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Although popular in <jats:styled-content style=\"fixed-case\">E<\/jats:styled-content>urope for many medical purposes, it is used for local cosmetic fat reduction in the <jats:styled-content style=\"fixed-case\">U<\/jats:styled-content>nited <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>tates. This paper reviews manuscripts indexed in <jats:styled-content style=\"fixed-case\">PubMed<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">MEDLINE<\/jats:styled-content> under \u2018mesotherapy\u2019, which pertains to local fat reduction. The history of lipolytic mesotherapy, the physiology of body fat distribution, the mechanism of action of different lipolytic stimulators and their increased efficacy in combination are reviewed. Mesotherapy falls into two categories. Lipolytic mesotherapy using lipolytic stimulators requires more frequent treatments as the fat cells are not destroyed and can refill over time. Ablative mesotherapy destroys fat cells with a detergent, causes inflammation and scarring from the fat necrosis, but requires fewer treatments. The historic and empiric mixing of sodium channel blocking local anaesthetics in mesotherapy solutions inhibits the intended lipolysis. Major mesotherapy safety concerns include injection site infections from poor sterile technique. Cosmetic mesotherapy directs the area from which fat is lost to improve self\u2010image. Studies were of relatively small number, many with limited sample sizes. Future research should be directed towards achieving a <jats:styled-content style=\"fixed-case\">F<\/jats:styled-content>ood and <jats:styled-content style=\"fixed-case\">D<\/jats:styled-content>rug <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>dministration indication rather than continuing expansion of off\u2010label use.<\/jats:p>","DOI":"10.1111\/obr.12049","type":"journal-article","created":{"date-parts":[[2013,6,25]],"date-time":"2013-06-25T11:37:01Z","timestamp":1372160221000},"page":"780-791","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Mesotherapy for local fat reduction"],"prefix":"10.1111","volume":"14","author":[{"given":"S.","family":"Jayasinghe","sequence":"first","affiliation":[{"name":"Rollins School of Public Health  Atlanta GA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T.","family":"Guillot","sequence":"additional","affiliation":[{"name":"Plastic 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