Welcome to our September email Update.

Gail and I just returned from a delightful week in Italy. A group of us rented a lovely villa. I had planned on writing this newsletter while away, but frankly the trip was so relaxing that I just couldn’t force myself to get to work on it. Still, it’s great to be back home at work were it not for the pile of mail awaiting me, We stayed in Tuscany and we were favored with some beautiful scenery including some beautiful sunrises as seen here.

Outpatient Surgery Safety

We have long stressed to our patients the importance of having surgery in a properly accredited and licensed surgical facility. As one of the very first cosmetic surgical centers to receive licensure by the Texas Department of Health, we have always had a commitment to providing the safest possible environment for our patients. Accreditation by the Accreditation Association for Ambulatory Health Care (the nation’s pre-eminent accrediting organization for outpatient health care) is further demonstration of this commitment.

Unfortunately, all surgeons do not share this commitment. Many surgeons carry out surgery in what they call Office Operating Rooms, which can be nothing, more than an area in the office designated for surgery. According to a recent article that appeared in the Philadelphia Inquirer, surgery carried out in a doctor’s office was reported to be as much as 10 times riskier than surgery performed in a properly licensed and certified surgical center. The report, which appeared in the September issue of the Archives of Surgery, was based on an analysis of adverse incident reports filed with Florida officials for both ambulatory surgery centers and physicians’ offices over a one-year period from 2001 to 2002.

The researchers found that 66 adverse events occurred per 100,000 procedures performed in offices, compared with 5.3 problems per 100,000 procedures performed in outpatient surgical centers.

Cosmetic surgery boosts self esteem

In an article in the July 17, 2003 Queens Chronicle written by Mary J. Leone, CSW, Researchers have shown that modifying one’s body image through cosmetic surgery can improve a person’s psychological functioning. She reported on a study carried out by the American Society for Aesthetic Plastic Surgery, which followed 105 patients undergoing cosmetic surgery. “The results showed a very significant improvement in the quality of life at six months following surgery compared to the quality of life before surgery. Patients showed a lower score for depression following surgery compared to prior scores before surgery.”

This study, like many others, confirms that physically attractive individuals are seen more favorably than those who are less attractive, and also receive preferential treatment in interpersonal and social situations. This supports the well recognized opinion that improving one’s appearance through cosmetic surgery can often be a positive, healthy self-care strategy, when carried out on appropriate patients.

Dr. Leone reports on one of her patients, a young lady who had developed a complex over the size of her nose. “She was born, of course, with a baby’s nose, but as she grew up, into puberty, her nose began to look extra large compared to those in her class. Her classmates began to make fun of her. She hated herself and became withdrawn. She didn’t want to come out of the house or socialize in public. She suffered many years with this complex throughout high school and early adulthood.” After surgery, “she started to become more self-confident and self-loving. She was able to dive into society more freely without being self-conscious or fearful. She also began to laugh and become less depressed. As her complex lifted, she began the work of loving herself.”

Cases such as these confirm the feeling of most cosmetic surgeons that while beauty may be just skin deep, the benefits of cosmetic surgery are far deeper.

Post-Operative Pain Management

Although cosmetic surgery is an elective procedure, it also comes with post-operative discomfort or pain. One of the first questions a person has during their consultation is “How much pain will I have?” Unfortunately this is a difficult question to answer since different people have their own individual perspective or tolerance of pain. Some patients have informed us that their post-operative course was “No big deal.” While others have stated, “I was in pain for a week.”

Many factors influence the type and degree of post-operative pain a patient may experience. Minor procedures may only produce mild discomfort, which may be controlled with a moderate narcotic or even Tylenol. Many procedures involve a Tumescent anesthesia, which contains a local anesthetic that helps to provide early pain relief. Other surgeries because of their nature will require strong narcotics post-operatively with the addition of a second mode for pain relief.

Some people naturally have an apprehension regarding pain after surgery. Here at the Cosmetic Surgery Center we want your experience to be as pleasant and comfortable as possible. We therefore offer to our patients undergoing abdominoplasty, and other surgeries, a pain pump for post-operative comfort. The pain pump contains a long acting local anesthetic with a catheter placed along the area of surgery. A one-way valve provides the ability to refill the catheter as needed. A flow regulator allows a slow continuous administration of the anesthetic for 2-4 days. Many patients spend the night and will have the pump refilled prior to leaving the Center. Once the pain pump reservoir is empty, the catheter is then simply removed without discomfort during a follow up appointment.

Our goal at the Cosmetic Surgery Center is not only help you achieve your desired aesthetic results, but to also make your experience as comfortable as possible.

And Finally

Again our congratulations to Stephanie Guerrero, Miss Texas USA for 2003. Stephanie is seen here with Dr. Tobin who was one of the judges for the pageant. We wish her the best of luck in her quest for the title of Miss USA.

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