Vol. 5, No. 6- August 2008

Welcome to our August Newsline.

Welcome to our August Newsline. It’s been a while since our last edition and I hope you missed us. As usual, things have been quite busy around here and we just haven’t had the time to write.

We hate to brag, but…

best award
Dr. Tobin and the Facial Plastic & Cosmetic Surgical Center were recently voted Number One Cosmetic Surgeon in Readers Choice of the Abilene Reporter News. The selection is based on unsolicited nominations and votes by readers of the newspaper. We want to thank all of our patients and friends who wrote in to the paper in support of us. We appreciate it and will try to live up to the honor.

Welcome to Dr. Rouleau

Chris RouleauAs of July 1st, a new Cosmetic Surgical Fellow has joined the staff. Dr. Christian F. Rouleau, DMD, MD was born and raised near Trois-Rivieres, Quebec, Canada. He graduated from college in Trois-Rivieres in 1993 and graduated from Dental School at Laval University in Quebec City, Canada in 1997. He practiced General Dentistry for 5 years in the Canadian Military Forces, until 2002. He then left the Military to specialize in Oral and Maxillofacial Surgery at Harvard/Massachusetts General Hospital in Boston, MA. He graduated from Harvard Medical School in 2005 and the arvard/Massachusetts General Hospital Oral and Maxillofacial Surgery residency program in June 2008. His other interests include flying, traveling, fishing, hunting and nautical sports.

Chris has already made a hit with our staff and patients, and we are sure that all of you who meet him will agree. Our former Fellow, Dr. Victoria Karlinsky, has returned to New York to enter private practice. We wish her well in her career.

Dr. Tobin Authors Book Chapter

fp clinics coverA recent edition of the popular textbook, FACIAL PLASTIC SURGERY CLINICS OF NORTH AMERICA was dedicated to topics related to dealing with difficult patients. Dr. Tobin was quite honored by being invited to write the lead chapter in this book. He was not selected because the editor felt that we had so many difficult patients, but rather because our Center is well known for our efforts to do whatever is necessary to please our patients from the time they first come in for consultation until after their surgery is complete.

Based on his experience developed through over 35 years of practicing in Cosmetic Surgery, the article describes techniques developed at the Facial Plastic & Cosmetic Surgery Center in Abilene which help to promote patient satisfaction. While geared toward practicing surgeons, we feel that our patients will also benefit from reading this article.

Recovery After Anesthesia Has Just Gotten Easier

No question about it, one of the most unpleasant consequences of general anesthesia is the nausea and vomiting that patients sometime experience after undergoing surgery. This has been a major concern for us as well and for the past five years we have been fine tuning our procedures to minimize this disagreeable occurrence. Unfortunately, this is a widely recognized problem in all surgery centers and is impossible to eliminate entirely.

We had begun our study five years ago, with a study that indicated that more than 7% of our patients experienced nausea and/or vomiting after undergoing surgery. In other words, out of one hundred patients we would operate on, at least seven would feel nauseated and vomit after they woke up. Our goal was to reduce this incidence to below 5%

Currently, we break down our patients into risk categories: depending on their history of nausea and vomiting with prior anesthesia; history of motion sickness; patient’s medical history such as reflux disease, diabetes, and obesity as well as the length of the surgery. Based on the information the patients provide us with, we give them a certain number of points. The higher the score, the more risk the patient has to experience nausea and vomiting after surgery.

We then use a number of medications in different combinations to minimize this risk. During our last review of the data we have collected, our overall risk for nausea and vomiting after general anesthesia has fallen down to 4%.

We will continue to investigate in order to improve our outcome. Our goal is to ensure that no one has to suffer with nausea and or vomiting after undergoing elective surgery at our center.

JetaJeta is growing up

In our last edition of the Newsline, we introduced you to Jeta, our new Doberman pup. At age 10 months, Jeta is already nearly full grown at 67 pounds, but still has a wonderful puppy spirit. She also has a new best friend. Dena Purvis, our Patient Coordinator, has a Rat Terrier puppy named Addie. In spite of the difference in size, they have become fast friends, both in the office and at home. When the two of them are together in the office, one never knows what will happen. They are truly a sight to see.

Beware of the “Quick Fix”

We have previously reported our concern with the host of mini-facelift procedures that are being touted. Based on over 35 years experience in facelifting, Dr Tobin has seen an evolution in technique which has occurred over the years. Early facelifting procedures were very much like the minilifts that are being advertised today. Because of the short duration of effect, more comprehensive procedures were developed. The complexity of these newer procedures make the surgery more difficult to learn, but, in the hands of experienced surgeons, offer longer lasting and more natural results. With the advent of mass marketing in cosmetic surgery, it is not surprising that entrepreneurial individuals have begun mass marketing franchised simplistic approaches to the surgery. These companies don’t want you to know about the large number of consumer complaints that have arisen from these procedures.

An example is the so called “Lifestyle Lift” The website www.infomercialscams.com reported close to 100 complaints by consumers about the procedure. In an effort to suppress this information, Lifestyle Lift entered a lawsuit against the website – a suit that seems totally frivolous. Another website, www.realself.com reported that 60% of Lifestyle Lift patients felt the procedure was not worth the money.

All in all, it seems to confirm that a “quick fix” is not usually the best answer in cosmetic surgery. At an average cost of over $5,000, it can’t even be considered a bargain.

That’s all for now. As always, your comments and suggestions are welcome. Let us know if there is a topic you would like us to cover.


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

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