Vol. 2, No. 9 – December 2003

Welcome to our December email Update.Happy New Year

It’s hard to believe another year has gone by. We at the Center want to extend our best wishes for you holiday season. We hope that your year has been as good as ours and we wish you health and happiness for 2004.

Accreditation for Outpatient Surgery

Gail and I just returned from Las Vegas where I spent the weekend attending a refresher course for AAAHC surveyors. AAAHC (the Accreditation Association for Ambulatory Health Care) is the major accrediting organization for out patient health care facilities. Many of you are familiar with the “Joint Commission” which accredits hospitals. AAAHC serves the same function for outpatient facilities. For many years, I served on the Board of this organization and I still volunteer as a surveyor.

Surveyors are sent out to inspect various types of health care organizations who seek accreditation. An accreditation survey involves and in depth inspection of the facility including the physical plant, the policies and procedures, the medical records as well as a host of related areas.

Every two years, surveyors take recurrent training to keep up with changes in the standards that are set by the organization.

Accreditation is one of the most important ways in which a surgery center such as our can be sure that they are providing the best and safest care possible. Only by having outside inspection can you be sure you are providing top-notch care. We are proud of the fact that we have been continuously accredited for over 15 years, and I am similarly proud to donate my time to help others who are seeking accreditation.

There was one sad note to an otherwise productive weekend. We had great tickets to see the Celine Dion show, only to find it was cancelled when we got there!

Male Chest Enhancement

With all the emphasis on breast augmentation in women, it is easy to overlook the fact that men also are candidates for chest enhancement. Men, in increasing numbers, are choosing to have implants to build up the pectoral area of the chest. There are similarities between the operation as performed on men and women in that in both cases, an implant is placed beneath the pectoral muscle under endoscopic control. A tiny incision is made in the armpit and a pocket is developed under the muscle. A telescope is inserted allowing precise dissection of the implant pocket.

Pec Implants

Unlike the female breast operation, the implant used in men is made of a soft but solid silicone rubber. The implant is placed beneath the muscle and positioned after which the incision is closed. Since the implant is made of solid rubber, there is no risk of leakage. Scar tissue contracture is also not a problem as can be the case in women. Most men find the operation relatively easy to undergo and typically patients are back to normal activity within a few days.

Are You a Candidate for Cosmetic Surgery?
Steve Peterson, D.O.
Cosmetic Surgical Fellow

Cosmetic surgery is becoming more acceptable in today’s society. You yourself may have thought about improving a certain aspect of your appearance. Whether this is taking the small hump off your nose, increasing your breast size, improving your body contour or trying to turn back the clock of time.

The main reason cosmetic surgery has become so acceptable is that many people are doing it for the right reason (what is that?). People are not having surgery because of vanity, but are trying to enhance their outward appearance to feel better about themselves.

If you are considering cosmetic surgery you need to ponder an important question, and if you have the right motivation for the answer.

Why do I want surgery?
” I could get that job…”
“I could find someone to love me and get married.”
“I want to improve my self-esteem and look how I feel.”

It is essential that a person understands that cosmetic surgery will not change the way you are accepted, however it may help you project a different outward personality and build your self-esteem.

Realistic goals are another key component when considering cosmetic surgery. It is important that you understand that everyone is different in size, shape and symmetry. This is normal. Some patients who have unrealistic goals my bring in pictures of models and say, “I want her nose.” Others may bring in a picture of themselves from 20 years ago and say, “I want to look like this again.” Surgery will not make you “perfect” and your body will help dictate what type of results you will have. In fact, your normal body asymmetry will often be pointed out to you before surgery because after surgery many patients develop a hyper critical eye on how they look and may have concerns about their normal imperfections or asymmetries.

Therefore if you are asking “Am I a candidate?” Remember, as with anything, there are limitations and your personal expectations will influence how you view your outcome. Someone who matches their expectations with their surgeon’s advice and recommendations along with the capabilities of the procedure will likely be very satisfied.

That’s it for this month. We appreciate your interest and welcome your suggestions.
That’s it for this month. As always, we appreciate your feed back.


Howard A. Tobin, M.D., F. A. C. S.

For general information: askdena@newlook.org or n41gt@newlook.org