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 swimwear 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 4 mm 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, aminophylline, an asthma drug normally taken orally, and isproterenol 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 multi-vitamins), which is used in Germany and Italy to treat clogged arteries via injection. Unlike mesotherapy's ingredients,, injectable soy lechithin is not approved for any use in the US 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 LA, New York City, and Palm Beach. There are enough similar anecdotes to keep the roughly 20 US mesotherapy doctors - only physicians can perform mesotherapy - double booked (New Jersey-based osteopathic physician Marion Shapiro treats 150 clients a week). The treatment isn't painless, though: To ensure that weight loss is evenly distributed, mesotherapiest 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 Lipostablil shots for one year, says he smooths cellutlite 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 CURVES
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 US to prove their effectiveness (mesotherapy research has been published in France). Anecdotally, mesotherapy fares better than Lipostabil. In Brazil (where Lipostabil is now banned), Lipostabil patients complained of lumpiness, nodules, and necrosis a breakdown of the skin that leads to open sores. In the US, one woman, injectred under an eye, experienced two months of swelling and vision problems. "If it's illegal in Brazil, you know there's something wrong with it," Sobel says of the country known for its leniency in regulating plastic surgery.

While mesotherapy may have a better reputation than Lipostabil, many doctors question the logic behind choosing it. "Why spend $10,000 for 10 weeks of bruising when you can pay $5,000 for liposuction and have it done in one hour with only five days of bruising?" Sobel asks. Even Loeb, who uses Lipostabil, admits, "Liposuction is by far a better method".