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In recent years, mesotherapy has become one of the most frequently discussed procedures in aesthetic medicine. However, this popularity has also led to some misunderstandings. On the internet and social media, mesotherapy is sometimes presented almost as a treatment capable of solving every problem.
In reality, this is not the case.
Mesotherapy is a valuable treatment method that can support skin quality when applied to the right patient, for the right indication, and with appropriate formulations. However, it is not a filler, it is not Botox, and it does not replace surgery. Therefore, it is important to clearly understand both the expectations from mesotherapy and the results it can realistically provide.
I have been using mesotherapy for approximately twenty years as an important supportive tool in my aesthetic and reconstructive periocular surgery practice. However, I also consider mesotherapy not only as an adjunct to surgical procedures but also as an effective standalone treatment option in many non-surgical cases.
The foundations of mesotherapy were laid in the 1950s by the French physician Dr. Michel Pistor. He observed that the administration of various medications in very low doses into the skin could be beneficial in certain conditions and defined this approach as “mesotherapy.”
Initially used in fields such as pain management, circulatory disorders, and sports injuries, mesotherapy later found its place in dermatology and aesthetic medicine applications.
Today, mesotherapy refers not to a single procedure but to a broad group of treatments involving the injection of various biologically active substances into the skin.
Mesotherapy involves the administration of various biologically active substances into the middle layer of the skin or superficial subcutaneous tissue via small injections.
The goals are to:
The key point is that the primary aim of mesotherapy is to support the biological quality of the skin.
It is not intended to lift sagging tissues, remove excess skin, or restore lost volume. However, it can contribute to making the skin look healthier, more radiant, and higher in quality.
Mesotherapy is not a single product. Different ingredients may be used depending on the patient’s needs and treatment goals.
Hyaluronic Acid Derivatives
Unlike cross-linked hyaluronic acid used in dermal fillers, mesotherapy uses more fluid and biostimulatory formulations.
Their main purpose is not to add volume but to support skin hydration and quality.
Amino Acid and Peptide-Based Products
These aim to support skin regeneration processes by providing the building blocks involved in collagen synthesis.
Vitamin and Antioxidant Mixtures
Products containing various vitamins, minerals, and antioxidants can be used as supportive treatments, especially for skin affected by environmental factors.
Polynucleotides and Regenerative Ingredients
In recent years, polynucleotide-containing products have gained attention, particularly for the periocular area, face, and neck.
These products aim not to create volume but to support tissue quality and stimulate the skin’s biological regeneration processes.
Mesotherapy can be applied using different techniques depending on the treatment area and the product used.
This is the most commonly used method. Very fine needles are used to inject small amounts of the product into the skin.
In some areas, a cannula may be used to achieve a more homogeneous distribution and to reduce the risk of bruising.
Some mesotherapy ingredients can be combined with:
In these applications, the aim is not only to deliver the product but also to support a controlled skin regeneration process.
Although mesotherapy is often mentioned alongside surgical or other aesthetic procedures, it can also provide significant benefits as a standalone treatment in many patients.
It is particularly effective in cases such as:
In these cases, the goal is not to change the face, but to make the skin look healthier, more radiant, and better cared for.
However, it is important to understand the limitations of mesotherapy.
Mesotherapy cannot:
In such cases, other treatments or surgical procedures may be required.
The periocular area is one of the thinnest and most delicate skin regions of the face. The earliest signs of aging often appear here.
Fine wrinkles, loss of elasticity, sun damage, and reduced skin quality are common concerns in this area.
In suitable patients, mesotherapy may help support the quality of the periocular skin.
However, the eye area is also one of the regions that requires the utmost caution in terms of complication risk. Therefore, product selection, depth of application, and technical details are of great importance.
In my own practice, I prefer a personalized approach in the periocular region rather than a standard protocol, tailoring the treatment according to the patient’s anatomical structure and skin characteristics.
I do not use mesotherapy solely as a supportive treatment for surgery or device-based procedures. When applied to the right patient, it can also provide significant benefits as a standalone treatment.
In some patients, there is not yet a condition requiring surgery. Instead, reduced skin quality, dehydration, fine wrinkles, or loss of elasticity are the main concerns. In such cases, mesotherapy can be used alone to support skin quality and slow the progression of aging signs.
In other patients, even if periocular problems have already been corrected surgically, additional treatments may be required in other facial areas. Mesotherapy becomes an important complementary option, particularly for the cheeks, perioral region, neck, and décolleté.
Another group of patients consists of those who have undergone surgery years ago and wish to maintain the results. Long-term preservation of a successful surgical outcome depends not only on anatomical structure but also on skin quality. Therefore, in some patients, I include mesotherapy as part of a regular skin maintenance and protection program.
Aging is not only about sagging or volume loss.
Over time, the skin becomes thinner, its hydration capacity decreases, elasticity is reduced, and surface irregularities begin to appear.
Not all of these changes require surgery.
In many patients, the goal is not necessarily to look younger, but to appear healthier, more vibrant, and better cared for.
At this point, mesotherapy is an important tool. With regular and properly planned applications, skin hydration, radiance, elasticity, and overall quality can be supported.
For this reason, I consider mesotherapy not only as a treatment method but also as part of a long-term skin health maintenance strategy.
One of the important uses of mesotherapy is its role as a supportive treatment alongside surgical and energy-based device procedures.
In eyelid surgeries, facial rejuvenation procedures, microneedle radiofrequency, and other skin resurfacing treatments, anatomical correction alone is sometimes not sufficient. The quality of the skin’s biological structure is one of the key factors determining the final outcome.
Therefore, in suitable patients, I may add mesotherapy to the treatment plan in order to:
Wound healing does not occur in the same way in every patient.
While some individuals heal very smoothly, others may experience redness, firmness, irregularity, or prolonged healing.
In suitable patients, mesotherapy can be used to:
In some cases, however, dermal fillers, energy-based devices, or other regenerative treatments may be more appropriate.
Therefore, an individualized assessment is necessary for every patient.
When used in the right patient and for the right indication, mesotherapy is a powerful treatment tool that can support skin quality. However, it is not a youth elixir or a miracle solution that can address every problem.
I do not view mesotherapy as a miraculous treatment, but rather as an important method that can be used alone when appropriate, or combined with surgical and device-based procedures, to support skin health and tissue quality.
Every patient has different needs. Therefore, the decision to perform mesotherapy should always be based on a detailed examination, realistic expectations, and an individualized treatment plan.
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Altuğ Çetinkaya, MD, FEBOOphthalmologist Turkey
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