Dr. Dowden apparently mailed it to all of his patients, current and former. [Note: This is not an April Fool's joke.]

Not a very subliminal message. Translation:
"Rumors of my retirement are greatly exaggerated. Fear not, loyal patients. Yet should you be hesitating on having me render you more beautiful, tarry no further; else you may find yourself out of luck ... "
I wonder if by this method he'll drum up business and retire in a blaze of cosmetic glory.
This post by John H. Schumann, MD, FACP, originally appeared at GlassHospital. Dr. Schumann is a general internist. His blog, GlassHospital, seeks to bring transparency to medical practice and to improve the patient experience.