The Patient’s point of view
We will attempt to answer this question by looking at the treatment from
the point of view of the patient and the practitioner.
Since patients always come first in medicine and their safety and comfort
is the physician's number one priority we will look at the patient first.
Probably the number one concern patients have when inquiring about mesotherapy
is pain . When they first learn that the procedure may consist of
100 to 200 injections the next question is usually: How much is that going
to hurt doctor?
In order to answer this question let us first review various factors that
contribute to the patient's perception of pain. These include individual
pain threshold, sensitivity of the treatment area, diameter or gauge of the
needle, sharpness of the needle, speed of needle penetration, needle vibration
at the time of puncture, skin stability at the time of puncture, the medication
being injected and finally the speed of injection.
Among these factors, variables that can be affected by use of an injection
gun are speed of needle penetration, needle vibration at the time of puncture
and skin stability at the time of the puncture.
Skin stability
When performing injections manually usually there is some skin movement
before the skin gives and allows the needle penetration. This is significantly
reduced with an injection gun. Most injection guns come with a skin stabilizer
which is typically mounted at the very tip or the nose of the gun. This usually
consists of a plastic end piece that rests on the skin at the time of injection.
This small addition helps to stabilize the skin and prevent movement at the
time of injection therefore reducing the pain perceived by the patient.
Needle Vibration
Needle vibration at the time of injection typically depends on the physician's
technique and hand stability. This also is considerably reduced with use
of a mesogun.
To what extent? The answer of course is that it depends on the gun.
There is much less vibration with automatic mesotherapy guns compared to
semi-automatic ones. This difference will be explained later. However a recent
innovation in some injection guns which tremendously affects needle stability
and therefore patient comfort is the needle-syringe separation . As
implied by the term, this creative modification in some of the newer guns
allows the needle to move without the syringe having to go back and forth.
Although this may seem trivial, this creates much less inertia and force.
Less mass movement not only allows the needle to be more stable at the time
of skin puncture, but also causes less trauma to the skin at the time of
penetration. For the patient this translates into less pain and less bruising
and allows treatment of more sensitive areas such as the face or the scalp.
Speed of needle
The speed of needle is probably the variable that makes the most difference
in patient pain perception. Of course the faster the needle penetrates the
skin the less pain is perceived. This is probable one of the main reasons
mesotherapists use an injection gun. This again is very variable among different
guns. In semi-automatic devices the speed of the needle is directly controlled
by the practitioner who needs to push the devices. In fully automated devices
this step is controlled by the gun itself and tends to be much faster. The
difference between semi-automatic and fully automatic devices is explained
below in the section on automatic injection devices .
Let's now consider the practitioner's point of view:
Of course physicians our concerned about all aspects of the procedure, but
as far as the ease of technique itself is concerned, several factors were
consistently mentioned in our discussions with physicians performing mesotherapy.
These included wrist and hand fatigue, comfort while administering injections
and consistency and accuracy from one injection to the next.
The Physician’s point of view
Fatigue
Fatigue was probably the number one concern among physicians performing
a significant volume of mesotherapy. Practitioners commented that doing
several treatments in one day could be quite demanding on the hand and wrist.
We have found that automatic injectors alleviate this concern to a great
degree. In fact some physicians who previously noticed blistering and callous
formation in their palms noted complete resolution of the discomfort since
they started using a mesogun. The reasons are simple. When using a mesotherapy
gun, instead of needing to holding a syringe and needle in a tight grip
while concentrating on administering dozens to hundreds of injections in
a consistent desired manner, when using a mesogun the physician simply needs
to press on the trigger (fully automatic injectors) or press on the trigger
and push the device forward.
Comfort
In most devices the handle is ergonomically designed for added comfort.
Consistency and accuracy
When the procedure is performed manually consistency and accuracy from
one injection to the next and from one treatment to the next depends on
the mesotherapists skill level and experience. The mesotherapy gun takes
this human factor out of the equation. Once the settings are adjusted as
desired, most devices are designed to administer consistently the same amount
of medication and at the same depth of penetration over and over and over
again. Each device however is different in number of settings that can be
adjusted in order to perform the procedure as desired. These settings include
dose, rate, frequency and depth of injection. These need to be carefully
considered before any injector is purchased.
How to choose the right Mesogun?
Fully automatic versus semi-automatic
This distinction refers to the mechanisms of injection (i.e.: skin penetration)
and delivery of medication. In fully automated devices both of these functions
are performed by the injection gun at the press of a button. In other words,
once the gun is in position on the patient's skin, upon pressing the trigger,
the needle penetrates the skin at the desired depth and the gun delivers
the cocktail without any further effort by the mesotherapist. By contrast
in semi-automatic devices usually the operator needs to push the injection
gun holding the needle in the skin while the gun delivers the medication
automatically. Semi-automatic devices tend to be considerably cheaper than
fully automatic ones.
Currently the most popular semi-automatic devices on the market include
the Dermotherap, the Meso-basic and the Den'hub.
The fully automated devices which are becoming increasingly more popular
include the U225, the Pistor 4, the Mesomega, DHN 4, DHN3, DHN2, DHN1 and
the Meso-system.
Each of these devices offers its own unique differences, advantages and
disadvantages. Therefore practitioners are urged to do their research in
order to find out which would be most suitable for their individual practice
before the purchase decision. Some of these devices distributed by USA Meso
are described below. For further information on these or other mesotherapy
guns you can contact USA Meso. Our friendly staff will be happy to answer
your questions or address your concerns.