A therapy that promises to melt fat away with the help of a syringe has not yet been proven a safe and effective alternative to Liposuction, according to a new report.

The report, by a committee of the American Society of Plastic Surgeons (ASPS), points to a lack of research data and standardized techniques for the treatment, known as mesotherapy.

Mesotherapy, its proponents say, breaks down pockets of fat that dwell anywhere from the jawline to the waistline to the hips. It involves a series of injections into the problem area, with the ingredients of those injections varying from case to case.

A mixture of various drugs, plant extracts and other substances may be used. One of the most common ingredients is phosphatidylcholine, or lecithin - a waxy substance found in the cells of plants and animals. Lecithin is added to food and other products as an emulsifier, which means it helps mix fats with liquid. The product may act similarly when used in mesotherapy, emulsifying body fat and allowing natural enzymes to break it down.

But whether and how mesotherapy works is still unclear, according to the ASPS report. Other important questions, including the possible effects of the procedure on the liver and other organs, remain unanswered, the authors report in the journal Plastic and Reconstructive Surgery.

Mesotherapy also carries a hefty price tag, with charges as high as $1,500 per treated area and practitioners generally recommend three to six rounds of injections over time.

That is not to say, however, that mesotherapy is quackery. Research into the purportedly fat-melting procedure is underway, and it could yet turn out to have a place alongside liposuction in the “body contouring” repertoire, according to Dr. Alan Matarasso, an associate clinical professor of plastic surgery at Albert Einstein College of Medicine in New York, who is a coauthor of the report.

“I would cautiously keep an open mind,” he told Reuters Health, “but I would like to see more data.”

In their report, Matarasso and his colleagues point to a couple small studies that have found mesotherapy effective at trimming some fat and cellulite from a majority of patients in the short term. But the data are sparse, they add, and it’s unclear whether the therapy has lasting benefits.

The procedure is called mesotherapy because injections are made into the mesoderm, the layer of fat and connective tissue under the skin. The method was developed by a French physician in the 1950s for the treatment of disorders of the blood vessels and lymphatic system.

More recently, it has become a popular non-surgical alternative to liposuction in Europe and South America. Advocates tout mesotherapy as far safer than the surgery, which, like all invasive procedures, carries some serious risks-including infection, blood clotting and, rarely, death.

But according to Matarasso and his colleagues, it’s too soon to consider mesotherapy a safe and effective alternative to liposuction, for which there is a good deal of supporting evidence of effectiveness.

A major gap with mesotherapy, Matarasso said, is the lack of standardization in the formulations and dosages used, and of guidelines stating, for instance, which patients are good candidates.

Mesotherapy practitioners are free to put a range of medications, extracts and other substances into the syringes. Besides lecithin, other substances promoted for use in mesotherapy include the asthma drug isoproterenol. The rationale for that choice seems to be the fact that the drug can stimulate certain receptors that dwell on the surface of fat cells and encourage the cells to break down.

In the U.S., the individual components used in mesotherapy must be approved by the Food and Drug Administration (FDA), but their use in the context of mesotherapy has not been shown safe and effective. And the FDA has never approved a drug specifically for the body-contouring procedure.

It’s also unclear, Matarasso noted, where the body fat ends up after it’s purportedly melted by mesotherapy; it could, for instance, get deposited in the liver.

As it stands, Matarasso said, he would tell patients to hold off on mesotherapy until more research evidence becomes available, which, he noted, should be fairly soon.

“The jury is still out,” he said. “But the good news is, the jury is deliberating.”

SOURCE: Plastic and Reconstructive Surgery, April 15, 2005.