Tribute to My Wife

Dr. Paul S. Howard      “Have your cake and eat it too.” This was the tag line for an advertisement we did several years ago for the Cheesecake Factory menu. As a plastic surgeon, the ad worked fabulously mainly because of the photo of a beautiful blond in a bikini that we highlighted to indicate the quality of my work. The blond “bombshell” was, in fact, one of my patients and not just a random photo from my portfolio of blond models. That blond happens to be my wife of 9 years and she had liposuction as indicated in the advertisement, but over the years (23 total) that she has been my patient she had breast augmentation to great effect, fat injections to her luscious lips and fat to erase other facial manifestations of aging. When I first saw her in consultation at age 21, she had a familial problem with excessive Peri-orbital fat collections. It was unconventional to do blepharoplasty so young, but she was a budding model looking for perfection. Several years later she returned for a breast augmentation. She came to me mainly because I had become locally famous for my endoscopic trans-axillary approach in the early 1990’s. Everything went well and my blond “bombshell” was now a swimsuit model of some repute. Perfect “C” cups were evidently not awesome enough. She also had rippling which was rather common for thin women with textured saline implants and the pre-operative photo of her ripples was in a paper I published on the subject. Silicone was still unavailable so we went with smooth saline implants to increase cup size to a perfect D. Being unmarried at the time, I could only dream about the possibilities yet I must at all costs be professional. During her post-operative examinations her results seem to get better and better. Usually I would have very little to say to attractive patients at consultation. This lady insisted on engaging me in discussions on a wide range of political, scientific, and plastic surgical issues. The dichotomy was intriguing so much that we started to see each other outside the office and married years later.

It seemed that everyone in town knew of our doctor-patient relationship before and after we were married. In fact, there was a covey of older ladies friendly to us, but behind the scenes passed the rumor that Pamela was a reclamation project starting from homely to now beautiful. The point being that if they (the older women) could snag a plastic surgeon they could be transformed into beauties too. I decided not to be the one to tell them that I was good, but as plastic surgeons we rarely perform miracles! Additionally, they had not taken the time to explore her inquisitive and well established intellect. As an English major in college with a minor interest in Astrophysics our discussions, especially with other friends, tilted toward the eclectic. When it came to plastic surgery, its practice, principles, techniques, and economics, she has become a superstar. Although she is a fabulous example of plastic surgery done well, I asked her and she consented to run my private practice. Once she got her feet on the ground, running the busy office was not enough so she dived fully into my non-profit The NewFace Foundation and she coordinated the complex surgical and dental care issues of my large cleft practice. In 2001, she won a $100,000 grant from United Parcel Service awarded to NewFace Foundation to help pay for the extensive orthodontic care for these special children.

Pamela in 1993

Pamela in 1993

Pamela in 2013

Pamela in 2013

As the years passed, we did delicate fat injections to her cheeks and peri-oral areas. She was knee deep in my practice so she began the practice (which she still does today) of attending the ASPS and the ASAPS annual meetings with me. Both to learn more about the administration and marketing of plastic surgery, but also to network with my colleagues in the Dr. Ralph Millard Plastic Surgery Society. She immediately became the go-to person for all things having to do with Ralph Millard. This process was particularly interesting to watch as Millard liked very few of our wives as he tended to compare them to his beautiful wife Barbara. She was a model with the smarts to run Millard’s life for many years. Evidently he saw something in Pamela that reminded him of his beautiful Barbara. The two hit it so well that he proclaimed Pamela “The Queen” and should be the Executive Administrator of Ralph’s non-profit corporations where all Millard trainees (185) are charter members. Plastic surgeons, including myself, are a difficult group to organize; she often talked to Ralph about it in the years before he died in 2011.

One of the major intellectual tenets of the Millard Society is a working knowledge of the Principles of Plastic Surgery that he wrote about and flogged us with as trainees. Very few of us found it comfortable to talk to “the boss” in an easy manner outside the surgical arena. On most occasions on our yearly trips to Miami to discuss Millard Society business, the great, intellectually intimidating man to some of the best plastic surgeons in the world, would engage Pamela in enlightening discussions about his Principles, the Society, and Plastic Surgeon in general. I think I learned more about the great man from his discussions with Pamela than reading his autobiography Saving Faces.

Pamela, Dr. Millard, & Dr. Howard

Pamela, Dr. Millard, & Dr. Howard

After his retirement on one of our visits to Miami, Ralph wrote me a nice thank-you note for visiting and pointedly told me to take good care of “The Queen” as she was the best thing I had making me understand that I had married well and in a father-son sort of sentiment was to take good care of her. I still have that note today.

As time rolled on, the practice of plastic surgery became more and more challenging mainly due to the poor economy and the new phenomenon of non-plastic surgeons elbowing their way into the arena and practicing our specialty without sufficient education or training, but good marketing skills. To answer the threat to everyone’s practice, Pamela became the voice of “Real Plastic Surgeons” especially on the internet. She started with basic books on the internet and quickly was facile with the most complicated internet problems and software. Soon her “The Plastic Truth” website and video were watched, used, and referred to all the way to the hierarchy of our professional societies who believed and tacitly approved of her ideas, but still gave ground to those cosmetic cowboys as some sort of gesture of good will that I think most already regret.

Pamela HowardIn recent years, a few chemical peels and the use of topicals with the occasional fat grafting has the now 44-year-old “Barbie doll” looking half her age. She continues the responsibilities of Practice Manager, marketing director, SEO guru and social media maven. On the side, she continues to run and coordinate the disparate members of the Millard Society which she lovingly likens to “herding cats.”

Going to plastic surgery meetings since 1984, there is a common denominator especially at the Aesthetic Society meetings that entertains both of us every year. Where there are 2000 plastic surgeons, there are 2000 plastic surgical wives all having the benefit of a plastic surgeon for a husband. For many years we thought it almost comical knowing what we know about the intricacies of plastic surgical procedures (Pamela can not only circulate but in a pinch she is a great first assistant). Pamela has noted a recent improvement in the quality of the wife-surgery proudly displayed at the meetings. Every year Pamela still draws the furtive glares of the husbands and the smirks of the wives who figure I have “robbed the cradle” and am probably “jail-bait” thinking the beautiful “Barbie Doll” I’m with every year must have a teenage sister. In many ways it is the ultimate compliment as we stop and talk about plastic surgical issues of the day, Pamela leading the conversation with their husbands trying to keep up with the facile mind on the beautiful blond with the tiny waist and world-class cleavage.

Ralph Millard, one of the most influential plastic surgeons of the 20th Century realized how valuable Pamela was to his legacy The Plastic Truth Video Headerencouraging her at every visit to keep the Millard Society together after he was gone – and this is exactly what Pamela is doing. As a spokesperson for the Millard Society there is none better. She has become an active participant in all things plastic surgery. All that is missing is the active support and active backing of our leadership who seem unable or unwilling to say and/or do the things necessary for those of us in private practice to survive. Pamela has been yelling at every opportunity plastic surgical truths that we all need to embrace if we are to survive in the 21st Century. She will lead the Millard Society into the 21st Century and could help the Aesthetic Industry in the same way; as a plastic surgery patient, as a plastic surgeon’s wife, a Patient Coordinator, Practice Manager, internet web site SEO manager, and the impetus talent behind her website From what I have noticed on her to-do list, she isn’t stopping there holding her promise to Ralph “to continue the efforts of the Millard Society well until after [he is] gone.” Stay tuned . . . . . “The Queen” is still going.


Dear Plastic Surgery Colleagues and Friends:

Little did I know a year ago when I wrote this article, that there would be another operation for Pamela that had nothing to do with Plastic Surgery – or does it?

Many years ago I had the honor of meeting Joseph Murray during his world speaking tour after winning the Nobel Prize. As many of you know, Dr. Murray was not only a great Plastic Surgeon but a gracious man. While in Birmingham, I had to opportunity to talk with him. He was an avid historian and intrigued that I had videotaped a history of UAB and was fluent in all things “Millard.” The time I spent with Dr. Murray discussing Plastic Surgery history, UAB history, and Dr. John Kirklin, with whom I had trained, was unforgettable, and in a lot of ways prophetic. Part of our discussion included Dr. Arnold “Gil” Diethelm who succeeded Kirklin as Chief of Surgery at UAB. Gil Diethelm was not only Chief of Surgery, but one of the world’s preeminent kidney transplant surgeons and the reason why I went from UAB to the University of Miami for Plastic Surgery training.

Dr.Howard, Dr. Fix, & Dr. Murray

Dr. Howard, Dr. Fix, & Dr. Murray


One of Dr. Diethelm’s legacies at UAB was the world-class transplantation unit where Pamela and I will be admitted July 24, 2014. This is the same hospital and the same hallways where I toiled as a general surgery resident under Dr. Diethelm 30 years ago.

Dr. Murray’s story is well-known as a Plastic Surgeon who performed the first kidney transplant. In 1954, our knowledge of the immune system was primordial at best and the subject of Dr. Murray’s research. The best knowledge of the time led Dr. Murray to bypass our lack of knowledge about the immune system and transplant identical twins. Basically, the only real improvement on the surgery that Dr. Murray and his colleagues performed in the early 1950’s is our ability to manipulate the immune system to accept the less than perfect match of identical twins.

What would make a good story is if I married a beautiful woman with B+ blood type with two kidneys and was my genetic match. Evidently, I have become over the years a master of the understatement. Ralph knew and told me as much; that beautiful woman is also a beautiful person willing to offer a gift that no one has the right to ask. Our lives together are fuller than they are apart. Although true, they are just written words until put to the test of life and death.

On July 25, 2014, Pamela and I will experience something rare and wonderful, a true medical miracle of our times at a place where I trained to be a surgeon and was sent to learn our art from Ralph Millard, and will benefit from a procedure worthy of a Nobel Prize given to one of our colleagues, a fellow Plastic Surgeon, Dr. Joseph Murray.

You can never tell me we aren’t the most fortunate people in the world to do what we do – I thank all of you for your thoughts and prayers. Remember, I’m the luckiest guy in the world with a creatinine of over 6.


July 23, 2014


20 thoughts on “Tribute to My Wife

  1. Good luck Pamela and Paul. You are truly special people and I can only believe that your fairytale lives will continue through this upcoming hurdle. Yours will be truly worthy of a Millard disciple.

    Will be thinking of you tomorrow.

    Bless you both.

    Al Aly

  2. Paul and Pamela
    Good luck on your upcoming surgery. You will be in our prayers and hope for a speedy recovery.
    Steve Steinmetz

  3. Prayers for both of you Pam & Paul.

    “Greater love has no one than this, that one lay down his (her) life for his (her) friend/s.” Jn 15:13

    God Bless,
    Mary Lyn Lu

  4. Your family’s prayers will go with you for both you and Pamela. We love you both very much. Aunt LuLu

  5. Pamela and Dr. Howard:I’ve enjoyed working with the two of you over the years. You’re quite a Team! Go TEAM!! Wishing for you a great outcome tomorrow.

  6. Dear Paul and Pamela, We have been following your recent health concerns. We are praying for the best outcome for the surgery for both of you. With love, Ralph and Elizabeth Ann Latham
    July 24, 2014

  7. Best of luck to your and Pamela. I have always admired you and your work since our early days at the McCollough clinic. I pray your surgery goes well and you both recover quickly

  8. Dear Pam and Paul, I’ve known you both long enough to know how sweet and kind you both are. I hope all things go well and you’re both around for a very, very long time. Best always, Cat

  9. Paul,
    Wow, that was a bit of a stunner at the end…Our thoughts are with you on the upcoming surgery and wish both of you a speedy recovery. . As I’ve gotten to know Pamela the last couple of years,I agree completely, she is very special. Best thoughts to both of you.

  10. Pingback: 60 Years Ago this Month a Plastic Surgeon Made History | The Plastic Truth by Pamela Howard

  11. Dear Dr. And Mrs. Howard:
    By now I hope you have recovered well.
    I am a board certified plastic surgeon from Puerto Rico, and member of tha ASPS and ASAPS.
    Bravo! , for your recent article.
    Two years ago I stood up at the executive meeting of the ASAPS and let the attending know that I couldn’t comprehend why the ASPS meetings had an open registration for any medical doctor. At the time, Dr. Evans was the ASPS President stood up and said that because of Illinois laws and statues, the meetings have to be open.
    Following my obsesive compulsive plastic surgeon personality I investigsted further. I would appreciate if you could give me your personal e-mail to discuss thos further, because I’m interested in changing this policy.
    I hope to hear from you soon.
    Roberto J. Méndez M.D.

  12. Just now reading this article. I worked in transplant clinic 1986-1990 and sometimes in Plastic Surgery with Dr V. I was over Dr Diethelm’s clinic and designating labs for transplant patients. Then later worked with Patsy Johnson doing all of your billing in 1993-1995. You are truely a great Plastic Surgeon with lots of success. One day I would love to come and see everyone. I now tattoo 3D Areolas and Nipples for breast cancer patients. Such a rewarding job in helping people. Definitely enjoyed your article!

    • Wow, Carla! Great to hear from you and thank you for your comment! Can you email my office your contact information in case we encounter a patient in need of your services? Thanks! Email:

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