The Beauty of Experience

The procedures we perform in facial plastic surgery require both art and craft. Experience benefits our patients and helps us improve both our technical skill and artistic judgment. Extensive science is behind the “10,000 hour rule” that it takes that amount of practice to become expert in a given skill. This practice, however, must be “deliberate practice” to develop specific skills, and at least initially, under the supervision of a skilled mentor.
Continue reading “The Beauty of Experience” »

The Larrabee Center Celebrates Veteran’s Day

On this Veteran’s Day we are proud to recognize the military fellows we have trained over the years. We have had especially close relationships to Madigan and Tripler over the decades and have taught residents at both hospitals. Dr. Larrabee trained at Letterman General Hospital in San Francisco and then was Chief of Civic Action and Disaster Relief for the Southern Command in the Panama Canal Zone. He received the Army Commendation medal for that service.

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1992 – 1993 Fellow was Capt. Craig Cupp, MD. He taught in San Diego at the Naval Hospital
2000 – 2001 Fellow was Jennifer Lee Henderson, MD. She taught in Washington DC.
2005 – 2006 Fellow was Scott B. Roofe, MD. He taught at Tripler in Hawaii and is now at Ft. Bragg NC.
2007 – 2008 Fellow was Joseph Shvidler, MD. He taught at Madigan Hospital here in Washington
2014-2015 Fellow was Scott Bevans MAJ, US Army. He is teaching in San Antonio on active duty.

Plastic Surgery in Asian Patients

Seattle is a gateway to the Pacific and the Asian Rim countries.  As a facial plastic surgeon I have worked extensively in Asia performing surgery and on broader educational programs.  In recent years, I have lectured in Hong Kong and mainland China plus performed surgical procedures such as facelifts and cleft lip palate repairs in China. I have been invited by the Chinese University of Hong Kong to be their Distinguished Scholar lecturer for 2016 and also to lecture in Hangzhou, China in the spring of 2016.

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We are proud of our work with cleft children in China and honor Joseph Wong who began these missions. You can read my article to honor Joseph Wong in JAMA Facial Plastic Surgery

The Larrabee Center Is Proud to Support the Local Asian Community

We also support the Asian members of our local community. The Larrabee Center was a major sponsor for the ACRS 40th Anniversary Gala.   The Asian Counseling and Referral Service (ACRS) is a nationally recognized nonprofit organization offering a broad array of human services and behavioral health programs to Asian Pacific Americans in King County. ACRS is the largest multiservice organization serving all the different Asian Pacific American communities – immigrants, refugees and American born – in the Pacific Northwest. This is a wonderful organization and we are proud to support its mission and our good friend and fellow board member Derek Edmonds.

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Serving Seattle’s Asian Community

The Larrabee Center is fortunate to have a large number of Asian patients. We have tailored our skincare program and non-surgical laser treatments to be able to specifically treat Asian skin. We have worked over the years to develop surgical expertise in Asian eyelid surgery and Asian rhinoplasty. Both require different technique than in the average Caucasian patient.  Our surgical experience in Asia and working with Asian surgeons in their own countries has helped refine our understanding of these patients. We will address our specific techniques for Asian eyelids and noses in future blogs.

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Patient photos from China Cleft missions

Dr. Patel in Honduras

facial fracture
Dr. Patel repairing a mandible fracture
Dr. Sapna Patel Our UW Facial Plastic Surgery Fellow for 2015-2016
Dr. Sapna Patel Our UW Facial Plastic Surgery Fellow for 2015-2016

Sapna A. Patel MD, our University of Washington facial plastic surgery fellow for this year, just completed a mission trip to Balfate, Honduras on March 12-20, 2016 at the Hospital Loma de Luz in Balfate, Honduras. Here are some of her insights from that trip as well as some personal impressions about her mission. The model of combining education with surgery and commitment to follow-up is one we have embraced over the years.

Dr. Johnson grabbed my attention, “Hey, can you come see this patient with me? The other attending recommended a lip switch flap for reconstruction.” Imagining an elderly man with squamous cell carcinoma of the lip, my breath was taken away as there sat a petite, young blind girl whose face was consumed by a disease that I had only read about in textbooks, xeroderma pigmentosum.

The Honduran sun had transformed her beautiful face into one consumed by malignancy – a fate predestined despite all the medical and surgical care we could provide. “She wants to touch your hands,” said her caretaker. I slowly approached, as her hands reached out to my fingers, tears rolled down my face. During my ten years of medical training, I had never felt so moved by a patient. The intraoral bleeding from her dehisced excision site was treated with a simple bolster and figure of eight stitch, realizing that less is more for Deleny. Deleny’s story was echoed in every patient we saw, and it outlined the reality of healthcare in Honduras. The town of Balfate is served by missionary doctors and families providing for the local population. Together, they put this city on the map and made the Hospital Loma de Luz a tertiary care center for patients in the region. More impressive than the organization and high standards for patient care was the selfless dedication displayed by the physicians and surgeons on the front lines. For most Hondurans, aside from the hospital in the capital city of Tegucigalpa, no real options exist.

During our week-long mission trip, we performed a variety of cases from maxillomandibular fixation, gold weight placement for eyelid paralysis, scar revision from a machete wound, cleft palate repair, total parotidectomy, complex thyroidectomies, and even a rhinophyma excision. Each case we saw and the surgeries that we performed affirmed my confidence and knowledge in facial plastic and head and neck surgery. The challenges we faced humbled me each time; I had never done a parotidectomy without a facial nerve monitor. We may not have had the sharpest instruments or the best dissector, but each case was done without reservation to provide the best care possible. We planned accordingly and brought down our needed instruments, including arch bars, an eyelid gold weight, and a lacrimal set, providing sub-specialized care to a population that didn’t have access to it elsewhere. At the end of the week, we reviewed each patient’s case, and could rest assured knowing that our sister team from the Eastern Virginia Medical School would be able to provide follow-up in the fall, creating a continuity of care unlike most mission trips.

These missions, combining surgery with education and organized for excellent ongoing care, provide a good model for humanitarian assistance from the developed to less developed world. On our last day in Balfate, we visited the Children’s Center, which like many organizations in the community is run by a missionary family. As we walked through, there she was sitting on her chair, so innocent and welcoming. She touched my hands and hair, and tears filled my eyes yet again. Deleny had not had any further bleeding. She led us to her shoes and motioned for us to come outside with her. We sat in the shaded area on the porch, as she crawled in our arms wanting to listen to music; her sense of touch, smell, and hearing remained, while the rest were consumed by the disease. We may not have cured her cancer, but at age six, her smiling face as she listened to music reminded me that sometimes the smallest things have the greatest impact. While we are proud of what we accomplished, we also recognize that our team members benefited so much from the experience and will be bringing those new insights back to our home practices.

About Us

Over two decades, Larrabee Center has become an internationally recognized center for aesthetic surgery and complementary procedures. Our core strength is the quality of our staff, who all share a passion for excellence. We opened our Aesthetic Center in 2010 to provide the most advanced rejuvenation techniques and products for our patients.

The Surgeon’s Art

Artistry is central to the specialty of facial plastic surgery. The surgeon must first visualize the patient’s desired outcome and then create it. Most surgical training is directed towards the scientific craft of facial plastic surgery, but its art is equally important. We believe the study and practice of the arts train the mind to concentrate and really “see” more deeply. The selection of photography and poetry below demonstrate those connections to the arts through paths taken and new directions explored.

POEMS

Dr. Larrabee trained at Charity Hospital, New Orleans. A poem he wrote was published in The Journal of the American Medical Association (JAMA) after the hospital was closed because of Hurricane Katrina. Dr. Larrabee’s poem “Charity Hospital, New Orleans” describes the experience of training there.  A signed copy is presented at graduation to select surgical residents from Tulane Medical School. Click here to read the poem.

Two more poems published in the Lancet were written during Face to Face missions to aid victims of the war in former Yugoslavia. “Dubrovnik” was written by Dr. Larrabee and given to a friend after experiencing the peace and calm in that area. It has since been published in the Lancet. Click here to read the Poem.

The poem “American Voices” was written for some of the women Dr. Larrabee treated in the Face to Face Domestic Violence program. It was published in The Lancet.  Denise Levertov was Dr. Larrabee’s friend and mentor. Dr Larrabee’s son Gregory had reflux esophagitis, sometimes called colic, which he outgrew but not before inspiring this Lancet poem.

Dr Larrabee came of age in Nebraska, Wyoming, and Utah.  The Lancet poem “On the Road” remembers that mental geography.

Most of the poems in Dr. Larrabee’s Chapter book, Racing the Train, have been published in well known, and some not-so-well-known, literary journals.  The cover design is by his son Shane, who was then in high school.

Dr. Larrabee was inspired at Christmas in 2014 to write this poem. Click here to read the poem.

While at Camp Orkila in Eastsound, WA, Dr. Larrabee was inspired to write this poem. Click here to read his poem on Camp Orkila.

Dr. Larrabee wrote another Christmas poem in 2015. Click here to read the full poem.

In 2008, Dr. Larrabee donated a series of photographs to the Swedish Medical Center Foundation. Click here to read the SMCF’s letter of thanks to Dr. Larrabee.


PHOTOGRAPHS

Dr. Larrabee’s book Roslyn is both a history and a photographic celebration of a small town in Washington – best known as the site of the television show Northern Exposure.  Professional photographer, Robert Adams, called the book “just right.”

The Gobi Desert/China and Lanahou Hospital were cover photographs on the Archives of Otolaryngology – Head and Neck Surgery and the Archives of Pediatrics.  Both were taken on Smile China cleft lip palate missions.

This Chicago River photograph was taken on a break during a meeting of the American Board of Otolaryngology – Head and Neck Surgery.

This cover photograph from the Archives of Otolaryngology- Head and Neck Surgery is a sunset over the Adriatic Sea taken during a Face to Face mission to Croatia.

Many of Dr. Larrabee’s published photos are from his travels to Latin America as a public health physician.

For years, Dr. Larrabee traveled to Alaska to consult with patients and to experience this land.

 

Dr. Larrabee donated a series of photos to the Sweedish Medical Center. One of the donated photos of scenic Kirkland, WA, shown below, was featured on the cover of a medical journal.

Mail0001 (1) Scan10001 Scan10006 Rome fountain Scan10008 Scan10002 Scan10007 kirkland photo by Dr. LarrabeePeru On the Road from  The Lancet Oban, Scotland MLK Spindrift London Station Lancet Poem Balkan Wars Lakeview Cemetary Spindrift Lake Union Lake Atitlan, Guatemala Lake Atitalan, GuatemalaIsle of Skye Spindrift Guatemala City Gregory Teanaway French church Face to Face British Museum Dubrovnic during Balkan Wars Lancet Poem Youth and Age New York Wayne F. Larrabee  Morning Flight Alaska in Spindrift The Troll, Fremont Neighbood, Seattle The Intereurban Spindrift Stonehedge Spindrift Photo Silence (France) Sascha Sascha Bristlecone San Juan Islands- Kai Reflux  Gregory Lancet Poem Racing the Train West Wind Review

 

 

 

 

 

Elibrary

Surgical books and Articles


Osteotomy Techniques to Correct Posttraumatic Deviation of the Nasal Pyramid
Click here to read more.


Clefts In China
Click here to read more.


Ptosis Repair and Cosmetic Blepharoplasty
Click here to read more.


The First Composite Face and Maxilla Transplant
Click here to read more.


Computerized Three Dimensional Facial Analysis
Click here to read more.


Facial Analysis for Rhinoplasty
Click here to read more.


Otoplasty
Click here to read more.


Preoperative Facial Analysis
Click here to read more.


Rhinoplasty in the Aging Patient
Click here to read more.


Finite Element Analysis of Skin Deformation

Click here to read more.


Global Burden of Surgical Disease (Co-Authored by Dr. Larrabee)
Click here to read more.


Cleft Craft (Foreword by Dr. Larrabee)
Click here to read more.


Claus Walter- Regensburg Address
Click here to read more.


Dr. Larrabee founded the International Federation of Facial Plastic Surgery Societies (Federation) when he was president of the AAFPRS. In this article, he describes the history of the Federation and how it has developed over the years to become a strong force in the international education of facial plastic surgeons.

Click here to read more.


Joseph Ka Hoi Wong was born in Guangzhou, China, to two loving parents, Hsi Huang and Ching Lam. He came to Canada at the age of 17. He completed his medical degree at the University of Toronto, his residency in otolaryngology at the University of West Ontario, and spent a year in Tokyo, Japan, on a fellowship with the renowned cleft lip and palate surgeon Takuya Onizuka, MD. Joe later established a busy and respected private practice in facial plastic surgery and continued throughout his career to be active in academic teaching.

Click here to read more.

Poems, Photographs, and Essays

Christmas 2015

Click here to read more.


Camp Orkila

Click here to read more.


Christmas 2014

Click here to read more.


Racing the Train

Click here to read more.


Charity Hospital
Click here to read more.


Roslyn
Click here to read more.


3 Poems from Duckbush Journal
Click here to read more.


Camp Orkila Poem
Click here to read more.


Domestic Violence King County Bulletin by Dr. Larrabee
Click here to read more.


Dubrovnic during Balkan Wars Lancet Poem by Dr. Larrabee
Click here to read more.


Foreword to Cleft Care by Dr. Larrabee
Click here to read more.


Lancet Poem Balkan Wars
Click here to read more.


On the Road from The Lancet
Click here to read more.


Racing the Train West Wind Review
Click here to read more.


Reflux Gregory Lancet Poem
Click here to read more.


Sascha Bristlecone
Click here to read more.


William Carlos Williams Page 1
Click here to read more.


William Carlos Williams Page 2
Click here to read more.


William Carlos Williams Page 3
Click here to read more.

Our Fellowship

Dr. Larrabee believes training the next generation is a core mission of our Center.  The obligation to teach those who will care for patients in the future has been recognized since Hippocrates.  Dr. Larrabee directs the University of Washington Fellowship in facial plastic surgery.  The fellows have already completed their residency training and work as junior faculty and teachers at Harborview Medical Center, Children’s Hospital, the UW Medical Center, the VA Hospital and the Larrabee Center.  We have one of the most competitive fellowships in the country and are proud of our graduates who have gone on to great careers in academia, the military, and private practice.

We are also proud to have educated many surgeons from around the globe who came to observe and learn our techniques.

We welcome the opportunity to follow their success both personally and professionally!

1987 – 1988 Fellow was Donna J. Millay, MD

1988 – 1989 Fellow was Robert F. Nemeroff, MD

1989 -1990 Fellow was Deam M. Toriumi, MD

1990 – 1991 Fellow was Douglas J. Kibblewhite, MD

1991 – 1992 Fellow was Brock D. Ridenour, MD

1992 – 1993 Fellow was Capt. Craig Cupp, MD

1993 – 1994 Fellow was David A Sherris, MD

1994 – 1995 Fellow was Gary Nishioka, MD, DMD

1995 – 1996 Fellow was Raffi Der Sarkissian, MD, FACS

1996 – 1997 Fellow was Maurice M. Khosh, MD

1997 – 1998 Fellow was Neal D. Goldman, MD

1998 – 1999 Fellow was Rudolph J. Triana, MD

1999 – 2000 Fellow was Henri P. Gaboriau, MD

2000 – 2001 Fellow was Jennifer Lee Henderson, MD

2001 – 2002 Fellow was Sam Peyvan Most, MD

2002 – 2003 Fellow was Stella Desyatnikova, MD

2003 – 2004 Fellow was Carlo P. Honrado, MD

2004 – 2005 Fellow was Dewayne T Bradley, MD

2005 – 2006 Fellow was Scott B. Roofe, MD

2005-2006 Fellow was Bryan Thomas Ambro, MD

2006 – 2007 Fellow was Holger G. Gassner, MD

2006-2007 Fellow was Amir A. Rafii, MD

2007 – 2008 Fellow was Toby Pincock, MD

2007 – 2008 Fellow was Joseph Shvidler, MD

2008 – 2009 Fellow was Amit Bhrany, MD

2008-2009 Fellow was Amar C Suryadevara, MD

2010-2011 Fellow was Richard Zoumalan, MD

2011- 2012 Fellow was Richard J. Wright, MD

2012 – 2013 Fellow was Cody A Koch, MD

2013 – 2014 Fellow was Farhad Ardeshirpour, MD

2014-2015 Fellow was Scott Bevans MAJ, US Army.  He is active duty, will follow our year with a year of head and neck reconstruction at the UW.  He will then return to the military to teach at one of their major hospitals and perform trauma and reconstructive surgery for our military members.

2015-2016 Fellow is Sapna Patel.  She graduated from the UW program and is seeking a University position where she can perform both reconstruction and cosmetic surgery as well as teach residents.

Visiting International Surgeons  – Observerships

Tuan Pham – Perth, Australia

Lucas Patrocinio – Uberlandia, Brazil

Sun Y – Hangxhou, China

In The Media

Dr. Larrabee has been most recognized for his surgical skills and innovative techniques. His three surgical books for surgeons have been widely used and are currently going into new and updated editions. Surgical Anatomy of the Face describes the scientific basis for much of his aging face and rhinoplasty surgery.

Principles of Facial Reconstruction is widely used by surgeons around the globe and introduced his innovative “Note Flap” and “Triangular Fixation Suture.” The Art and Craft of Facial Rejuvenation describes his current techniques for both surgical and non-surgical facial rejuvenation, focusing on eyelid and facelift procedures.

PUBLICATIONS

Dr. Larrabee founded JAMA Facial Plastic Surgery and served as its Editor in Chief for over 15 years. It is now the preeminent facial plastic surgery journal in the world. He has stepped down as its Editor in Chief to focus more on his children and the Larrabee Center for Plastic Surgery in both its Seattle and London sites. Click here to read more.

The commitment of Joe Wong to the children of China was essential to the many cleft missions he organized. Please see my memorial comments to his life of public service.

Dr. Larrabee has been recognized by the editors of Town and Country over the years. Click here to view his 2014 profile, or click here to view his 1987 profile.

Over the years Dr. Larrabee’s work has been covered by a multitude of publications here in the United States and abroad. Article one, Article two, Article three, Article four, Article five, Article six, Article seven, Article eight (page one, page two).

 


HUMANITARIAN PROGRAMS

Doctor and Patient in SeattleDr. Larrabee began his medical career in public health and has maintained his commitment to pro bono programs, both in the US and abroad. He was one of the founders of the AAFPRS program, Face to Face and, with Regan Thomas, accepted the AMA’s highest public service award for its Domestic Violence program.

Dr. Larrabee continues to work with Face to Face, Seattle Anesthesia Outreach and other programs such as Smile China. He is currently director of Global Surgical Outreach, which sponsors cleft revisions around the globe and has also committed to a long term educational program at the Black Lion Hospital in Addis Ababa, Ethiopia.

The Larrabee Center’s LATISSE® Eyelash Program is a pro bono project dedicated to the treatment of breast cancer survivors.  In collaboration with our medical colleagues at the Swedish Cancer Institute, patients are enrolled into a 16 week program for the restoration of hair loss around the eyes and brow complex. The program has been described as a “bow on top of the gift of the life” that has been provided by the Swedish Oncology teams. We are grateful for the generous contributions from Allergan, Coloratura and Jeri Morgan-Reiner as well as the patients who are so generous in their trust and who inspire us with their strength.

arthursmilechina06 84904-2007 Patients  Rounds 278

Links:

www.globalsurgicaloutreach.org
www.seattleao.org

 


Doctor Larrabee Helps Survivors of Domestic Violence

Click here to read the news article


Dr. Larrabee is Recognized by The Seattle Times for his surgical craft and commitment to the community

Seattle Times Face of Compassion Larrabee

Dr. Larrabee’s craft in both surgery and poetry was noted in Seattle Magazine

Private Eye Seattle Magazine

Dr. Larrabee has been recognized as a strong supporter of women’s health issues for decades

Best Physicians for Women%27s Health

Camp Orkila, Seattle Times

Best Physicians for Women%27s Health

Domestic Violence King County Bulletin

Best Physicians for Women%27s Health

Mr. Tony Bull…Surgeon, Teacher, Visionary, Friend

Best Physicians for Women%27s Health

Northwest Physician Page 1

Best Physicians for Women%27s Health

Northwest Physician page 2

Best Physicians for Women%27s Health

Dr. Larrabee Recognized for Reaching Out to Those in Need.

Best Physicians for Women%27s Health

Innovations

Facial Plastic Surgery Innovations

At Larrabee Center for cosmetic surgery, we’re improving on our specialty all the time by supporting new research, authoring articles and texts, and developing new and innovative surgical techniques.

Our latest publications include:

Analysis of the Upper Face and Selection of Rejuvenation Techniques, article in press in the Facial Plastic Surgery Clinics
Textbook in press: Surgical Anatomy of the Face, 2nd Edition.
Textbook chapter in press: Atlas of Facial Plastic and Reconstructive Surgery, Facelift Chapter.