Aesthetic Plastic Surgery

, Volume 34, Issue 2, pp 153–156 | Cite as

Mesotherapy for Benign Symmetric Lipomatosis

  • Toshio HasegawaEmail author
  • Tomoyuki Matsukura
  • Shigaku Ikeda
Case Report



Benign symmetric lipomatosis, also known as Madelung disease, is a rare disorder characterized by fat distribution around the shoulders, arms, and neck in the context of chronic alcoholism. Complete excision of nonencapsulated lipomas is difficult. However, reports describing conservative therapeutic measures for lipomatosis are rare.


The authors present the case of a 42-year-old man with a diagnosis of benign symmetric lipomatosis who had multiple, large, symmetrical masses in his neck. Multiple phosphatidylcholine injections in the neck were administered 4 weeks apart, a total of seven times to achieve lipolysis.


The patient’s lipomatosis improved in response to the injections, and he achieved good cosmetic results.


Intralesional injection, termed mesotherapy, using phosphatidylcholine is a potentially effective therapy for benign symmetric lipomatosis that should be reconsidered as a therapeutic option for this disease.


Benign symmetric lipomatosis Madelung disease Mesotherapy Phosphatidylcholine 



Magnetic resonance imaging


  1. 1.
    Ruzicka T, Vieluf D, Landthaler M et al (1987) Benign symmetrical lypomatosis. J Am Acad Dermatol 17:663–674CrossRefPubMedGoogle Scholar
  2. 2.
    Smith PD, Stadelmann WK, Wassermann RJ et al (1998) Benign symmetric lipomatosis (Madelung’s disease). Ann Plast Surg 41:671PubMedCrossRefGoogle Scholar
  3. 3.
    Becker-Wegerich P, Steuber M, Olbrisch R, Ruzicka T, Auburger G, Hofhaus G (1998) Defects of mitochondrial respiratory chain in multiple symmetric lipomatosis. Arch Dermatol Res 290:652–655CrossRefPubMedGoogle Scholar
  4. 4.
    Berkovic SF, Andermann F, Shoubridge EA, Carpenter S, Robitaille Y, Andermann E et al (1991) Mitochondrial dysfunction in multiple symmetrical lipomatosis. Ann Neurol 29:566–569CrossRefPubMedGoogle Scholar
  5. 5.
    Klopstock T, Naumann M, Seibel P, Shalke B, Reiners K, Reichmann H (1997) Mitochomdrial DNA mutations in multiple symmetric lipomatosis. Mol Cell Biochem 174:271–275CrossRefPubMedGoogle Scholar
  6. 6.
    Leung NW, Gaer J, Beggs D et al (1987) Multiple symmetrical lipomatosis: effect of oral salbutanol. Clin Endocrinol 27:601CrossRefGoogle Scholar
  7. 7.
    Adamo C, Vescio G, Battaglia M, Gallelli G, Musella S (2001) Madelung’s disease: case report and discussion of treatment options. Ann Plast Surg 46:43–45CrossRefPubMedGoogle Scholar
  8. 8.
    Martinez-Escribano JA, Gonzalez R, Quecedo E, Febrer I (1999) Efficacy of lipotectomy and liposuction in the treatment of multiple symmetric lipomatosis. Int J Dermatol 38:551–554CrossRefPubMedGoogle Scholar
  9. 9.
    Faga A, Valdatta LA, Thione A, Buoro M (2001) Ultrasound assisted liposuction for the palliative treatment of Madelung’s disease: a case report. Aesth Plast Surg 25:181CrossRefGoogle Scholar
  10. 10.
    Pistor M (1979) Un Defi Therapeutiche: la Mesotherapie, 3rd edn. Maloine, Paris, pp 1–50Google Scholar
  11. 11.
    Matarasso A, Pfeifer TM (2005) Mesotherapy for body contouring. Plast Reconstr Surg 115:1420–1424CrossRefPubMedGoogle Scholar
  12. 12.
    Rittes PG (2003) The use of phosphatidylcholine for collection of localized fat deposits. Aesth Plast Surg 27:315–318CrossRefGoogle Scholar
  13. 13.
    Rohrich R (2005) Mesotherapy: what is it? Does it work? Plast Reconstr Surg 115:1425CrossRefPubMedGoogle Scholar
  14. 14.
    Rotunda A, Kolodney M (2006) Mesotherapy and phosphatidylcholine injections: historical clarification and review. Dermatol Surg 32:465–480CrossRefPubMedGoogle Scholar
  15. 15.
    Rose PT, Morgan M (2005) Histological changes associated with mesotherapy for fat dissolution. J Cosmet Laser Ther 7:17–19CrossRefPubMedGoogle Scholar
  16. 16.
    Rotunda A, Suzuki H, Moy R, Kolodney M (2004) Detergent effects of sodium deoxycholate are a major feature of an injectable phosphatidylcholine formulation used for localized fat dissolution. Dermatol Surg 30:1001–1008CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC and International Society of Aesthetic Plastic Surgery 2009

Authors and Affiliations

  • Toshio Hasegawa
    • 1
    Email author
  • Tomoyuki Matsukura
    • 2
  • Shigaku Ikeda
    • 1
  1. 1.Department of DermatologyJuntendo University School of MedicineTokyoJapan
  2. 2.Division of Plastic SurgeryMatsukura ClinicTokyoJapan

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