Welcome to our March email update.


Hopefully, some of you have noticed, and missed, our Newsletter from the past couple of months. One reason was related to the fact that we had sent out a print Newsline in January, but the primary reason related to circumstances quite beyond our control. The company that hosted and managed our website was suddenly and unexpectedly bought out by another company. This occurred without warning and resulted in a major disruption of our service. We are slowly getting the situation back under control and hope to remain on a reasonable schedule of publication in the future.


It seems like a day doesn’t pass that we don’t get a call about these new minifacelifts that depend on sutures to provide lifting. Is it really possible that such a simple procedure can replace a major operation? First of all, lets get something straight. This is not really a new idea. For years, surgeons have attempted to devise ways to elevate tissue and maintain the effect with the use of sutures. Unfortunately, while immediate results seemed impressive, there was no lasting power.

Some of our readers may remember a few years ago when we reported on our early experience with a suture brow lift – a technique that I had learned while visiting in Brazil. We reported on this technique in our March 1999 Update. It consisted of attaching permanent sutures to the brow that were firmly anchored to the scalp. While the initial results were quite pleasing, the long-term benefits were disappointing. Some patients maintained the effect for up to a year, but rarely beyond. We rarely recommend the operation anymore, although in some cases, it can be useful for stabilizing a drooping brow when a patient is undergoing eyelid surgery and wants to prevent further drooping of the brow related to the tightening of the upper lids.

Now, doctors are claiming that by using special micro barbed sutures, they can perform facelifts without surgery. While they may avoid the surgery, they don’t seem to avoid the cost, with fees for the procedure often in the $5000 range. Perusing the internet, I was frankly unable to see much difference in the before and after pictures used to promote the procedure, and those were obviously the best examples the promoting doctors could offer. On top of that, none of them represented any type of long-term effect.

We remain highly skeptical of these claims. While investigation of new principals is always welcome, patients deserve to be aware of when a procedure is being studied and when it is being offered as a tested technique. While complications may be uncommon with these techniques, they do occur. We are aware of infections and disfiguring scars that have resulted from even these very conservative efforts. At the present time, we are unable to recommend these procedures to our patients.

We remain convinced that patients are better off waiting until they are ready for a real facelift rather than wasting time and money on quick cures that are very unlikely to be satisfactory in the long run. While short cuts seem attractive, as in so many cases, they ultimately prove unsatisfactory.


Appearing in a recent issue of The American Journal of Cosmetic Surgery, an article written by former Fellow, Dr. Jon Perenack and Dr. Tobin describes a technique developed by Dr. Tobin and Surgery Center Scrub Tech, Rudy Garza, which uses a tiny endoscope, and a built in laser to release contracted breast implant capsules.

Encapsulation of breast implants remains a significant problem for many women undergoing breast augmentation. This condition can result in pain, distortion of the breast shape as well as an unnatural feel to the breast. Unfortunately there is no absolute prevention of the problem, nor is there any non-surgical means of treatment. When it is not severe, many patients choose to do nothing, but in more advanced cases, surgery is required to correct the problem. Additionally, there is always the possibility of recurrence following successful surgical repair.

The technique developed by Dr. Tobin allows correction through a tiny incision made just beneath the nipple. A small endoscope, or telescope, is inserted which contains a laser and aiming device. The laser is used to cut through the scar tissue and release the contracted implant. Construction of the device provides for protection of the implant during the procedure and does not require removal or deflation, as is often the case with other methods of treatment. The operation is bloodless and allows patients to resume normal activity immediately following the procedure. In most cases, no dressings or drains are required in contrast to more conventional means of treatment.

The complete article can be downloaded in pdf format from our website through the following link:

By: Babak Farzaneh M.D., D.D.S.

Pain is a major cause of apprehension and anxiety in patients contemplating cosmetic surgery. At the Cosmetic Surgery Center, we strive to make your recovery as comfortable as possible.

The pain pump works as an adjunct to our routine post-operative oral pain medications. These pain-relieving devices are offered to our patients to be used after tummy tucks, medial thigh lifts, breast implants and other surgeries. Whenever possible, it is helpful to control pain at its source rather than to rely solely on drugs such as narcotics. A pain pump is a small, portable machine that delivers precisely measured safe dosages of a long lasting numbing medication directly to the surgical site through a very, very small catheter. The catheter is placed during surgery (while you are asleep) and allows the medication to numb the surgical area continuously for a few days after surgery. At your post op visit the catheter is removed without any discomfort. The pain pump is programmed by us and does not require any adjustment by you.

Currently, we are using pain pumps for our abdominoplasty patients, since this procedure seems to be associated with the most significant postoperative pain. Patients have had positive feedback with the use of pain pumps allowing quicker and more pleasant recovery.

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