Vol. 3, No. 6 – July 2004

Welcome to our July email update.


Arm lipoWhile many people still think of liposuction as a new procedure, we have been performing this operation for over 25 years and, certainly, progress has been made in the technique. Areas that we never would have dreamed of treating years ago are now very suitable for liposuction thanks to improvements in technique and equipment. As a result, patients in many cases have the option of considering liposuction as an alternative to more invasive surgery. In fact, sometimes liposuction is clearly the best alternative. For example, a patient concerned about a bulging abdomen who has good skin and good muscles would certainly do better with liposuction than a tummy tuck. But often the choice is not so clear-cut.

There are many patients with flabby arms that are seeking help, but unless the deformity is quite severe, few are willing to undergo surgery that leaves a long scar along the inner surface of the upper arm. Liposuction can be a valid alternative, although there is no guarantee that skin shrinkage will be sufficient to provide a totally satisfactory result. The bottom line is that often a compromise needs to be made. In some cases, dissatisfaction may lead to the need for future skin tightening procedures, and although this is not common, it is a possibility that must be kept in mind.

Many patients will avoid a facelift procedure, opting for liposuction, when fullness is more of a problem than skin laxity. In fact, there are a number of options that can be considered as an alternative to facelift including the use of chin or cheekbone implants combined with liposuction.

It all boils down to the question of how much you are willing to go through, what you can afford and what risk you are willing to accept. There is no question that in most cases, the more extensive procedures produce the best results, but that doesn’t mean that a more conservative approach my no be right for you. Only through a thorough consultation with a great deal of study and consideration on your part can you be sure you are making the right decision.


It seems like we are doing a lot of tummy tucks these days! Perhaps it is the summer months that make people pain pumpmore concerned about their shape. There’s no question that tummy tucks can be serious surgery and not the least of the problem is the soreness for the first few days. Fortunately, technology has helped to reduce that problem in the form of the “pain pump.” This is a device that infuses a small measured amount of a long lasting local anesthetic through a small catheter that is left in the wound for a few days after surgery. By numbing up the tissues inside the wound, patients seem to have much less muscle soreness. It really has been quite amazing what a difference it seems to make.

Several models of the device are available but all share the same safeguards that are built in to assure a steady measure dosage of the anesthetic agent without the risk of over medication. We can see an obvious difference in most patients who are up and about the day after surgery. The pain pump is usually left in around three or four days, after which it is no longer needed. Removal of the catheter is a simple pain free process.

While tummy tucks are major procedures, fortunately, in the majority of cases, problems can be avoided. While it does take many months to see the final results, patients are generally very happy with the results in spite of the significant scar that results from the incision. The reduction in post operative pain makes this an even more attractive option for the right patient.


visionPatients who want blepharoplasty and laser vision correction should have the blepharoplasty first, said Newport Beach, Calif., ophthalmic plastic and refractive surgeon Richard Weiss, M.D. in a recent report which appeared in the magazine Cosmetic Surgery Times. Laser vision correction is becoming increasingly popular and many of these patients are also requesting blepharoplasty. While both procedures are generally considered safe, complications can arise from the blepharoplasty which could prove very detrimental to patients who have undergone edition correction. According to Doctor Weiss,”

Another reason for having the blepharoplasty first, according to Doctor Weiss, is related to the fact that blepharoplasty patients often have dryness of the eyes for a period of time after surgery. This dryness could be detrimental to the recovery of patients undergoing vision correction.

No one has yet determined the exact amount of time one should wait following blepharoplasty to undergo vision correction. A good guideline would be to wait until the patient demonstrates normal tearing and when the eyes appear normal with no evidence of swelling. At that time, there should be no difficulty undergoing vision correction surgery.

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


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

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