(CBS)  A recent trip to the Carribean convinced 30-year-old Misty Koons that she needed to slim down her waistline.
"I was in my two-piece and every time I'd sit down, there was a bulge that was hanging over the bottom of my bikini," says Koons. "It bothered me. I kept looking at it and became obsessed with it."
That obsession led her to New York dermatologist Dr. Soren White. He suggested Koons try Lipostabil, an injectionable form of the nutritional supplement Lecithin. The substance is widely used in Europe and South America where doctors say it may literally melt fat away.
Dr. Mallika Marshall from WBZ-TV in Boston gave The Saturday Early Show the skinny on the new technique, which might one day replace the more invasive liposuction treatment. Liposuction is the most common type of cosmetic surgery performed on women and it's number two for men.
"Most of my colleagues — primarily in South America and Europe — find or believe that it accelerates lypolysis, which is the breakdown of fat," says Dr. White.
Most women in Koons's position would have turned to liposuction. While it's an invasive surgery, doctors say tremendous advances in the past decade have made it much safer and more effective. Unlike Lipostabil there is the ability to contour or shape the area where fat is being removed.
But with Lipostabil, the situation is quite different. "You are injecting a substance and it's going to go where it wants. You may be breaking up areas unevenly and then what do you do?" says dermatologist Dr. Howard Sobel.
Despite it's unproven track record in the United States, Koons insists Lipostabil worked for her.
Dr. Marshall explains on The Saturday Early Show that doctors typically recommend between three and five sessions. Those sessions can run anywhere from $1,000 to $1,500, depending on the part of your body that gets the injections. The stomach is more expensive than the arms. She says that really begins to add up and can in fact end up being more expensive than liposuction. But the idea of liposuction scares some people, which is why they may choose the Lipostabil option.
Lipostabil does not have approval from the Food And Drug Administration. It is made up of the nutritional supplement Lecithin, which traditionally doesn't fall under the FDA's jurisdiction. Dr. Marshall says it will take new studies with proper supervision to see whether the results of the Lipostabil injections are effective and safe.

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Fat-dissolving injections offer a scalpel-free alternative
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Hachette Filipacchi Media U.S., Inc.

For those who prefer to fine-tune their figure in a doctor’s office rather than at the gym, new fat-dissolving injections offer a scalpel-free alternative. But are they safe? Aida Leisenring investigates whether these methods are worth a shot

What’s injected, is illicit, and can cause bruising and weight loss? Unlike the infamous narcotic that first comes to mind, mesotherapy solution and Lipostabil won’t land you in jail. While these two fat-targeting injectables are unapproved by the FDA, their use has become a hotly debated topic among doctors seeking a nonsurgical alternative to liposuction. Rampant success stories—one waistless ballerina claims she developed curves in 24 hours; models have been getting “fixed” before swimsuit shoots—are turning ordinary people into junkies. Both techniques originated in Europe and work the same way: Doctors inject “fat dissolving” blends into the subcutaneous layer of skin, which over a series of sessions allegedly cause fat cells to shrink. The difference between mesotherapy and Lipostabil is largely what doctors put in that 4mm syringe.

Inside Information
Mesotherapists create a cocktail of up to seven ingredients tailored to each patient’s goal (cellulite reduction, weight loss, or body sculpting). Components usually include lidocaine, an anesthetic; various vitamins that are said to help to tone;  and isoproterenol, a beta blocker that supposedly inhibits the fat-building receptors of cells. All are FDA-approved for other uses, but none is approved for use as a fat-reducing injection. Lipostabil—also known as lipo-dissolve—contains soy lecithin (the same antioxidant found in much lower dosages in multivitamins), which is used in Germany and Italy to treat clogged arteries via injection. Unlike mesotherapy’s ingredients, injectable soy lecithin is not approved for any use in the U.S., so doctors get their stash overseas.

The Promise
“I have a patient who lost 13 inches from her waist in 20 sessions,” says osteopathic physician Lionel Bissoon, a mesotherapist who practices in L.A., New York City, and Palm Beach. There are enough similar anecdotes to keep the roughly 20 U.S. mesotherapy doctors—only physicians can perform mesotherapy—double booked (New Jersey­based osteopathic physician Marion Shapiro treats 150 clients a week). The treatment isn’t painless, though: To ensure that weight loss is evenly distributed, mesotherapists administer multiple injections, one inch apart. The overweight may require thousands of shots over as many as 30 weekly treatments, but Shapiro reports that 20 percent of her patients find that their pants are looser after one visit of roughly 70 shots. “In general, patients drop one size after four sessions,” she says. But some doctors believe it’s mesotherapy’s requisite diet and exercise plan that makes the difference. “If you refuse to diet and exercise, I won’t treat you,” Bissoon says.

While mesotherapy has been touted as an option for treating obesity and sculpting the body, Lipostabil targets only small amounts of fat, like patches of cellulite, love handles, and fat under the eyes and chin. Manhattan-based plastic surgeon Thomas Loeb, MD, who has been administering Lipostabil shots for one year, says he smooths cellulite lumps with extreme caution: “I use a diluted formula because I still don’t know the nature of lecithin. What if it shrinks other types of cells?” New York City dermatologist Howard Sobel, MD, won’t administer Lipostabil: “What if you get Lipostabil in your thigh, then you stand up and it gravitates downward, affecting other fat cells and creating an indentation?”

Dangerous Cuves
Considering that mesotherapy has been around for more than 50 years and Lipostabil for nearly five, there’s a surprising lack of data backing either: No independent, controlled studies or published, peer-reviewed articles exist in the U.S. to prove their effectiveness (mesotherapy research has been published in France). Even Loeb, who uses Lipostabil, admits, “Liposuction is by far a better method for very obess patients.”

Lose Those Love Handles

A CBS HealthWatch Special Report
Nov 25, 2002 10:38 pm US/Eastern
NEW YORK (CBS) I don't think any exercise will get rid of these love handles,” says 30-year-old Misty Koons.
But would she be willing to jab the flab?
“I want a quick fix,” replies Misty.
So Koons, a consultant from New Jersey, who says she isn't comfortable with the way she looks chose the latest way to a svelte waistline. CBS 2’s Dr. Mike Rosen has the story.
It's called lipostabil, no, it's not liposuction. It's a cosmetic technique just being introduced in this country, that's been popular in Europe and South America for years.
Lipostabil claims to break down fat deposits with 5-10 injections over 2-3 weeks. But what's in those needles?
“It's basically a molecule that emulsifies fat, it's in everbody's body, it's a natural substance,” says Dr. Soren White.
New York dermatologist Soren White has treated 40 men and women in the last 6 months with lipostabil, “It works on fat deposits resistant to diet or exercise - love handles, abdomen, knees, chins, under the eyes. It's a great thing, works well, easy to do and there are no side effects.”
The cost of each procedure can run anywhere from $350 to $1,000 depending on which part of the body you treat.
“It was easy, painless, pinched in a few places,” adds Misty.
“It's not dramatic on the outside, but for her the way she feels in her clothes will be different,” adds Dr. White.
Just two weeks later, after some minor bruising and swelling, Misty sees results, “As you can see, I can't pinch anymore. I feel like vast improvement.”
But Park Avenue plastic surgeon, Alan Matarasso warns that lipostabil is not FDA approved and still needs to be evaluated.
“We need to know the proper dosage, side effects, how many treatments. No one can tell us now how much drug to use or the long term consequences,” says Dr. Matarasso.
"There was a study published from a dermatologist in Brazil on bulges under the eyes and there were impressive results, no recurrences and no surgery,” responds White.
But Dr. Matarasso contends that liposuction is still the safest, most effective treatment for the permanent reduction of fat, although it may not be for everyone.
“I am more comfortable with lipostabil than with having anesthesia and surgery,” says Michelyn Camen, a 40 something marketing executive who wants lipostabil to melt away her "bra bulges."
“I trained to get rid of this area, and it's resistant, so when I heard about this, I made the call,” says Michelyn.
Meanwhile, Misty is back for treatment number two, “I love it, I worked out, everything is fine. I would rave about it to everyone.”

Interested in contacting Dr. Soren White? Here's how:

Skin Klinic
800 B 5th Avenue
New York, NY 10021
Tel: 212-521-3100
Fax: 212-521-3190
E-mail: info@skinklinic.com
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What Is Mesotherapy?

Story Highlights
A growing number of people are deciding to have doctors inject them with a cocktail of drugs, vitamins and supplements in hopes of reshaping their bodies.
It's a procedure called mesotherapy, and it involves undergoing hundreds of injections, once a week, for several weeks. The drugs are injected into the mesodermal — or middle — layer of the skin.
The technique was pioneered in France by Dr. Michel Pistor, and has been performed there since 1952. But it's just begun to attract practitioners and clients in the United States in the past few years.
Dr. Lionel Bissoon, who learned the technique in France five years ago, has become America's leading expert and advocate of mesotherapy.
Bissoon says mesotherapy — over the course of 10 sessions — blocks our ability to store fat and stimulates our ability to burn it up. He says a physician can target specific areas of fat by injecting a blend of medications commonly used for asthma and high blood pressure along with vitamins and supplements directly into a specific area of the body.
A single session can cost as much as $500, so a full course of treatment is a substantial investment. But it seems to be catching on. Bissoon, who has practices in New York, Florida and California, says his clients range from celebrities and CEOs to secretaries.
Bissoon claims the fat winds up in the muscle, where it's used for energy. It does sound too good to be true, especially since Bissoon says he refuses to take patients who won't exercise or follow a healthy diet.
But his patients seem to be happy with the results. Bissoon's most famous client is Roberta Flack. The superstar crooner had a long battle with weight and thought that her extra pounds were indeed killing her softly.
"When you're young and you're overweight, it's just there. After you pass a certain point in your life, well, gravity takes over. And you have a fat stomach that has rolls on top of rolls on top of rolls. And you can't breathe with that," Flack said.
Since starting mesotherapy last year — along with exercise and changing her diet — Flack has lost more than 40 pounds.
Two Patients’ Progress
20/20 followed two of Bissoon's patients for weeks to see how mesotherapy worked for them.
One patient, Josselyne Herman-Saccio, is a 35-year-old mother of two who has a full-time job. She looks fit now, but, she says she used to look much better before she had kids. Now, she says, she can't find time to work out. To see the effect of the mesotherapy alone, 20/20 asked Herman-Saccio not to exercise or change her diet.
The other patient 20/20 followed is Katie Noonan-Ewald, a 32-year-old business executive. Noonan-Ewald says she exercises regularly, but had hit a plateau and was unable to get the results she wanted. Every week she flies from her home in Detroit to New York, where she gets her mesotherapy injections.
After six weeks, we checked in with Herman-Saccio — who changed neither her eating nor her exercise habits. She was very happy with the results.
"I've lost over four and a half inches in my waist," she said, "three or four inches in my hips … I'm wearing clothes that I haven't worn in four years."
Noonan-Ewald's results were even more dramatic. We visited her after she had undergone 12 weeks of mesotherapy. She had lost 14 inches from her waist, and another 12 inches from her hips, legs, and saddlebag area, according to Bissoon's records.

Is It Safe?
While Bissoon's patients are thrilled with the results of their therapy, some physicians have voiced some serious concerns about the procedure.
Dr. Lisa Donofrio, a dermatologist who teaches at Yale University and practices cosmetic surgery with a specialty in liposuction, has been monitoring reports about mesotherapy and says she worries about its possible long-term effects.
"The problem with mesotherapy," she said, "is that it's a cocktail. The ingredients change on a whim all the time."
While Bissoon says all of the drugs he injects have been approved by the Food and Drug Administration, 20/20 discovered one that hasn't been.
In fact, that ingredient, phosphatidylcholine, is usually consumed as a dietary supplement, has just been banned by Brazil's equivalent of the FDA for cosmetic purposes in injectable form. That agency lists the known risks of phosphatidylcholine as including nausea, diarrhea, depression and arrhythmias.
Even the FDA-approved drugs that Bissoon uses haven't been approved for these sorts of cocktail injections. But Bissoon doesn't seem troubled by this. "The biggest complication I see with mesotherapy," he said, "is black and blue marks."
However, Donofrio says she's aware of reports of toxic reactions "where pieces of skin will die and slough off." A report from Belgium, for example, cited several examples of serious skin infections.
Bissoon said that those infections happened because the doctors were sloppy. "We use gloves, we use sterile needles. … Using the proper technique you should not really have that worry," he said.
20/20's investigation found no reports of bad infections in American patients.

Where Does the Fat Go?
The drug cocktail actually does seem to break down fat, as Bissoon claims.
Professor Susan Fried, an obesity expert at the Baltimore VA Medical Center, tested Bissoon's concoction on human fat cells. "The rate of fat breakdown actually increased about two to three times," Fried said.
However, Fried cautions that the fat being released may go places you don't want it to. "The question is, what happens to those fatty acids? Could they end up in another tissue? Could they end up in your artery? That's a real concern."
Bissoon said the fat should go into your bloodstream because that's how stuff is going to get excreted. "But as far as getting a large component of fat in the blood vessels," Bissoon said, "I don't think that's possible to happen because it's a very slow process."
Several other medical experts 20/20 consulted said they were skeptical about mesotherapy's claims, or they hadn't heard of it. They expressed concern about the minimal research behind the therapy.
Fried was concerned about the release of the fatty acids. She said if they are released from the fat cells, they're going to go to other tissues.
"Those tissues could possibly use them to deposit fat within them where they could cause damage to the tissues, and increase our risk of diabetes and cardiovascular disease," she said. "Just because the fat is released does not mean that it's burned. If that fat is moved from the thigh to your heart or to your liver, it can actually cause diabetes."
But Flack says she's not worried. "I do other things to protect myself," the singer said. "I see a nutritionist weekly, and I have myself checked all the time."
Still, Donofrio says she's concerned. "I think that people need to be cautious. This is their body. You get one."
But Bissoon is confident that the therapy is effective and safe. And so, this latest way to zap fat looks likely to continue. And that thrills Bissoon's patient Noonan-Ewald, who says she plans to keep up the mesotherapy and keep melting away her unwanted fat.
Lipostabil is the ® trademark of Nattermann & Cie [GmbH] and Aventis Pharma.

Injections Dissolve Fat Away
October 9, 2003, Las Vegas
Beth Fisher reporting

We're all looking for a miracle to get rid of fat. We try diets. We MIGHT exercise. And in desperate cases, we try lipo-suction. Now a Las Vegas doctor says he has a better solution: lipo-dissolve. Instead of going under the knife, you go under the needle. And he says tiny injections help the fat fade away.
Crystle hates the way one side of her back seems fatter than the other does. "On my left side, there is no fat sagging. On my right side, there is fat sagging. So I need to target one specific area. What better way than to inject it in that specific area?"
After numbing the area with gel, and marking the injection sites, Dr. Ed Hoffman begins a series of shots he says will dissolve a stubborn section of fat.
Dr. Ed Hoffman says he decided to try Lipo-dissolve on himself before giving it to patients. He is a triathalete who eats a healthy diet. But even exercise wouldn't get ride of his love handles. So Dr. Hoffman has been injecting the lipo-dissolve into one side of his body, leaving the other side for a comparison. After a few weeks, he says the difference between the two sides of his body was remarkable.
Dr. Hoffman says, "This is more for specific areas that just don't seem to go away with exercise and diet. For the whole body you need exercise and diet. But for one area like this? Lipo-Dissolve."
Lipo-Dissolve can be used for love handles, hips, thighs, or even smaller areas like under the chin or eyes. He says patients should expect a little bruising or swelling, but the procedure takes just a few minutes and patients can head right back to work. So what's in these shots? Dr. Hoffman says, "It's a natural substance. It is actually in the bowel acid in your stomach and it dissolves fat. They've been using it in Europe in patients with heart disease to dissolve plaque. If it's safe to use intravenously, it's safe enough to inject just under the skin in fat deposits."
Smaller areas usually require one treatment. But larger areas may require 4 or 5. The cost varies from $500 to $2500, but that price includes all of the necessary treatments. It's also important to note this procedure is not yet FDA approved.

New Fat Removal Technique Getting Raves: Is it Safe? Does It Work?

(New York-WABC, February 7, 2003)
— A medical technique that's just catching on in America promises to melt your fat away. It's called mesotherapy, and while some people swear by it many doctors aren't so sure.

Dr. Marion Shapiro: "OK, what I'm doing right now is I'm injecting a combination of medications that melt the fat under the skin."
And believers say it works wonders. In fact, Christine Comba says she's now lost 25 pounds of fat.
Christine Comba, Mesotherapy Patient: "My bra size went down. I was wearing a 14, I'm now wearing a 10 in jeans."
Doctor Marion Shapiro is a former emergency room doctor who now performs this procedure in West Orange, New Jersey. It's known as Mesotherapy. It's for patients who want to lose weight or just sculpt their body. It's called Mesotherapy because it involves the injections of four to seven different compounds into the mesodermal layer of the skin.
Dr. Marion Shapiro, Mesotherapist: "What happens is when you inject the medication beneath the skin, it melts the fat and helps it dissolve and be excreted by the body."
Dr. Shapiro tells us she trained for the procedure in France, where this has been done since 1952. But it has never caught on here in the states. In fact, only a handful of doctors are doing it and some of the most well-known plastic surgeons in the city strongly caution patients about it because no US studies on Mesotherapy even exist.
Dr. Norman Schulman, Lenox Hill Hospital: "Don't do it. Wait till the homework is done. It may turn out to be something OK, but certainly not now."
Stacey Sager, Eyewitness News: "And you wouldn't feel comfortable doing it now?"
Dr. Schulman: "I would not do it now."
But patients continue to rave. They say it's much less invasive than liposuction, and that Mesotherapy works all over the body.
The big question is really whether the fat can come back. Technically, yes, because the fat cells remain intact, so diet and exercise are still key.
But the skeptics continue to wonder, especially about side effects and so-called "off-label use." That is, medications that may be FDA approved, but not together for this purpose together.
Dr. Schulman: "If you do have an adverse affect from off-label use, you're going against the directives of the FDA."
Sager: "So you could be held liable?"
Dr. Schulman: "You absolutely could be."
Dr. Shapiro: "There's been no case reports of ill effects from mesotherapy. And I would assume by this time that we would know, since 1952."
So Doctor Shapiro continues to believe in a treatment her patients love, even though the test of time in this country remains to be seen.

Fashion & Beauty
Fat Dissolving Injections

There's a revolutionary new cosmetic procedure on the market that promises no-hassle, 'lunch-time' weight loss! Commonly known by the brand-name Lipo-Dissolve, this 'cutting edge' cosmetic procedure is an injection that dissolves body fat and promises to shift stubborn pockets of fat through a series of injections into the body. But at around L300 per session and with up to six sessions needed, do these injections work and what are the side effects?

What is Lecithin?
The active ingredient of drugs like Lipo-Dissolve is a substance called Lecithin and the actual drug name used for cosmetic treatments is Phosphatidylcholine.

Lecithin is a naturally occurring substance that is produced in the human body and can also be found in foods like soybeans, milk and egg yolks. In the body, lecithin is produced in the gall bladder and is a fatty substance that acts as an emulsifier, helping to keep the blood's cholesterol circulation flow freely. Lecithin has also been shown to reduce cholesterol levels in the body.

When extracted and used in the manufacturing of foods, like chocolate and biscuits, lecithin is used as a thinner or emulsifier and will control, say, the 'flow' properties of chocolate.

Lecithin... The New Botox? In the medical world lecithin has been used in Europe for a long time, on patients with heart conditions and/or blocked arteries and can be injected into a blocked artery to dissolve a fat clot.

Then in the early 1990s a Brazilian doctor took lecithin and began using it for cosmetic reasons, injecting it into patient’s bodies in order to dissolve fat in specific areas.

The exact mode of action of the drug still remains unclear, however published studies have shown that it does work. Although the drug is still not legally licensed in the UK, the use of lecithin is gaining popularity and manufacturers have branded the drug for cosmetic use under such names as Lipo-Dissolve, FatAway and FlabJab.

Although Lecithin is not yet licenced in the UK, it is not illigal to use. For example, Botox, is not licenced either. These drugs are allowed to be used because the law states that any doctor can use any drug for whatever use, as long as the patient is aware of why and how the drug is being used.

The Cosmetic Process.
Lecithin is administered through a series of injections in localised areas of the body, like the abdomen, the hips, the back, the neck or on the face. It's best to deal with one area at a time and for large treatment areas patients will need up to six sessions of injections before their fat has dispersed and these sessions need to be a minimum of fourteen days apart.

Side effects from the injections will include a swelling of the area (which will go down in three to four days), a tingling or burning sensation, redness and some discomfort.

Lecithin injections are prescription-only and should therefore only be administered by a qualified doctor and depending on the size of the treated area, costs will range from around L200 to L350 per session.

Lecithin is not suitable for:
* pregnant or breastfeeding women
* people with kidney, liver or thyroid problems
* people with diabetes

Dr Samantha Gammell
Dr Gammell is a Cosmetic Doctor who runs a private clinic (Wimpole Street) dealing with non-surgical cosmetic procedures, like Botox and lip fillers. She travelled to the States to be trained by the doctor who pioneered the use of lecithin for the beauty industry and is now one of the first doctors in the UK to offer this treatment and since doing so she says she has been "inundated" with calls from women (and a small amount of men) eager to spend money to have their fat dissolved away by injection. She commented, "After an article appeared in the press, I had to take on two extra secretaries to deal with all the calls!".

Dr Gammell says she believes the intense interest in the procedure lies in the fact that it's relatively quick and easy and, unlike liposuction, doesn't leave any scarring or need a huge amount of recovery time. She says: "Lecithin injections are a real 'lunch-time' procedure. There's no anaesthetic involved and so the patient can literally walk-in and walk-out of the surgery in no time at all and with little discomfort. The results also happen quite rapidly and patients are always eager for quick results."

Dr Gammell, is eager to point out that she always makes clear to her patients that their injections of lecithin have to coexist with a lifestyle change and that they still have to keep in check their diet and exercise. She says: "I am about a size ten myself and know that I am like this because I watch what I eat. My patients have to be aware that the injections won't work miracles. They will help with stubborn areas of fat, where dieting hasn't worked."

For more information on Lecithin injections please contact:

Dr Samantha Gammell
The Hadleigh Clinic
08456 44 77 11 (local call rates)
or email sgammell@doctors.org.uk

Clinic locations are : London (Wimpole Street), Hertfordshire and Middlesex.

The British Association of Cosmetic Doctors
0800 328 3613
www.cosmeticdoctors.co.uk