Welcome to Our February Newsletter. This edition features news from the American Academy of Cosmetic Surgery Annual Meeting held last month in Phoenix, AZ

Former Cosmetic Surgery Center Fellow Elected President of American Academy of Cosmetic Surgery

Dr. Cuzalina & Dr. TobinDr. Angelo Cuzalina, who served as a Cosmetic Surgery Fellow at the Facial Plastic and Cosmetic Surgical Center in 1997 – 1998, was elected President of the American Academy of Cosmetic Surgery for the year 2011. Since completing his Fellowship, Dr Cuzalina has had a distinguished career. He founded and developed Tulsa Surgical Arts in Tulsa, OK which has developed an outstanding reputation not only for the care given to patients but also as a teaching center. In his acceptance speech, Dr. Cuzalina gave credit for his success to the training he received at our Center. Dr. Tobin expressed his great pride in our former Fellow who did such an outstanding job during his training and, since then, in his career development. We know he will provide great leadership to the Academy.

Guest Speaker at Academy Meeting outlines history of Cosmetic Surgery and the Challenges Facing the Specialty

Dr. Gaylon McCollough of Gulf Shores, AL gave an excellent talk about the history of the specialty of Cosmetic Surgery. He emphasized the conflict that has continue regarding the claims of many groups as to who is most qualified to carry out cosmetic surgical procedures, pointing out that many fields have contributed to the specialty.

Dr. McCollough shared his philosophy regarding the future of the cosmetic surgery profession. He emphasized the difference between cosmetic surgery and the newer nonsurgical procedures being touted. He felt that “surgeons should not be promoting or conducting nonsurgical procedures,” emphasizing that injectable treatments do not qualify as surgical procedures. His theme, decidedly, hung around the notion that it is counterproductive for surgical groups to perform nonsurgical procedures.

While, in principal, we agree with Dr. McCullough’s basic tenant that injectables do not qualify as surgical procedures, we do feel that they are a valuable adjunct that deserve a place in a Cosmetic Surgery practice. However, we also agree that, as surgeons, our primary emphasis remains on the core surgical practice upon which our Center was developed.

Another theme in his talk was the matter of using unproven technology on patients. Investigate the effectiveness and efficacy of new technology and products you use, he said, and physicians need to be confident enough to use that new technology on his or her own family if they plan to use it in their practice. “It takes 5 to 7 years for new technology to be proven…”

In this regard, we fully agree. Far too many inexperienced surgeons return from meetings and seminars to try new and unproven procedures. While we are always looking for improvements, it remains a fact that many, if not most, of the new ideas presented in journals and meetings do not pan out in the long run. Nothing ever replaces experience.

FDA Reports Possible Link of Breast Implants to Rare Type of Cancer

The U.S. Food and Drug Administration (FDA) has reported a possible link between breast implants and a rare type of cancer called anaplastic large-cell lymphoma (ALCL). 34 cases of the tumor in women with breast implants have been reported. This is a tiny proportion of the five to ten million women who have had implants. Most of the cases have involved silicone gel implants but seven cases have involved women with saline implants.

Breast Implants

The tumor usually shows itself by the development of a fluid build up outside the implant. Because of this, patients who develop unusual swelling or fluid buildup should have it investigated. The evidence suggests that the kind of ALCL found in conjunction with breast implants is less aggressive and is sometimes treatable by simply removing the implant, the capsule, and collected fluid.

The agency is advising women with breast implants not to change their routine medical care and follow-up. Because the risk for ALCL appears to be very small, the agency believes the weight of evidence “supports a reasonable assurance that FDA-approved breast implants are safe and effective when used as labeled.”

The FDA believes that women with breast implants may have an increased risk of developing ALCL, but also believes any potential risk is extremely low. Due to the rarity of ALCL, the small number of reports, and the incomplete and limited data from these reports, more information is needed to fully understand the possible link between breast implants and ALCL.

Further information is available by following this link to the FDA’s report: FDA report

Cosmetic Surgery continues to gain popularity for a number of reasons:

1. Positive change
Many people are working to a much older age than in earlier times. Also, it seems that people are coming out of retirement to go back to work for various reasons. Although they may be very healthy and in great physical condition, they don’t always look as young as they feel. Cosmetic surgery might actually allow these people to compete on a much more level playing field. Cosmetic surgery can have a profound effect on an individual. It can give them more confidence and a more positive outlook which translates into better job performance.

2. Easily accessible
Although it is not inexpensive, costs do not seem to be rising in cosmetic surgery as they are in other aspects of the medical field. This could very well be attributed to so much competition. It’s not just the CEO of a huge corporation having cosmetic surgery today; the salesperson, secretary, and the maintenance staff are having it as well.

3. Less risk
Another reason cosmetic surgery has gained popularity, is because of the growing number of ambulatory surgical centers. They not only make surgery more affordable, but surgery can be as safe as in a hospital setting. With proper staffing, accreditation and licensure, ambulatory surgical centers can provide top notch medical care to those seeking cosmetic surgery.

4. More Options
So many more options are available. In the past, patients undergoing a face
lift had to be off work for extended periods of time. Today, patients can have smaller less invasive procedures that allow them to be back to work in only a matter of days.

5. Widely accepted
Today, cosmetic surgery is so common, patients don’t worry about being looked upon in a negative way for having this surgery. You no longer have to feel the need to go into hiding. Usually patients are so open about their surgical experience that they are willing to discuss it with not only their close friends and relatives but also other prospective patients who are considering having procedures done. It is not uncommon to have a patient tell me that they would be happy to speak with someone about their surgery if needed.

Infection Prevention Program Updated at The Center

Infection ProtectionHistorically, the infection rate at our surgery center has always been extremely low but, in order to maintain that record, we have chosen to upgrade our current Infection Control Program to include new recommendations from the State of Texas.

Goals of the Infection Prevention Program are to decrease the risk of infection to patients, monitor and control any occurrence of infections and to identify and correct any problems related to infection control practices. This is not new to us as it has been an ongoing practice since the beginning.  All employees at the Facial Plastic & Cosmetic Surgery Center have begun receiving continuing education and training related to infection prevention.  As required, I have participated in indepth training and will now serve as the  program’s Infection Preventionist.

Infection prevention is a top priority for the entire staff of the Facial Plastic & Cosmetic Surgical Center. We strive to provide the best and safest surgical environment for our patients.  The number one way to accomplish this is by preventing problems before they occur. We. at the Center, value you as a patient and are confident that we have been doing everything in our power to make your surgical experience a positive one.  This ongoing training will simply be a constant reminder of why things have to be done a certain way.  All of this is to help to reinforce the importance of patient safety.   If you have any questions regarding our policies or procedures, we will be happy to discuss them you.

Kim McDaniel RN, BSN
Infection Preventionist

Surgery under the Fellowship Training Program

The Facial Plastic & Cosmetic Surgical Center is an approved training center for both the American Academy of Cosmetic Surgery and the American Board of Cosmetic Surgery. Post Graduate Surgical Fellows spend a year of training at the Center. They are fully licensed in the state of Texas.

As their training progresses, Fellows can take on responsibility as primary surgeon for selected patients who choose to have their surgery done under this program. Financial considerations are offered to patients who wish to have surgery done by the Fellows. The reduced fee for the procedure goes into the West Texas Foundation for Surgical Research and Education. It should be emphasized that unless these arrangements have been made in advance, the Fellow’s role in surgery is as an assistant and Dr. Tobin is the primary surgeon. The Fellow performs no primary surgery without the specific request of the patient.

Patients who are interested in considering having their procedure done under the Fellowship program should inform the staff when scheduling their appointment.  Depending on the circumstances, they may be seen initially by Dr. Tobin or by the Fellow, but will always have the opportunity to discuss their interest in surgery with Dr. Tobin before scheduling.  If the patient, after consulting with the Fellow, feels comfortable with the Fellow taking responsibility for their care, they can proceed with scheduling the surgery. On the other hand, in some cases, after consulting with the Fellow, patients may choose not to have their surgery done by the Fellow, but rather by Dr. Tobin.  This is fully recognized by the Fellows who understand that not every patient who considers the program ends up participating.

That’s it for this edition. As always, your suggestions and comments are always welcome.


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

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