Noonan-Ewald's results were even more dramatic. We visited her after she had undergone 12 weeks of mesotherapy. She had lost 14 inches from her waist, and another 12 inches from her hips, legs, and saddlebag area, according to Bissoon's records.
Is It Safe?
While Bissoon's patients are thrilled with the results of their therapy, some physicians have voiced some serious concerns about the procedure.
Dr. Lisa Donofrio, a dermatologist who teaches at Yale University and practices cosmetic surgery with a specialty in liposuction, has been monitoring reports about mesotherapy and says she worries about its possible long-term effects.
"The problem with mesotherapy," she said, "is that it's a cocktail. The ingredients change on a whim all the time."
While Bissoon says all of the drugs he injects have been approved by the Food and Drug Administration, 20/20 discovered one that hasn't been.
In fact, that ingredient, phosphatidylcholine, is usually consumed as a dietary supplement, has just been banned by Brazil's equivalent of the FDA for cosmetic purposes in injectable form. That agency lists the known risks of phosphatidylcholine as including nausea, diarrhea, depression and arrhythmias.
Even the FDA-approved drugs that Bissoon uses haven't been approved for these sorts of cocktail injections. But Bissoon doesn't seem troubled by this. "The biggest complication I see with mesotherapy," he said, "is black and blue marks."
However, Donofrio says she's aware of reports of toxic reactions "where pieces of skin will die and slough off." A report from Belgium, for example, cited several examples of serious skin infections.
Bissoon said that those infections happened because the doctors were sloppy. "We use gloves, we use sterile needles. … Using the proper technique you should not really have that worry," he said.
20/20's investigation found no reports of bad infections in American patients.
Where Does the Fat Go?
The drug cocktail actually does seem to break down fat, as Bissoon claims.
Professor Susan Fried, an obesity expert at the Baltimore VA Medical Center, tested Bissoon's concoction on human fat cells. "The rate of fat breakdown actually increased about two to three times," Fried said.
However, Fried cautions that the fat being released may go places you don't want it to. "The question is, what happens to those fatty acids? Could they end up in another tissue? Could they end up in your artery? That's a real concern."
Bissoon said the fat should go into your bloodstream because that's how stuff is going to get excreted. "But as far as getting a large component of fat in the blood vessels," Bissoon said, "I don't think that's possible to happen because it's a very slow process."
Several other medical experts 20/20 consulted said they were skeptical about mesotherapy's claims, or they hadn't heard of it. They expressed concern about the minimal research behind the therapy.
Fried was concerned about the release of the fatty acids. She said if they are released from the fat cells, they're going to go to other tissues.
"Those tissues could possibly use them to deposit fat within them where they could cause damage to the tissues, and increase our risk of diabetes and cardiovascular disease," she said. "Just because the fat is released does not mean that it's burned. If that fat is moved from the thigh to your heart or to your liver, it can actually cause diabetes."
But Flack says she's not worried. "I do other things to protect myself," the singer said. "I see a nutritionist weekly, and I have myself checked all the time."
Still, Donofrio says she's concerned. "I think that people need to be cautious. This is their body. You get one."
But Bissoon is confident that the therapy is effective and safe. And so, this latest way to zap fat looks likely to continue. And that thrills Bissoon's patient Noonan-Ewald, who says she plans to keep up the mesotherapy and keep melting away her unwanted fat.