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SKIN LAYERS AND CDT CONCERNS
CDT indications require different planes of injection, depending on the effect desired. We can schematize two different injections: subcutaneous and intradermal; each one giving different effects.
Skin Layers
Mesotherapy 30 G needles for CDT have an approximate length of 11 mm. This size is ideal for targeting the two different layers of the skin. Although the subcutaneous layer is easy to inject, intradermal injections may be hard for novices to administer precisely, a problem similar to that encountered by medical students trying to administer intradermal reaction tests for tuberculosis vaccinations. Carboxytherapists should proceed in the same way in order to target intradermal layers.
CDT CONTRAINDICATIONS
CDT contraindications are limited and very similar to those for mesotherapy. There are general contraindications, local skin contraindications and temporary ones.
General Contraindications
The general contraindications for CDT are:
Main effects of CO2 into the body
Vasodilatation The first effects following CO2 injection is a strong vasodilatation, a blood flow increase and a higher pO2 in the treated area.
The Bohr effect Local oxygen release is improved because of the Bohr effect. The Bohr effect describes the tendency of haemoglobin to have less affinity for oxygen when the blood concentration of CO2 is increased. This lower affinity leads the haemoglobin to release the oxygen better in superficial tissues and muscles. CO2 is quickly converted to bicarbonates and H+ acid in presence of the carbonic anhydrase enzyme.
Carboxytherapy medical and aesthetic indications
We can split indications into two groups: medical vascular diseases and aesthetic procedures. The first group is the best documented, with a large number of publications since 1930.
Carboxytherapy introduction
Carbon dioxide therapy (CDT) is a procedure which is very similar to mesotherapy. It consists of intradermal or subcutaneous injections of medical grade CO2 using 30 G needles. With a few medical applications published in the medical literature, CO2 insufflation has been widely used in the last 8 years in South America and in particular in Brazil for cosmetic purposes, such as stretch marks, cellulite, localized adiposities and under-eye dark circles, in combination with other minimally invasive aesthetic procedures. The low morbidity, high level of patient tolerance and minimal side effects makes it a very interesting technique in our battery of face and body rejuvenation techniques, with a high level of patient satisfaction.
