Feb 09 vol 8 #1

Welcome to our February Newsline.

Welcome to our February Newsline. We hope that all of you had a happy Holiday Season. I’m sure everyone is looking forward to a brighter New Year. While the entire country is seeing the effects of the poor economy, fortunately those of us in Texas are being spared the worst of the recession. At least in Abilene, the general economy remains fairly strong.

Surgery financing is still available

Quite a few of our patients depend on financing to pay for their surgery. We are pleased to note that the companies that provide financing for our patients seem to be in good shape, and financing remains available for our patients. Lower interest rates may also make this a good time to consider surgery.

Love is in the Air

Valentine’s Day is coming fast and how better to show the one you love how much you appreciate them than by giving them a gift of pure indulgence.


At the Facial Plastic & Cosmetic Surgical Center, we offer many ways to indulge and make one feel better about their appearance. Restylane, Perlane and microdroplet silicone injections can be used to fill lines and wrinkles or plump up thin lips. Neova is a home use glycolic skin care program used to freshen one’s appearance. Botox is used to diminish lines and wrinkles caused by facial expression. In addition to the above, another option which has become quite popular is light chemical peels. In this procedure, Dr. Tobin applies Trichloracetic acid (TCA) to the face which then (over a period of 3-5 days) peels away the rough, dry, discolored layers leaving the skin much smoother with a more even tone.

Whatever you or your Valentine choose, the results are sure to give them a boost for many months to come.

Individual gift certificates are available and can be purchased via phone or email.

Call or email: 1-800-592-4533 askdena@newlook.org

New Domain for our Website

InternetFor years, our website www.newlook.org has been a popular source of information about cosmetic surgery. We receive as many as 9000 hits per day on the website. We have tried to make this a good source of fair and unbiased information about surgery and have avoided making it a promotional source. In line with our goal of making this site educational, we feel that the designation newlook.org is more in fitting with our philosophy.

While there will be no change in the content of the site, we will now become www.newlook.org . With the new identity, our email addresses will also change to the newlook.org identity.

The following addresses will be used.

Dr. Tobin drtobin@newlook.org

Dena Purvis – Patient Coordinator askdena@newlook.org

Sandy Smith – Secretary and Fellowship Coordinator – sandysmith@newlook.org

We hope you will make note of these changes. The old addresses should work for at least the next few months.


Many options in breast lifting

While breast enlargement remains among the most popular procedures carried out at our Center, many of our patients seeking breast enhancement are primarily concerned with lifting and may or may not desire increased volume. The medical term for breast lifting is mastopexy, and this is a very common procedure. The decision as to exactly what is done, however, can be a bit complex.

Quite often, patients who are concerned about sagging of the breasts come to us with the notion that by simply inserting implants, the filling effect will eliminate the sag. In some cases, this may be true. Women who have lost volume as a result of childbirth, nursing or weight loss may find that by replacing that volume, their breasts are restored to their natural shape. This option is particularly useful for women whose nipples have not settled below the level of the fold beneath the breast.

In cases where significant nipple settling has occurred, some form of surgical lifting will be indicated. In most cases, this will be combined with breast implants. When we combine these two procedures, we still insert the implants endoscopically through a small armpit incision. We do this because we want to keep the two surgical sites isolated to reduce the risk of implant infection. While many surgeons recommend staging these procedures, our experience has shown that both are complementary and benefit from being performed simultaneously.

The reason implants are so often combined with mastopexy is explained by the fact that a breast lift alone has the effect of decreasing the apparent volume of the breast. Even though no breast tissue is removed, the tightening effect will appear to decrease the volume, usually by about a cup size.

In its simplest form, one can think of a mastopexy as a form of skin tightening. Actually, the full thickness of the skin is not removed. Rather, we remove only the outer layer of the skin, the so called “epidermis.” The deeper layer of the skin – the “dermis” is preserved since this relatively fibrous layer increases the support of the lift.

The amount of skin removed determines the nature of the incision and the resulting scars. The least invasive form of mastopexy requires only an incision around the areola. There are no incisions made in the lower part of the breast, as is the case with most other techniques. The disadvantage of this technique is that there is more likelihood of an irregular scar and more persistent fullness in the lower breast. We find this technique most useful in patients who wish to combine lifting with significant enlargement.

Other techniques of mastopexy require an additional incision running vertically down from the nipple and an incision in the fold under the breast. Most surgeons use what is often referred to as an anchor shaped incision. We usually prefer one single incision that curves down and laterally in the fold. This technique is called a “b mastopexy.” Additional information about the surgery can be found on our website through this link: breast elevation/breast lift surgery .

In recent years, we have been frequently combining breast reduction with augmentation. We find that in women with more severe forms of breast ptosis or drooping, we obtain a much stronger and longer lasting lift by removing some of the dependent breast tissue and replacing it with an implant. While it does involve a bit more surgery, the improved results make it a much more appealing option for many patients.

If and when patients note some additional sagging following these procedures, it is usually not necessary to completely redo the operation. Often a simple tuck up can restore the lift achieved by the original operation. We discussed this in our last Newsline which can be referenced here Secondary Breast Tuck .

Breast lifting is a popular option, but with so many variations, in depth consultation is required to help our patients achieve the best possible result. Time is required after surgery for final settling, and patients must understand that the desired result will not be achieved overnight. While not an operation to be taken lightly, the results are satisfactory to most patients who choose these procedures.

Dr. Tobin re-certified as Accreditation Surveyor

For many years, Dr. Tobin as served as a voluntary Accreditation Surveyor for The Accreditation Association for Ambulatory Health Care (AAAHC). This is the nation’s largest accreditation organization serving ambulatory health care, accrediting over 3800 facilities.

What makes this organization unique is that it uses practicing health care professionals to perform the accreditation survey. Surveyors are experienced volunteer medical practitioners who bring a professional “real world” understanding to the process that permits more flexibility in implementing any recommendations. Accreditation from AAAHC ensures that ambulatory care centers adopt the best practices in health care and comply with nationally-recognized standards. Our Center has been accredited for over 20 years.

Recently, Dr. Tobin completed a Re-Training program to insure that he remained up to date on the standards that are applied by the organization during the survey process. In addition to providing valuable information used while surveying other sugery centers, this helps to insure that our facility remains in full compliance of the standards. This, in turn, helps our patients feel confident that we are fully committed to the safety of each and all who choose us for their surgery.

That’s it for now. As always, we appreciate your comments and feed back, and remember: www.newlook.org is now www.newlook.org .


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

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