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Phyician's vocation is also avocation

Article-Phyician's vocation is also avocation

Dr. Zins, Chairman of the department of plastic surgery, administers an injection of Botox (Allergan).
James E. Zins, M.D., chairman of the department of plastic surgery, the Cleveland Clinic Foundation (CCF), Cleveland, always has to be on his professional toes. As an academician, he is constantly challenged by inquisitive plastic surgery residents and fellows at the CCF.

Dr. Zins, who also calls his profession his hobby, might even be charged to ponder the profession at home. His wife, Cynthia A. Kavouksorian, M.D., is also a plastic surgeon.

But Dr. Zins says that is how he likes it.

"I think training the future generation of plastic surgeons is an extremely important job for us," he says. "It also keeps the people doing the educating young and forces us to stay abreast of all new and evolving areas of plastic surgery. Residents are very inquisitive, and they do not let you fall behind."

In the beginning

Dr. Zins has been on the CCF team since 1983, starting as staff surgeon in the department of plastic and reconstructive surgery, accepting the role of chairman in 1992 and as professor in the department of surgery in 2003.

Today, Dr. Zins and colleagues at the CCF run an independent plastic surgery residency and aesthetic surgery fellowship.

"We take two fellows every year, which is somewhat unique," he says. "There are not too many aesthetic surgery fellowships in the country."

While he is immersed in academia, he also has a busy aesthetic plastic surgery practice. He finds the constantly evolving field exciting and challenging.

"There is very little that I do today that I was specifically trained to do when I was a resident," Dr. Zins says. "Cosmetic surgery has totally changed, becoming more sophisticated and widespread. Just think about things including myocutaneous flaps, muscular cutaneous flaps, free tissue transfers. The evolution toward minimally invasive surgery is new. The field is evolving daily."

Facial aesthetic specialty

Dr. Zins concentrates in private practice on facial aesthetic surgery and publishes frequently on such topics.

In a study published in May 2005, he reported on a study of the anterior-only approach to neck rejuvenation as an alternative to facelift surgery. Surgeons make the incision for the procedure in the chin, then perform liposuction through the incision.

Dr. Zins performs platysmaplasty in patients with muscle laxity, or subplatysmal fat postauricular stab incision in those patients with significant skin excess; then, if indicated, he inserts a chin implant through a submental incision.

In the paper, he reported that young patients with minimal subplatysmal fat can be treated by liposuction alone, while patients with subplatysmal fat and mild or moderate skin or muscle laxity are best off with platysmaplasty and submental lipectomy. Patients with severe skin laxity are best candidates for skin excisional procedures.

"I think it is an operation which is excellent for patients who want to change a profile only, and it is a much smaller operation than a traditional facelift. For the properly informed patients — one who is not expecting the results of a full facelift — it is an excellent operation," he says.

Own greatest critic

His own greatest critic, Dr. Zins wrote in the introduction for the the CCF department of plastic surgery's recently published 2005 outcomes in the areas of facelift, necklift through chin incision only as well as use of continuous infusion pain pumps and autologous platelet-rich plasma: "Only by objective analysis and critical review of our clinical efforts can we fairly judge our results and be certain we are on the right path."

Dr. Zins says that even as a child he was interested in science and biology.

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