BREAST REDUCTION

By Liposuction alone

Large female breasts such as size D to G can often be distressing or cause discomfort such as pain in the neck, shoulders or back. Reduction is usually performed for relief of this pain or for aesthetic reasons to improve the look of an overly voluminous and/or sagging breast/ bra indentations.

 

Breast Reduction Surgery

Dr Lanzer was featured on TV on “Good Medicine” (TV& Magazine), “A Current Affair”, “Woman’s Day” and “New Idea” magazines with his world pioneering “new” technique of breast reduction through liposuction.

 

Breast reduction until now, has been performed with surgical intervention called mammoplasty. This particular procedure involves cutting out sections of the breast and usually cutting around the nipple area and elevating the nipple and loose skin.

 

Liposuction underwent a dramatic change in 1987 when an American Dermatologist discovered the tumescent technique. This involves filling the fat with a very diluted form of local anesthetic which numbs, softens and prepares the fat. The next step was to use this method on the breasts without the surgical cutting of a mammoplasty.

 

Dr Lanzer has helped pioneer the “new” technique of breast reduction by liposuction alone. He is an accepted world pioneer in this area and has presented his work at the American Academy of Cosmetic Surgeons – San Diego 2001 the Surgical Symposium of the American Academy of Dermatologists in Washington 2001 and at the annual meeting of the Australian College of Dermatologist. Dr Lanzer has performed the procedure on many hundreds of patients.

This new method that allows breast reduction via liposuction alone uses three breakthroughs in technique. Tumescent fluid is put into the breast with a micro-cannula using the method of superficial liposuction which is treating fat very close to the skin.

 

Expert Reference

A well known American Professor visited Dr Lanzer in Australia and saw him perform breast reduction via liposuction. Clinical Professor Dermatologic Surgery of the University of California San Francisco USA, Dr Christopher Zachary MD wrote:
“Please click here to read his letter”

 

 

Why Breast reduction surgery?

The breast is undoubtedly the characteristic most associated with the idea of femininity. A full, firm breast is associated with the idea of youth and health. On the other hand, an overly voluminous breast (hyperplasia or gigantomasty) is not just an aesthetic problem, but can often be the cause of psychological distress and physical discomfort for the woman concerned (bad posture, back and joint pain, scoliosis).

 

Breast reduction provides an effective treatment, and is a procedure that can be carried out at all ages. Dr Lanzer has performed this on girls as young as 12 with consultation with their doctor and child psychologist. He has also lightened the breasts in 70 year old women but most women are middle aged.

 

How much fat can be removed and what are the results:

 

Approximately between a third and half of the breast can be reduced in size with this technique. Generally older patients or women who have had children have more fatty breasts and therefore more volume can be removed. The amount that is removed may vary from 200ml to 2000ml of fat from each breast and it’s important that preoperatively, some guidance is given to Dr Lanzer as to what would be the ideal size the patient wishes to obtain. Often large breasts are associated with a breast tail, where the fat continues around the side of the chest and under the axillae. This area and others can be removed at the same time with liposuction. Most people having liposuction are surprised at the extent of the skin contraction. Nipple elevation varies from 3-10cm. By using the “superficial technique” of removing the fat layers immediately under the skin, maximum skin contraction and breast elevation occurs. There is more lift of the nipples when breast reduction is performed through the surgical alternative.

 

Advantages of the Tumescent method for breast reduction

• Numbs the area so that the procedure does not necessarily require a general anesthetic, and post surgery discomfort is reduced.

 

• Seals the blood vessels so that there is little or no bleeding, resulting in less bruising. There is no need for intravenous ‘drips’ or blood transfusions.

 

• Softens the fat so that it comes out smoothly and evenly, allowing much greater amounts of fat to be removed safely.

 

• The fluid used is anti-bacterial, so that infection is less likely.

 

• Newer liposuction techniques have resulted in many more patients requesting this technique.

 

Procedure Technique:

Pre-operative patients require an examination and a mammogram of the breast to assess how much fat lies within the breast and to exclude unknown breast cancer. It may also assist in long-term follow-up of the breast. Routine pre-operative blood tests and antibiotics are arranged and a full history and examination to exclude breast cancer. Patients with a close family member who has had breast cancer have a higher risk of developing breast cancer during their lives and therefore Dr Lanzer suggests an examination by a specialist breast surgeon in these cases, which he can arrange.

 

Dr Lanzer will mark out the areas on your breast to be suctioned. This allows for an accurate targeting of fat and often highlights that the two breasts are different. Next a large amount of fluid is infused into the target treatment areas, before the suction is performed. This fluid consists of saline solution, local anesthetic (lidocaine) and adrenalin (a vasoconstrictor); the term “tumescent” actually refers to the “turgid” state of the tissues into which the solution has been infiltrated.

 

This technique makes for much easier fat drainage, less or no blood loss, better anesthesia during the procedure and afterwards, and fewer post-operative bruises. The excess fatty tissue is then removed. This is achieved by means of a cannula connected to a suction device by either a vacuum or large syringe, the cannula is introduced into the fat situated under the skin through small incisions (2-3 mm) made close to the targeted treatment area; it is then pushed through the fat until it reaches the area in question. The cannula is then moved about so that the fat is broken up and suctioned simultaneously.

 

The procedure time is approximately 1 hour and a compression garment is applied afterwards and worn for 2-4 weeks. Post operatively there may be some tenderness and bruising and there may be weeping of fluid through the small nicks during the first 24 hours. Most patients can return to ordinary duties after 1 to 3 days, however this may vary between patients.

 

Recovery

Patients should wear a compression garment continuously for 2 weeks and then part time for 2 weeks. Physical activity can be resumed 5-6 days after surgery. Work can generally be resumed within days of the surgery. Sporting activities such as jogging, dance and yoga may be resumed after 2 weeks, but its advisable to wait at least 4 weeks before taking up more strenuous sports again such as eg. skiing, tennis, football, basketball, sailing, swimming and scuba diving.

 

Commonly asked questions

Results of Dr Lanzer’s personal study of 250 patients:

Dr Lanzer performed the first large study of 250 patients having the new liposuction alone breast reduction. This was published in an American Journal and Dr Lanzer presented his findings at a number of major conferences and was featured on Television in the USA.

 

• Virtually all patients noted significant improvement in symptoms such as back pain and dents on shoulders

 

• Virtually all patients happy with the result

 

• All mild deep bruising

 

• No or minimal scarring

 

• No infection, necrosis or excessive loose skin

 

• No permanent sensation change

 

• Average reduction from size DD to a size C size

 

• Maximum fat removed was 2.7 Litres from each breast changing the size from a G size to a C size.

BREAST REDUCTION

 

(note natural elevation of nipple 10cm up to level of small mole-note no scarring)

Possible Complications / Risks

 

Ordinary surgical complications include bruising, pain, swelling and infection. The tumescent technique reduces the infection rate, due to the fact that the fluid is anti-bacterial. Dr Lanzer has never seen a case of infection of the breasts. The procedure is performed under a highly sterile environment in his Accredited Day Surgery Hospital.

Pre-operative antibiotics are given to each patient. No guarantees can be made to the extent of nipple elevation or skin retraction although there usually is a lift.

 

In the many hundreds of patients Dr Lanzer has treated, there was no cases of significant loose skin but Dr Lanzer still warns that a second surgical procedure may be required in very droopy or saggy breasts. Significant scarring does not occur with liposuction, as there are only nicks on the skin, about 3mm in length, which normally heal nicely. There are no sutures.

 

The risk of skin necrosis and skin loss can occur with a surgical option called mammoplasty. Dr Lanzer has not seen skin loss with the liposuction alone procedure. The surgical option will always give more lift and may be required in very droopy breasts. In Dr Lanzer’s study of 250 patients there was no permanent altered sensation to the nipple. There have been no long term studies to ascertain the effect of liposuction on the ability to breast feed, although Dr Lanzer has had patients who had the reduction and where able to successfully feed later.

 

A major issue with all forms of breast reduction is whether changes will occur in the breast that would be identified on the mammogram at a later day and confuse a mammographer as to whether they are marks from previous surgery or in fact, breast cancer developing. This area is under investigation and in early studies there were no long-term difficulties seen on the mammogram after six-twelve months in his patients. (This is based on 11 years follow up and many hundreds of patients).

 

Dr Lanzers routine is to perform a pre-operative mammogram and to have it repeated at six-twelve months to see if there are any changes which will then be used as a reference for mammograms later in life. This hopefully will avoid any confusion and requirements for unnecessary biopsies. If you do not understand this issue, please speak to your local doctor or breast surgeon. Dr Lanzer has not had any issues with this since he began this surgery. It is important to understand that cosmetic surgery is not an exact science and no guarantees can be given as to the exact outcome. Also, all patients react differently and liposuction of the breast tissue is still considered a new procedure in its development stages.

 

Summary

 

Three breakthroughs have allowed liposuction alone to be the first-line treatment for breast reduction. These are the tumescent technique, Micro-cannulae and superficial Liposuction. Dr Lanzer has been recognized throughout the world as a major contributor to this new and exciting procedure. His pioneering work was published in the International Journal of Cosmetic Surgery and Aesthetic Dermatology and his work and patients were featured on national and international television.

 

All photographs represent one person’s experience, and results may vary for each patient. All photographs are of actual patients of Dr Lanzer. The visible change in these photographs has occurred as a result of the procedure/s undertaken. Best results are obtained when the procedure is combined with a balanced diet and exercise.

Some before and after photos shown are not exact, in that they vary in light, contrast, clothing, background, distance from camera, hairstyle and make-up.

 

“Click here to the before and after photos”

We offer a FREE, No Obligation Cosmetic Surgery Consultation and a detailed explanation of the procedure.

 

Dr Lanzer can email all patients a detailed consent form which provides information related to the surgery. This information is made available to all patients before surgery, allowing enough time for the patient to ask any questions they may have.