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Many women find overly large breasts to be an unwelcome burden, For women who have begun the menopause or experienced an early menopause, MicroLipo Breast Reduction is an innovative and minimally-invasive way to feel comfortable and confident in your body. Large breasts can predispose women to yeast infections of the skin in areas where the skin rubs together.
ITV Lorraine Kelly show featured MicroLipo procedure for Breast Reduction – May 2011.
MicroLipo for Breast Reduction, as recommended on TATLER 2011 Guide to Beauty and Cosmetic Surgery. Traditional breast reduction, known as surgical-excision breast reduction, involves cutting the breast with a scalpel to remove large amounts of breast tissues.
Dr Gupta is our experienced MicroLipo specialist and is probably the only practitioner in the UK and Europe trained by the creator of the technique himself, Dr Jeffrey Klein. With the Microcannula Technique large amounts of very dilute local anaesthesia is injected into the fat causing the targeted areas to become swollen and firm. Surgical scars are not visible in most patients after breast reduction by liposuction using microcannulas. Breast-feeding after breast reduction is a more likely possibility after liposuction using microcannulas than after a surgical excision. There is so little trauma to the breast tissue that x-ray examinations of the breast, known as mammograms, usually appear normal after microcannula liposuction of the female breast. Breast reduction by liposuction using microcannulas can be accomplished totally by local anaesthesia. Measuring the breast volume is accomplished by immersing the breast in a beaker full to the brim of comfortably warm water.
MicroLipo breast reduction is only suitable for women who have undergone or are experiencing the menopause with a large proportion of fat in the area. I had my consultation with Dr Gupta and he made me feel so at ease and explained the whole process of a breast reduction using microcannular liposuction, making sketches explaining what would go where, how long the process would take, recovery period and said to go away and think about it. I never once felt apprehensive about my decision and couldn’t wait to get the job done. I was in a little discomfort for 3 days and waited for the swelling to go down and then I looked at my wonderful new breasts.
I made a decision to go ahead and the rest is history as they say – I am thrilled to bits with the whole process. My friends and colleagues can notice the difference it has made on me and every time I look in the mirror it just looks right, and not all squashed in my dress.
I really can’t begin to express how much this has had an impact on me, it really has changed my life in many aspects! I met Dr Gupta who was lovely and talked though the whole minimally-invasive procedure which I would go though only under local anaesthetic.
At the beginning of this year I came across some internet articles about breast reduction by liposuction. I was given an initial appointment at The Private Clinic’s Manchester consulting rooms where I was assessed for the procedure by one of the senior nursing staff. Dr Gupta was professional yet friendly and took care to ascertain whether I was a suitable candidate and would get the reduction I was hoping for. Although I have only gone down from a 32G to a 32E, which doesn’t seem like a huge reduction, my breasts feel tiny to me compared to what they were and I am delighted with the result. Welcome to Revive Body Sculpting, a non-invasive and effective solution for those wanting to tighten and smooth loose skin on their faces and bodies. The proof is in the pictures and testimonials from those who’ve already completed their treatments! Background: The abdominal pannus is a well known medical condition of a large overhanging apron of skin and fat that extends well beyond the waistline. There are five degrees of an abdominal pannus from a grade 1 that rests on the mons pubis to a grade 5 that hangs down to the knees.
An abdominal panniculectomy procedure should not be confused with a more traditional tummy tuck. 1) Large abdominal panniculectomies can be safely done in an outpatient surgery center if the patient is otherwise healthy. 2) Enough abdominal pannus is removed to relief the obstruction on the pubic area and eliminate any overhang on the groin creases. 3) The most likely complication from any abdominal panniculectomy is a seroma or fluid collection.
The abdominal pannus is a stomach deformity where any amount of tissue hangs over the waistline. But despite the popularity and widespread availability of bariatric surgery, not every obese patient undergoes it or is eligible to do so.
In the October 2014 issue of the Annals of Plastic Surgery, an article was published entitled “Supersize” Abdominal Panniculectomy: Indications, Technique, and Results’.
The relevance of this paper is that it demonstrates that larger abdominal panniculectomies can be done and offer a dramatic improvement in mobility and function of the patient. Not infrequently, there may be a need for a panniculectomy to be done with other abdominal and pelvic procedures such as hernia repair, hysterectomy, and even gastric bypass surgery.
Interestingly, an abdominal panniculectomy is not considered medically necessary when the main reason it is being performed is to relieve back, hip and knee pain.
One procedure that is never needed and certainly not medically covered as part of a panniculectomy is liposuction.
The abdominal panniculectomy is a variation to the traditional tummy tuck or abdominoplasty.  The pannus  or abdominal apron is that overhang of skin and fat that extends below one’s waistline.
The abdominal panniculectomy, historically, refers to the pre-bariatric surgery era when extremely overweight patients had large skin and fat overhangs. The abdominal panniculectomy is different than a true tummy tuck in that the skin edges are not as undermined, no muscles are tightened, and no areas are treated by liposuction.  It is simply an amputation of whatever overhangs the waistline.
Because of the relief of medical symptoms, the abdominal panniculectomy may be covered by insurance. Since the advent of bariatric surgery and the rise in the number of such procedures every year, a traditional body contouring plastic surgery procedure is undergoing a change. Panniculectomy surgery is a reconstructive procedure performed to remove a panniculus, sometimes referred to as a pannus or overhanging abdominal apron.
In the recent past, prior to weight loss from bariatric surgery, an abdominal pannus was quite large (as was the patient) and quite hefty in weight.
While removal of a massive abdominal pannus solved a few health problems for the very obese patient, it did little for their general well-being or improve longevity. These sizes of abdominal pannuses are much more manageable, have fewer complications after their removal, and the patients are overall much healthier.
A panniculectomy is a very close cousin to a tummy tuck or abdominoplasty.  The term pannus refers to a large apron of skin and fat that hangs over the waistline.
In the historic obese patient, there was a significant improvement in the patient’s quality of life as the skin and infectious symptoms that it caused were eliminated as well as the weight removal improved back and knee pain.
Disclaimer: The information contained on this website should not be construed as medical advice. Our results show that denting of medial canthus and appearance of lower orbital ridge is the first sign of orbital region ageing. By analysis of the upper orbital region (upper eyelids) he has proven that there are two types of ageing, and by analysis of the lower orbital region (lower eyelids) he has determined that there are 14 types of ageing. If the patient has excess skin on eyelids (that appears after dents and bulges appear), the excess skin needs to be removed. Eyelid lift (Blepharoplasty) is used as a standalone procedure or combined with facelift aiming to rejuvenate the face.
Indications for this type of the operation are: localized atrophy of the skin of the upper or lower eyelid that is thin and flabby and hangs over eyelid rim, pouches on upper or lower eyelid (blepharochalasis) or there is a herniation of the orbital fat pouch. In practice it is not unusual to see a considerable number of patients (of both genders) between 27 and 40 years of age that turn to mentioned surgical intervention.
The most common indications for plepharoplasty are: excess skin that hangs on eyelids, wrinkles around eyes, clusters of fat pouches, reduced field of view as a result of skin lowering on eyelids or skin pigmentation. Preoperative preparation for eyelid correction is the same as for face lift, and includes anamnestic data, as well as examination of the patient and his general condition. Before eyelids surgery an anatomical evaluation of your eyelids must be done, which will include evaluation of the skin, muscles, fatty tissue, height of the supratarsal fold, eyebrow height, orbital ridge, eye protrusion and preexisting eyelid ptosis (drooping).
Eyelid surgery is done in local anesthesia, and can also be done in combination with neuroleptanalgesia. Course of the surgery is removal of excess skin from upper and lower eyelid (or just from the upper or from the lower), removal and premodeling of fat pouches. Complications in blepharoplasty are rare, and if they occur they are most commonly swellings with bruising (which usually disappear within couple of days), infections, ectropion or visible scars. A couple of days after the eyelid surgery, patients can fully resume their earlier activities.

This can leave some women with excessively large breasts, causing pain, physical impairment and psychological problems. He has performed nearly 2,000 MicroLipo procedures, including well over 200 MicroLipo Breast Reduction procedures to date. Jeffrey Klein who wanted to achieve excellent cosmetic results but with rapid post-operative return to normal activities.
Liposuction reduces the weight of the breast and allows the natural elastic tissue in the breast to retract and produce a visible breast lift.
Because there is minimal trauma to glandular breast tissue it is reasonable to predict that a breast reduction by liposuction should not interfere with future lactation. In contrast, after excisional breast reduction, x-ray mammograms show calcification and other changes in appearance.
An accurate measurement of breast volume is necessary for planning the amount of fat to be removed from each breast. Traditional breast reduction by excision is associated with more complications than breast reduction by liposuction.
I didnt want to go away and think about it and booked a date there and then for my breast reduction.
The heaviness had gone and they looked exactly the same, no loose skin, nipples exactly in the same place, but smaller.
Gupta reduced my breasts from a 34F to 34D and it is an absolute pleasure to be able to buy pretty bras with thin straps and thin fasteners.
I was never able to find the ‘perfect dress’ as what would fit my waist would never fit my chest! Dr Gupta made me feel very much at ease, I was awake during the procedure yet the nurses and doctors reassured me that I was fine.
I was lucky enough to see a surgeon who I was introduced to by Channel 4 TV programme. I have been considering having a breast reduction since 2006, but had been put off having conventional breast reduction due to the recovery time following the operation. I read as much as I could find about the procedure and felt my age and breast size met the criteria for this type of reduction to be successful. She was of the opinion that liposuction breast reduction would be beneficial to me, and I was then referred to see Dr Gupta in Harley Street for a consultation. The procedure took about an hour and a half and whilst it was uncomfortable at times it was not painful.
I can wear clothes I hadn’t been able to wear for years, and I feel much less selfconscious about things like taking off my cardigan.
For the first time in Saskatoon, we are bringing the technology to firm and lift problem areas without the pain, risks, cost, and wait times that you find in Saskatchewan’s cosmetic surgery industry.
Technically the proper term is a panniculus but it is far more commonly referred to as a pannus. While no abdominal pannus is pleasant for the patient the grade 5 pannus is the most disabling. The scope of the problem being treated would indicate such but how the operation is performed and under what circumstance is also vastly different.
The term, pannus, is derived from a latin word for apron so it is fitting that any overhang is referred to as such. This still leaves certain patients who are overweight that suffer from a large pannus with all of its associated symptoms. In this paper, the authors reviewed a series of 26 patients over a six year period that had abdominal panniculectomies performed that weighed over 10 kgs. However, it creates a large abdominal incision and has a lot of ‘dead space’ inside to heal.
In the long run it will be very much worth it but expect a healing period of two to three months for a full recovery. This recontouring of the abdominal wall area is exclusively done for cosmetic purposes to create a more flat and firm abdomen. While the pannus produces a stretching of the tissues from the anterior abdominal wall, such effects are not treated by any form of muscle plication as in a tummy tuck.
While it may seem obvious that getting rid of an obstructive pannus could only benefit the results of these surgeries, the insurance companies rarely see it this way.
Even though the sheer weight of grade 4 and 5 pannuses clearly strain these areas, this consideration alone is insufficient for medical coverage.
In fact, thinning out of an abdominal skin flap with liposuction can impact its blood supply and create wound healing problems. Abdominal pannuses can exist in overweight as well as extreme weight loss patients after bariatric surgery.
Heavy pannuses were surgically removed to relieve the medical symptoms that they caused such as skin irritations and rashes from the moisture and heat that builds up underneath it. In the obese patient, this pannus may have considerable weight anywhere from 30 lbs or higher. Since the panniculectomy procedure in the bariatric surgery patient today weighs considerably less and often only involves improvement of an undesired contour, it is often called cosmetic by one’s health insurance. Because of the amount of excess tissue present, removal may need to extend way into the back and include a vertical cutout as well as that in the horizontal dimension.
That procedure is the abdominal panniculectomy…or the cutting off of one’s overhanging pannus.
The pannus frequently contributes to a number of health problems, including chronic wounds and skin infections due to the moisture underneath the skin folds. Many of these pannuses would hang at least down to the middle of the thighs and often to the knees. Along came bariatric surgery and we have seen a fortunate change in the large abdominal pannus patient. The typical pannus that is removed today, often part of a circumferential lower body lift, weighs 10 lbs. At that time, many abdominal panniculectomy procedures were done to relieve the medical symptoms that the pannus caused. This is different than a true tummy tuck in that the skin edges are not as undermined, no muscles are tightened, and no areas are treated by liposuction.  It is simply an amputation of whatever overhangs the waistline.
Because of the relief of medical symptoms, the abdominal panniculectomy  was often covered by insurance.
Barry Eppley is an extensively trained plastic and cosmetic surgeon with more than 20 years of surgical experience. Lip enhancement and modeling can be done through injection of resorptive (hyaluronic acid) or nonresorptive fillers (PMMA), own fatty tissue, parts of fascia, muscles or dermis. Milan Jovanovic has proven that first signs of ageing in orbital region are characterized by: dents and bulges, and then later by skin flabbiness. None of the classifications of the orbital region age signs includes different types of ageing. After the surgery bags or special eyeglasses with eyes are placed on the eyes, in order to reduce swelling. All testimonials are provided voluntarily by our patients and clients and all photos and videos have been consented to and have not been altered in any way. Breast-feeding may not be possible after traditional surgical-excision breast reduction because the excisions and subsequent scaring severs and blocks the milk ducts. In the hands of a surgeon who is well trained and experienced at doing liposuction totally by local anaesthesia, breast liposuction is routinely accomplished with virtually no pain. If the breasts are originally unequal in size, then the surgeon can remove an appropriate extra volume of fat from the larger breast, and thus improve the symmetry of the breasts.
A complication that can occur with liposuction is excessive bruising due to the use of a poorly designed elastic compression garment and inadequate post-operative compression. Finding bikinis that would fit and support me was a nightmare, and going underwear shopping only ever left me with buying and ugly one and not the pretty lace one I wanted to buy! He talked more about the microcannula and how the tinniest incision is made to my breasts to extract breast tissue and fat. I then searched the internet to find out where I could have the operation done in the UK, and found that the only Dr. Dr Gupta also felt that the procedure would be beneficial and I arranged to have the reduction on March 14th of this year at the clinic in Knightsbridge.
I had started a course of antibiotics the day before the operation and was also given a course of pain killers. I was perfectly fine to walk to the tube station afterwards, and then travel home on the train (with my husband).
Also I had become rather lopsided before but Dr Gupta measured them beforehand and took more out of one side than the other to even them up.
It not only obstructs the urinary stream and causes associated hygiene issues but its sheer weight makes mobility difficult.

Because of chronic skin infections and urinary obstruction he had been to the hospital numerous times. There are many large blood vessels that supply the abdominal pannus and intra- as well as postoperative bleeding is always a risk. In days before bariatric surgery, abdominal panniculectomy surgery was very common and it was almost always associated with morbid obesity. There has been some understandable reluctance to operate on such overweight patients due to the increased risk of complications that is known to occur . As a result, wound complications are common (and to be largely expected) and  revisits to the operating room for their management are not rare.
The abdominal pannus occurs exclusively in morbidly obese individuals or following substantial weight loss, most commonly bariatric surgery. Citing that there is ‘insufficient scientific literature’ to support any benefit, these combined procedures are usually denied.
I have performed over the years numerous panniculectomies that were requested by an orthopedic surgeon to first be done before they would consider knee replacement surgery.
The wound edges in closing a panniculectomy are already compromised from chronic swelling and lymphedema in many cases. With an obese patient, panniculectomies were associated with high wound complication rates due to the size and depth of the cut outs. To be considered medically eligible for insurance coverage, there has to be very specific criteria that are met and a documented trail of medical records that substantiate symptoms related to the pannus. This does leave long scars but patients with these skin excess problems always feel that it is a good trade-off. I have seen a few that hung well below the knee and one that hung down and rested on the floor.
As bariatric surgery has helped patients lose a lot of weight, so has the size of abdominal pannuses decreased. Specifically, skin irritations and rashes (known as panniculitis) resulted from the always present moisture and heat in the underlying skin fold.
Since the panniculectomy procedure in the bariatric surgery patient  today weighs considerably less and often only involves improvement of an undesired contour, it is often called cosmetic by one’s health insurance.
He is both a licensed physician and dentist as well as double board-certified in both Plastic and Reconstructive Surgery and Oral and Maxillofacial Surgery. HIGHLIGHTS: This is one of the most visited sites of this type, every month we have over 5,000 visits, just from countries of former Yugoslav republics.
It wasn’t surgical and there is more or less no scarring – I booked myself in for a consult straightaway! Within a few days the discomfort began to decrease and I returned to work nine days after the procedure. I was uncomfortable for a few days afterwards but this was mainly aching ribs and back due to the very tight compression garments you have to wear – I only needed to wear these for 48 hours and felt much better after that. It causes tremendous strain on the back and knees and leads to early deterioration of both. But despite his obvious need for a surgical solution, he stated that no one would take on his case because it was too dangerous or difficult. The operation needs to be performed as expeditiously as possible to get the patient off the operating room table as soon as possible.
Because of bariatric surgery, the most common abdominal panniculectomy today is much smaller and is done after large amounts of weight loss. The indications for surgery were typical including a large amount of overhanging abdominal skin and fat (hangs down to mid-thigh level) that was associated with underlying chronic skin infections, history of panniculitis, and the presence of a hernia.
This type of abdominal surgery should be confused in this regard with the more common tummy tuck.
Debate frequently ensues from the insurance company in the medical merits of removing Grade 1 and 2 types.
How they can not easily see that such benefits  as improved surgical access and less risks for wound healing problems after surgery is a mystery to me.
Apparently, the musculoskeletal problems that it causes by orthopedic specialists is not sufficient evidence for medical coverage. Such surgical removals of abdominal  overhangs today await weight loss through bariatric surgery first, leaving a smaller pannus on a thinner person.
Most importantly, photographs must demonstrate that the pannus hangs onto or below the groin creases. The biggest complications from these procedures is a seroma or build-up of fluids which is why drains are needed for several weeks after surgery.
My personal ‘record’ for an abdominal panniculectomy was a patient who weighted 715 pounds and a pannus that weighed 96 lbs. Most abdominal pannuses that I see today are in the bariatric surgery patient or someone that has lost over 100m lbs. In some cases, the size of the pannus and its amount of overhang actually cut off some of the blood supply and lymphatic outflow resulting in swelling and infection. This training allows him to perform the most complex surgical procedures from cosmetic changes to the face and body to craniofacial surgery.
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Milan Jovanovic's classification is very original and clear to understand orbit ageing as well as to setting the indication and choosing surgical and nonsurgical treatments in orbital region rejuvenation. If the transconjunctival blepharoplasty is performed, incisions are located on the insides of eyelids. I tired easily for a further two weeks, but almost exactly four weeks to the day from my operation I was back to full health, and feeling really well.
When performing the operation as just an overnight stay, the patient must have few other medical problems and be motivated to get up and moving as soon as possible after surgery. These pannuses are largely skin and the overall health of the patient is generally good since they are more weight appropriate for their height. Of the 26 patients, the mean pannus weight removed was over 15 kgs with a followup period of over a year.
A CT scan done before surgery can help discover a hernia which can be very difficult if not impossible to pick up on a physical examination of a large pannus. Such concomitant coverage can be obtained if the documentation of skin problems is first obtained however. Removing these large pannuses required some clever intraoperative methods to hoost them up (known as the ‘china wall’) just to get underneath it to do the cutting. Surgically removing the pannus was common then but the complication rate was high due to the patient’s obesity.
The adits were completely healed within a week and my breasts were down to their present size after about three weeks.
All in all, I don’t really think about them any more whereas I used to be totally preoccupied with them. Without adequate written evidence of symptoms, these lower grade abdominal panniculectomies will be viewed as a cosmetic procedure.There is little question that a massive overhanging apron of fat and skin creates chronic and unremitting skin problems underneath it.
Because of the magnitude of the abdominal wall resection, wound complications after large abdominal panniculectomies were the norm with fluid build-ups and problems with healing of the incision. Today, surgical removal of any abdominal overhang would await weight loss through bariatic surgery.
Eppley has made extensive contributions to plastic surgery starting with the development of several advanced surgical techniques. For the out of town patient this means that they will have to get some medical care at home to get it removed. In addition to the need for enhanced personal hygiene (which is very difficult), treatment of these skin conditions may require antifungal creams and powders and occasionally antibiotics. He is a revered author, lecturer and educator in the field of plastic and cosmetic surgery. The rate of major complications, defined as those complications requiring a return to the operating room, was just over 10%.
Jovanovic abides by his principle: "That what he does looks fantastic, and that no one recognizes that something was done".
Jovanovic is downright against over-emphasis of the lip thickness, because that way the lips loose their natural look.

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