Welcome to our November email Update.

Local Abilene Pride

Abilene is justifiably proud of its close relationship with Dyess Air Force Base. Dyess is the home of the B1 bomber that performed so admirably in the war in Iraq. Many of the servicemen from Dyess have been serving overseas both in Iraq as well as Afgahanastan. We have always been pleased to include a number of active duty service people among our patients as well as their families.

We recently received the following email from the husband of one of our patients and they have kindly given us permission to include it in our newsline. We are proud to have been of service!

Dr. Tobin and Crew,

I am currently deployed in support of Operation ENDURING FREEDOM. My wife had breast augmentation and liposuction procedures performed on August 15th. Attached are before and after pictures that she sent me. We could not be happier with the results! Even though it has only been a little over 60 days, the results are magnificent! I am looking forward to seeing the results in-person upon redeployment in December.

Thank you again. You are truly the “King of Saline”

D H Senior Master Sergeant USAF

Are Gel Breast Implants Coming Back?

Recently, a U.S. Food and Drug Administration (FDA) advisory committee voted to recommend approval of silicone gel breast implants for cosmetic use. The panel’s vote to recommend approval followed two days of hearings that included reports on the results of clinical trials conducted by the breast implant manufacturer Inamed and involving 26,000 women who have had the devices implanted. The FDA is not bound by Wednesday’s decision, but often follows the recommendations of its advisory panels. The panel voted 9-6 in favor of the implants.

It will still probably be some time, at least a year or so, before there is any general change in the availability of these devices. Even then, it is likely that most women will still opt for saline devices. Although there is ample evidence that gel implants pose no significant health threat, there is still some uncertainty as to the incidence of leakage. Even when they are released, it will require a number of years to accurately determine the long-term safety.

Women who are considering implant surgery should realize that even if the gel implants prove superior in the long run, it will not be difficult for patients with saline filled devices to have them replaced with gel. As is often the case, it is not always wise to be the first to opt for a brand new technology. This is a lesion that was sadly learned by women in Europe who chose the soybean filled implant and later found that the oil turned rancid.

As always, we will try to keep our patients up to date and fully informed while leaving the final choice up to them. We have now been using saline filled implants for the past 12 years with highly satisfactory results. Weather the advantages of gel prove worthwhile will have to be determined by experience. We will keep an open mind and try to give our patients the information they need to make an intelligent decision.

Nausea after Surgery

In spite of all the advances in general anesthesia, some patients are still faced with the prospect of nausea afterwards. Studies have shown that approximately 10% of patients undergoing general anesthesia experience nausea afterwards. When we first studied our data a year ago, our patients had an 8% incidence of nausea. While we were below the average, we felt we could do better. We set a goal for ourselves to reduce the rate to 5%. Over the past year, our anesthetists and nursing staff have outlined a few changes in our protocols. Last month, our surgical fellow, Dr. Peterson reviewed our data and found that we had reduced the rate to 5.1%. We are close to our goal, but we are striving to reduce the incidence even father.

We have instituted some additional changes based on the data we have accumulated and we are redesigning our study protocols to try a get better information on which patients are likely to experience nausea and what we con do to reduce it.

It is unlikely that we will be able to entirely eliminate this problem but we wanted you to know that we are concerned and doing everything we can to reduce it.

Wedding Bells in the Tobin Family

On October 25, our youngest daughter Jill became Mrs. Jill Rosson. The wedding was celebrated at the beautiful Grace Museum in Abilene. Gail spent countless hours working on the wedding and it was all-worthwhile. We were delighted to have guests from coast to coast, and the party couldn’t have been more fun. The two make a beautiful couple as you can see from the photo. After a honeymoon in Hawaii, Jill and her husband Rob will be living in Dallas.That’s all for now.

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