patients with cardiopathy, hepatopathy or nephropathy Patients with cardiopathy, hepatopathy or nephropathy Pregnant or lactating women Pregnant or lactating womenWarnings: Avoid combinations if unsure of the effects Avoid overdose. More is not better Avoid self-medication

37. Dr. Alta Smit_Mesotherapy_Speakers' Training 2006 Mesotherapy recommendations Massage therapy is practiced before each session Rest for ten minutes following the session Drink copious liquid Stop treatment in case of any undesirable reaction

38. Dr. Alta Smit_Mesotherapy_Speakers' Training 2006 Mesotherapy recommendations Anti-aging weight control Healthy nutrition Regular physical activities Full relaxation Good mental and emotional attitude Create favorable ambience