Arguably, the greatest turning point in cosmetic surgery was around 1990 when American Dermatologist Dr Geoffrey Klein discovered the tumescent method of liposculpture. The concept is to fill the fat layer with large volumes of water that is super concentrated in local anaesthetic and Adrenalin. The anaesthetic numbs the fat so liposuction can occur with the patient awake and the adrenaline closes the blood vessels.
I brought this method to Australia in 1992 and since then have performed over 20,000 cases. The key advantage is essentially no bleeding, so in my personal series not one case has required a blood transfusion despite removing many litres of fat. One of the most unexpected outcomes was the amount of skin retractions and tightening after liposuction. As a Dermatologist I found this most intriguing.
Developments in Cosmetic Surgery
Initially the method was for small areas like ‘saddle bags’, stomach or inner thighs.
With time we tried the tumescent method in different clinical settings.
1) Full body Liposculpture became a reality where we removed fat from nearly all areas of the body in one procedure. This can include arms, back, hips, inner & outer thighs, knees and stomach.
2) liposculpture of the neck and face without cutting surgery became a very effective form of anti-aging surgery
3) In the year 2000 I performed the world first clinical study on using this method for heavy large female breasts. We removed between 400 ml and 1.5 litres from each breast. The breasts became lighter and elevated and avoided the need for cutting surgery.
4) Another major breakthrough and trend change was about 15 years ago with the introduction of Hi Definition 6 Pack liposculpture in men. I attended the first hands on training for Australia in Japan.
With this started a massive interest in man boob – gynaecomastia removal surgery. Men changed from 5% of our patients to now 50%.
5) in the last 10 years another development has been the lipotuck. It is for patients who have lost weight either via diet or Gastric surgery. The intense tumescent liposculpture is first performed followed by skin removal. Often we perform a mini lipotuck which means no movement of the umbilicus- belly button.
6) over the last few years BBL- Brazilian Buttock Lift has become very popular. The goal is to create a deep curvy body with buttock prominence. Care must be taken as there is a risk of fat entering the blood system.
7) Breast augmentation remains popular. Surgeons are moving away from textured silicon because of the rare risk of cancer. More interest recently has been using the fat transferred from liposculpture to enhance the breast volume.
Laser Cosmetic Surgery
In 1994 a group of Dermatologist held teaching conferences regarding the new breakthrough of laser’s In cosmetic surgery and medicine. These included:
1) Laser resurfacing of wrinkles especially smoker lines or sun damage
2) Co2 laser for removal of heavy eyelid skin and lower lid fat bags
3) Laser for cellulite called cellulase
4) Laser removal of hair, blood vessels and pigmentation
I also noticed a trend that patients wanted to look younger and fresher but not pulled or startled. The goal became to look “natural”. As a result one of the post popular procedures that we perform is the miniface lift mainly to create a sharper jaw and neck line.
Social media
Interestingly technology of a different type has changed cosmetic surgery. The Iphone allows rapid responding and retrieval of photos and social media allows the public to actively view inside the surgeons office. I instagram many times a day and show what people are having done and how they look. Personally it’s such a pleasure to be able to share that knowledge with over 150,000 followers, when in the past no one but the patient saw the outcome.
The public has a thirst for understanding cosmetic surgery and as a result I was asked to feature on channel 7 television in a reality type series with over 20 patients. Media and cosmetic surgery are now closely integrated.
By Dr Daniel Lanzer
Dr Daniel Lanzer is a Cosmetic Dermatologist with 3 decades of experience in cosmetic surgery. He is a world pioneer in methods of liposculpture and has been the call to person for the media with over 100 interviews in Australia and around the world. Dr Lanzer has his own registered Day Hospital in Melbourne and surgical clinics in Sydney , Brisbane and Perth. He has a popular following on Instagram @drlanzer and had his own TV show called Cosmetic Coffee. (repeats can be seen on drlanzer.com.au)
