Another request for dermatology consult.  I even told Dr. May the type of
instrument used to determine elasticity of the skin. Please note this was back
in 1998.  In a recent issue of Aesthetic Surgery Journal, the CUTOMETER is used
for this type of evaluation after laser resurfacing.. and they make it sound
as if it is something new.  Is isn't.  It is a simple vacuum device.
 ______________________________________
November 4, 1998

James W. May, Jr., M.D.
Massachusetts General Hospital
Dept. of Plastic Surgery
Fruit Street
Boston, MA  02114

Dear Dr. May,

I am writing to you to ask for your help.  I appreciate the time that everyone at MGH has taken to assist me through my difficulties with the results of my surgery.  If my attitude has been less than civil at times, it is only due to  my frustration in dealing  with this situation on a daily basis and receiving  no real explanation as to why the condition exists and what has caused it.
   
I have seen four surgeons outside MGH, all with different opinions as to what  can be
done to make an improvement, but until I am comfortable with the fact that my  skin has not sustained any permanent damage from the use of tumescent  anesthesia injected under pressure with the further insult to that tissue from the  post-rhinoplasty swelling, I do not have sufficient information to make a  decision in regard to further surgery.  I know that Dr. Feldman does not use the  tumescent technique in his facelifts, and I still have not found a surgeon who  does.  I am aware that almost all surgeons use large volumes of anesthesia in  facelifts, but that is quite different from the technique used in my procedure.  Please consult my operative report.

Would it be possible for you to arrange for me to be seen by the Dermatology  Dept. at MGH?  I am sure they must have some kind of diagnostics to assess the  condition of the involved areas and compare them with the unaffected skin.  I  believe there is a piece of equipment called a CUTOMETER that determines skin  elasticity.

I spoke with Dr. Courtiss a few days ago and asked him if he received any of  the letters and photos I have been sending him since April 2.  He said he had,  but evidently did not think they warranted a reply.  He refused to see me in  the clinic and told me to take up any further concerns with you.  I am grateful  to you, Dr. Feldman and Dr. Zigzula for the time you have devoted to me.

I have an appointment to consult with you privately on November 12 and pray  you will have something to offer that will give me a more hopeful outlook for  the future.

Sincerely,

Lucille Iacovelli