Aesthetic medicine
Facial mesotherapy
Mesotherapy is a series of superficial micro-injections into the skin. Unlike fillers it does not create volume or change contour — it addresses skin quality and hydration, and it does so over a course of sessions rather than in one appointment.
Skin that looks dry and dull
Facial skin loses its capacity to hold water with age, and sun exposure, smoking, poor sleep and rapid weight loss accelerate that. The result is a feeling of tightness, a dull surface, fine lines that show more when the skin is dehydrated, and a general loss of freshness.
This is not a disease and does not require treatment. If it bothers you, mesotherapy is one possible approach — but it is neither the only one nor the most powerful factor. Sun protection, sleep and stopping smoking do more, for longer, than any injectable procedure.
What the procedure involves
Multiple superficial micro-injections are placed into the dermis with a fine needle. The preparation usually contains non-stabilised hyaluronic acid and, depending on the protocol, vitamins, amino acids and antioxidants. The hyaluronic acid here is not a filler: it is not cross-linked and does not create volume, but participates in holding water in the tissue.
It is delivered as a course. Typically that means several sessions a few weeks apart, followed by maintenance. A single session does not produce a lasting result, and anyone promising one is not describing the method honestly.
An honest account of the evidence
The evidence base for mesotherapy is more limited and more heterogeneous than for botulinum toxin. Studies differ considerably in the composition of the preparations, the number of sessions, the technique and how outcome is measured, and many are small or lack an adequate control group.
That does not make the method useless. It means expectations should be moderate and nobody should present the result to you as predictable. So there are no percentages and no promises on this page. At consultation we will describe qualitatively what can and cannot be expected in your particular case.
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What mesotherapy does not do
It does not lift lax tissue, does not fill deep folds, does not remove static wrinkles and does not replace surgery. Nor does it treat skin disease — for acne, rosacea, pigmentary disorders or anything suspicious we refer you to a dermatologist.
If you are looking for a change in contour or volume, this is not the instrument. If you are looking for an improvement in skin quality, it is one possible approach, and it makes sense alongside basic daily care and sun protection rather than instead of them.
Stages of treatment
How the course runs
Each session takes between 20 and 40 minutes depending on the area.
Consultation
Assessment of the skin, your goal, medical history, allergies and medication. We establish whether the method suits what you are expecting at all.
Consent and course plan
You receive written information on the preparation, the number of sessions planned, the intervals, the expected effect, the risks and the total cost of the course.
A session
Cleansing, topical anaesthetic if you wish, then multiple superficial micro-injections. Mild redness and small papules are common and usually settle within hours.
Interval and repetition
Subsequent sessions follow at the agreed interval. The effect accumulates gradually across the course rather than appearing after one visit.
Maintenance
After the course, maintenance sessions are planned. Without them the effect fades — that is a characteristic of the method, not an exception.
Who this is for
Who this suits
- Adults with dehydrated skin and moderate expectations
- Willingness to commit to a course rather than a single session
- Understanding that the effect is temporary and needs maintenance
- No active skin disease in the treated area
Good to know
- Pregnancy and breastfeeding
- Active infection, inflammation or rash at the injection site
- Known allergy to a component of the preparation
- Expecting tissue lift, filled folds or a permanent change
Good to know
Risks and limitations
The most common reactions are redness, small papules at the injection points, swelling, bruising and tenderness. These usually settle within hours to a few days, and with repeated sessions in a short period they are expected rather than exceptional.
Less common are infection, prolonged swelling, allergic reaction to a component of the preparation, and temporary hyperpigmentation at puncture points, particularly in darker skin types and with sun exposure immediately after treatment.
The main limitation, though, is not a risk but an expectation. The result is moderate, gradual and temporary. Nobody can promise you a result, and with a method whose evidence base is more mixed, the honest formulation is that outcomes vary between patients more than with well-standardised procedures.
If after a first course you cannot see a change that justifies the cost, the sensible decision is to stop rather than continue in hope. We will say so at the review as well.
Alternatives
What else we will discuss
Daily care and sun protection
These do more, and for longer, than an injectable procedure. They are the first step rather than the fallback.
Platelet-rich plasma
Another approach to skin quality, using your own plasma. Its evidence also varies by indication and deserves the same honest discussion.
Dermatology referral
For acne, rosacea, pigmentation or anything suspicious we refer you on. Skin disease is not treated with mesotherapy.
Doing nothing
An entirely valid choice. If your expectations exceed what the method can deliver, it is more honest not to start.
Meet the dentist
Dr Nevena Karadjova
Dentist · Specialist in Oral Surgery
All implantology and All-on-X surgery of the clinic: implants, bone grafting and sinus lift, oral surgery, aesthetic medicine.
- DMD, Medical University of Varna
- Specialty in Oral Surgery, MU-Varna, 2019
- Assistant, Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, MU-Varna, 2016–2019
- Resident, Maxillofacial Surgery Clinic, UMHAT “Sv. Marina”, Varna, until 2017
- 2,000+ implants placed personally
Frequently asked questions
Questions about mesotherapy
The method works as a course rather than a single appointment. Typically that means several sessions at set intervals, followed by maintenance. The exact number is decided at consultation according to your skin and your goal, not by a standard package.
No. The effect is gradual and accumulates across the course. Immediately after a session, redness and small papules at the injection points are common and usually settle within hours. Judging the result makes sense once the course is complete. We take photographs at the start of the course so that comparison is objective rather than remembered.
The evidence base is more limited and more heterogeneous than for other aesthetic procedures, and studies differ in composition, session count and outcome measures. That is why we describe a moderate effect and give no percentages. If you expect a visible change in contour, this is not the right method.
A filler contains cross-linked hyaluronic acid, creates volume and is placed more deeply. In mesotherapy the preparation is not cross-linked, is placed superficially and does not create volume. The aims differ, and the two are not interchangeable. If your goal is volume, we will say so and will not propose mesotherapy instead.
The usual advice is to wait until the following day, to reduce the risk of irritation and infection at the puncture points. You will receive written aftercare following the session, including guidance on sun protection and exercise in the first 24 hours.
We do not publish a price, because the cost depends on the preparation, the area and the number of sessions in the course. After consultation you receive a written price for the whole course rather than a single session, so you can judge the real outlay.
Related treatments
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