Vol. 4, No. 8 – December 2005
Welcome to our December Newsline.
Whether it’s Merry Christmas, Happy Hanukkah, or just a pleasant holiday season, we, at the Center, wish joy and good health to all our patients and friends. We hope that your year has been as good as ours, and that next year will be even better!
NO CURE FOR CELLULITE, BUT HOPE SPRINGS ETERNAL
We get an awful lot of inquiries about how to treat cellulite, and unfortunately our response is not too encouraging. The truth of the matter is that no cream or potion has been shown to be effective in reducing or removing cellulite. That certainly hasn’t stopped cosmetic companies from coming up with endless remedies to the tune of millions of dollars. It seems that hardly a week goes by without an ad appearing in the newspaper, usually endorsed by some doctor who claims to have invented a “new formula” that works where others have failed.
Most women have some cellulite, which seems rather unfair, since men never seem to have it. Cellulite is the result of tiny 
collagenous fibers that pull down the skin, much like the buttons in a cushion. While there is no cure for cellulite, there are a number of treatments that may provide at least temporary improvement.
One of the more common treatments is called Endermologie This device was designed in France more than 25 years ago to soften the skin of burn victims. The machine uses suction and rollers to knead the skin. This is one of the most common methods of treatment offered for cellulite, and the temporary improvement that results is probably the result of mild swelling. There has been no documentation of any permanent benefit.
Many of our patients ask if liposuction can benefit cellulite. Unfortunately, the answer is no. As is the case with Endermologie, liposuction produces swelling, which can hide the appearance of cellulite for many months. Years of experience with liposuction have confirmed our belief the cellulite is unchanged by liposuction in spite of the promising early post op appearance of improvement.
The latest in a seemingly unending series of gadgets developed to counteract cellulite is called the Tri-Active-Laser, which combines an Endermologie like suction effect with a low energy – laser and a cooling device. But, at a cost of $135 to $200 per session, even this device only provides temporary relief.
Mesotherapy, an untested and unproven method of injecting an array of chemicals has been previously discussed in our Newsline. Unfortunately, this has proven no more effective than anything else; while exposing the patient to greater risk.
The bottom line: equipment manufacturers, cosmeceutical companies as well as many physicians are making a bundle on cellulite. Often these products and devices can provide temporary relief. Unfortunately patients are often the losers when they expect too much. Too bad that in many cases, the main thing they lose is money!
THE VALUE OF ACCREDITATION
Gail and I just got back from a long weekend in Las Vegas. Vegas is always a fun place to visit and we had an enjoyable time. Neither of us are gamblers, but we enjoy the shows and Gail, especially, enjoys the fine dining. We were there during Rodeo Week and the hotels were filled with lots of colorful characters.
The real purpose of the trip was for me to take my bi-annual re-certification training for my duties as an accreditation surveyor. This is a volunteer activity that I have undertaken for many years. It involves traveling to various surgical centers where I inspect the facility to be sure that they are in compliance with the accreditation standards of the organization.
With so much cosmetic surgery being carried out in private facilities, it is important that patients thoroughly investigate the facility to assure themselves that they are going to have surgery in a safe environment. Accreditation by The Accreditation Association for Ambulatory Health Care (AAAHC) is certainly one of the best ways to confirm that the surgical environment will meet national standards.
THE GIFT OF COSMETIC SURGERY
Without sounding to commercial, we are often asked about how one can give another person a gift of cosmetic surgery. We are always happy to cooperate with this endeavor. When asked, we can prepare a very nice certificate confirming the gift. Of course, it is important to be certain that the one for whom the gift is intended actually wants to undergo the procedure. Using a gift certificate to suggest that someone should have surgery would certainly be inappropriate. When such a gift is given for our services, it is always understood that the prospective patient would have a full consultation before surgery.
Before giving such a gift, be sure that it is something the recipient desires. We will assist you with the rest of the details. A consultation will be scheduled and, if appropriate, the surgery will be scheduled. All fee arrangements will be made with the giver.
For the right person at the right time, the gift of cosmetic surgery can be a wonderful option.
FACIAL LIPOSUCTION
Excess neck and facial fat is very amenable to removal by liposuction. We use very small cannulas that do not require incisions, but are inserted through tiny punctures made behind the ear and under the chin. Swelling and bruising are greatly diminished though the use of “tumescent infiltration,” the injection of a saline solution containing small amounts of adrenaline, to shrink small blood vessels, and lidocaine, a local anesthetic. The procedure can be done under local anesthesia, although most patients prefer to be asleep. The limiting factor is that patients must have adequate skin elasticity to shrink the skin after the fat removal.
Often patients will combine facial liposuction with other procedures such as chin or cheekbone implants, or removal of buccal fat (deep cheek fat) which can be removed through a tiny puncture incision made inside the mouth.
That’s it for this edition. As always your comments and suggestions are always welcome. We will try to address all responses in future Newsline editions.
Sincerely,
Howard A. Tobin, M.D., F. A. C. S.
www.newlook.org
For general information: askdena@newlook.org or n41gt@newlook.org