Welcome to our January Newsline. We hope that all of our patients and friends enjoy a happy and healthy Holiday Season.

The Internet as a source of Cosmetic Surgery Information

Nearly all of us have come to depend on the internet as a source of instant information on almost every subject. This is also true regarding Cosmetic Surgery. There is indeed a great deal of useful information on the subject, but unfortunately, much of it is quite misleading. Cosmetic Surgery Practice Promotion has become big business. At a meeting in Chicago, many of the vendors present were there to market internet presence. While there is nothing wrong with that in principal, unfortunately, there is no means to insure that the information presented is accurate and not misleading. Two examples come to mind.

Last year, the Attorney General of New York found that the company that was promoting the Lifestyle Facelift was actually responsible for many of the positive reports on the procedure that were being published on the internet. Company employees were assigned to submit glowing reports. Even with this bogus input, the overall response of patients undergoing this procedure was not very positive.

More recently, the SF Weekly News out of San Francisco published an article about a San Francisco Plastic Surgeon using the same techniques. A web search about the Doctor revealed glowing recommendations. Unfortunately few, if any, seemed to be real patient endorsements. To quote the article:

“There’s just one big problem with all of these fantastic reviews directing readers to [Doctor] Rajagopal for medical procedures. It’s impossible to know which of them — if any — were written by actual patients. In fact, some of the reviews appear to be classic cases of what’s commonly referred to as astroturfing — ringing endorsements that look like a groundswell of support when in fact they are being paid for. The practice is named after Astroturf — synthetic carpeting designed to look like real grass.”

For those interested, here’s a link to the complete article: Doctoring the Web – Page 1 – News – San Francisco – SF Weekly The article clearly points out the importance of being critical when depending on information gleaned from the internet.

Fat Injections: Hand rejuvenation and Buttock Augmentation

There continues to be a great deal of interest in fat re injection. It is being used in many areas including the face, breast, buttocks and many other areas. While many surgeons report good results which are long lasting, others find that the fat often absorbs and can prove lumpy or uneven. Only time will tell. We have been quite conservative in our recommendations of this procedure primarily related to our concern regarding it’s longevity.

There are two areas where we are rather upbeat about the procedure. One is for hand rejuvenation and the other is buttock augmentation.

Many women complain about loss of volume in the hands as they age. Bones and veins become more prominent with the loss of supporting soft tissue. Synthetic fillers have been used with fair success. Temporary fillers such as Restylane can be used, but because of absorption, must be repeated. Permanent fillers such as medical grade silicone can be used but require quite a few treatment sessions to be safe and effective. Furthermore, while we have found silicone to be an extremely safe filler when properly used, it is not FDA approved for this purpose.

Fat injections appear to be a worthwhile option for this purpose. While our experience has not allowed us to make any judgement on the long term success, we do feel that the fat is more likely to last in this area than in many other areas of the body. While the example shows a four month followup, we have the impression that the results last much longer in the patients we have treated.

Fat Injection Hands

As we reported in our November 2009 Newsletter, the buttocks also seem to be a very favorable area for fat injections. November 2009 We have now seen patients over a year following injection with continued favorable results. We now feel comfortable recommending this procedure for those who are looking for fuller and more rounded buttocks. Obviously to successfully undergo the treatment the patient must have some excess fat in other areas of the body to serve as a source of fat for transfer.

Reshaping Buttocks

IPL Hair Removal available at the Center
By Dena Purvis, Patient Coordinator and Skin Care Specialist

Imagine… it is now possible to conveniently obtain the ease, beauty and confidence of smooth, hair free skin.

Intense Pulsed Light better known as IPL hair removal technology makes it possible to permanently reduce unwanted body hair, quickly and easily, with proven long-term results.

Each of your hair follicles is in one of 3 stages of growth at any given time. The “active growth” (anagen) phase, “regressive” (catagen) phase, and “resting” (telogen) phase. This treatment is most effective at disabling “actively growing” hairs during treatment. It is during anagen phase that the hair shaft contains the greatest abundance of melanin. This melanin is the target of the laser light. Other hair follicles are in their resting or regressive stages at any given time. The length of the growth cycles also vary slightly by body area.

With this knowledge, it is reasonable to expect that an average treatment program will consist of 3 to 5 sessions scheduled approximately 4-6 weeks apart. It is important to avoid the sun for 4 weeks prior to any IPL treatment because tanned skin can absorb the light keeping it from penetrating the hair follicle. The only restriction following treatment is sun avoidance.

Prices vary depending on the area being treated and are discounted heavily when a package of 5 are paid in advance.
For example:

Upper Lip 125.00 pkg of 5 375.00
Chin 150.00 pkg of 5 500.00
Lip/Chin 250.00 5 750.00

Shown in this photo is a patient who is approximately 28 days after only 2 treatments.

IPL Hair Removal

You can see a remarkable difference in the amount of regrowth he is experiencing. It is my expectation that 3 more sessions will be necessary to complete the treatment. The approximate cost of this treatment is $3000.00 for 5 sessions.

Call 1-800-592-4533 and schedule a complimentary consultation with Dena Purvis, Patient Coordinator and Skin Care Specialist to discuss your interest in hair removal.

Tracy Johnson

In Memory of Tracy Johnson

September 16, we lost our daughter Tracy following a long and difficult battle with triple negative breast cancer. Tracy waged a heroic battle, refusing to allow her illness to keep her from the many activities with which she was involved. In spite of severe pain, she remained vibrant and optimistic until the end.

Tracy was very active in her community of Kingwood, Texas, being a past president of
the Willow Creek PTA and active in the Riverwood Middle School. She served on many different committees and never seemed to turn down a request for help.

Her greatest joy however, and the catalyst for her steadfast involvement were her children. Tracy’s family was the center of her universe and their love and support helped her to fight to the end.

The most amazing thing Tracy shared with so many was her spirit, determination, and courage. Her eyes always sparkled, giving those around her encouragement to get the job done. Tracy taught us to have courage – courage to do the right thing, courage to speak out, and courage to live.

Part of Tracy will live on in her husband, Tracy (yes, that’s right, they are both Tracy) and her children, Tobin, Maddy, and Abby. Part of Tracy will live on in each of us who mourn her loss. To the many of you who have expressed your condolences, Gail and I offer our thanks.

That’s it for now. Again we wish all of our patients and friends a Merry Christmas, Happy Hannukah and a prosperous and healthy New Year.


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

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