Bolitho MD

9834 Genesee Ave Ste 311 La Jolla San Diego, California
Phone: (858) 458-5100


25Mar, 2015

Common Reasons Why Women Undergo A Breast Lift

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Woman field Serge Bertasius PhotographyPrior to having cosmetic surgery, it’s important that one researches the procedure they are interested in as well as taking the time to thoughtfully consider the surgery as a whole. For women who consider having a breast lift, many really have done their research and have thought a great deal about it before visiting with a board certified plastic surgeon.

They’ve read content articles on the web and learned about surgery variations in regard to the extent of a lift they very well might need. Inevitably, this leads up to their first consultation.

With that said, there are various reasons why a woman decides to undergo a breast lift. It’s also important to note that there really is not a particular age range for this surgery because it can vary between the ages of thirties to sixties.

However, plastic surgeons will tell their potential patients to have their children first and then their breast lift procedure. It’s not advised to have the surgery if a woman wants to continue building her family.

Once she has had her last child, then that is the optimal time to have the surgery in where redundant skin can be removed and the breasts lifted. Some mothers choose not to have implants, while others may want more projection and volume and request them.

For the most part, however, mothers generally are happy with the lift alone since it does restore a level of volume.

The very next reason a woman may choose this surgery is following significant weight loss.

Weight gain can also occur in the bosom, and after the pounds drop on the scale, volume is lost and sagginess remains. A breast lift can restore this area to a more youthful appearance. The use of implants can also be discussed.

There is also a significant amount of women who have challenges with breast asymmetry in where one breast is larger than the other. For this type of condition, a surgeon will recommend if a lift, breast reduction or breast augmentation is in order. While every patient differs in their needs, sometimes two procedures are recommended such as a breast lift and augmentation to correct the aesthetic issue.

The last reason a woman may consider a breast lift is if she decides to downsize her augmentation. For those who had an augmentation in their earlier years, they may come to the realization that they prefer a smaller implant size which compliments their physique and personal comfort levels.

If a woman changes larger implants for smaller ones, a plastic surgeon will be able to assess whether or not there will be redundant skin following the exchange. If this is the case, then a surgeon will implement a breast lift with the procedure.

A consultation will provide great insight into this procedure regardless of why a woman decides to undergo it. While looking for a surgeon who specializes in this area, do peruse their patient gallery to assess whether or not their skill sets match one’s need for this surgery.

21Mar, 2015

The History of Breast Augmentation

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Think that the first breast augmentation surgery was in the 1980s? Try earlier, and flip a couple numbers to read the 1890s. While breast augmentation is one of the most highly performed cosmetic surgeries both nationally and internationally, doctors have been testing ways to enhance volume for decades.

And, yes, it has come a long way.

Back in the 1890s, paraffin was injected into the bust for enhancement, but this treatment stopped rather quickly after it was discovered that the ingredient was seeping into other areas of the body.

Years later, more specifically in the 1920s and 1930s, doctors tried an “early version” of a fat transfer. They actually extracted fat from parts of the patient’s body and injected it into the breasts. This treatment didn’t have a very long shelf life.

In the 1950s, the introduction of the insertion of sponges, cartilage, polyurethane and even glass balls were utilized to examine what method was best. Out of all of these, the sponges worked well, but the results were not long lasting. The sponges would shrink and become stiff after a period of time.

In 1962, a shift in breast augmentation occurred. Timmie Jean Lindsey, hailing from Houston, Texas, agreed to undergo the surgery using silicone implants. What she originally went into surgery for was to remove tattoos on her breasts and what she got in return was an enhancement from a B to C cup and a gratis otoplasty which she wanted for aesthetic improvement.

In the operating room were Drs. Frank Gerow and Thomas Cronin performing this historical surgery.

Little did anyone know that this two hour procedure would change the way breast augmentation would be done in the future.

For Cronin, the concept really became a reality when he gave his presentation at the 1963 International Society of Plastic Surgeons convention in Washington DC. Those in attendance thought it was remarkable.

And as many say, the rest is history.

Known as medical devices, breast implants have solid silicone shell. Inside them, doctors and patients have a choice whether they prefer a silicone or saline filled implant. Each kind is approved by the FDA.

And since the 1960s, these implants have improved and changed dramatically including these following nuances and features:

  • The shell texture of an implant
  • The projection and profile of an implant
  • The anatomic shape of an implant
  • Diameter of an implant


It’s also important to note that while the U.S. Food and Drug Administration conclude that the silicone-gel implants to be “generally safe,” it is advisable that patients who undergo an enhancement using these medical devices communicate with their surgeons on a frequent basis. Routine postoperative appointments are part of this protocol, and sometimes an MRI may be recommended every few years.

When a woman decides to undergo a surgery such as this, it should never be done in haste. It’s always recommended to have a thorough consultation with a board certified plastic surgeon, discuss the benefits of the procedure, choose the right size of an implant which is proportionate to the body, and touch upon any risks factors.


12Mar, 2015

Virtual Cosmetic Surgery Portal

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Woman by marin

While the popularity of cosmetic surgery continues to climb, a virtual component to it has begun to take shape. No, this is not referring to cell phone apps where one can alter their photos and erase years. Instead, this is actually having a virtual consultation with a board certified plastic surgeon either living in a different state or abroad.

In the United States, there is an array of plastic surgeons which skill sets are specific to specialties. It appears that a new trend is not only locating a top-tier plastic surgeon but finding one that is out of state. For example, a New Yorker may want to flee the bitter cold and come to sunny San Diego during the winter months for a brief vacation and a cosmetic surgery procedure.

Progressive plastic surgeons are affording patients advanced websites where virtual consultations can be done with ease.

For patients it begins with researching a board certified surgeon in a particular state and/or city. Once one has reviewed top doctors listed regionally along with locating any accolades, they can begin to narrow their search more sharply.

Once a person has assessed that they have found a great candidate, it’s suggested they visit their website to ensure there is a virtual consultation feature. Normally on the website, one can download pictures of the area(s) they are interested in cosmetically changing or enhancing. Along with the photos, there is an area where a potential patient can convey their aesthetic wishes.

Following this submission, the plastic surgeon’s patient concierge will step in to help this navigation process. They will be in touch with the individual usually within a 24-hour period.

When the doctor assesses the photos and the patient’s “cosmetic wish list,” it is at that time when a decision is made as to whether or not to proceed with a virtual consultation. This can be done via Skype or even by phone.

During this meeting, the doctor will offer ample time to discuss the procedure in detail while answering any questions one may have. Just like a traditional in-person consultation, it is important for a potential patient to establish a nice rapport with the surgeon. Indeed, this can be done virtually.

Every step of the way, the plastic surgeon’s patient concierge will be by a patient’s side. They will assist with travel and hotel suggestions and arrangements, help coordinate any bloodwork or medical screening, and schedule a nurse to stay with a patient the first night or two after surgery.

While having a nurse isn’t mandatory, it is highly suggested. The nurse will drive the patient back to their hotel suite or other residential choice following the procedure and drive them back to the office for their first preoperative appointment the very next day. The nurse will also serve as the doctor’s primary point of contact after surgery giving the doctor frequent updates.

Listening to the doctor’s suggestions and recommendations, the patient concierge will also be able to give patients a recovery timeline and when it would be best for them to return home.

Additionally, if the patient is traveling with family members who may want to do a little sightseeing, the concierge will ensure they receive information on the top places to visit and dine.

Generally, doctors do like their patients to arrive a few days before the preoperative appointment.

In the digital age, so much has changed for the better. People are now empowered to pick the right plastic surgeon, undergo the cosmetic procedure they always wanted, and combine a mini vacation for themselves and family.

3Mar, 2015

Percentages Increase With Men Seeking Cosmetic Surgery

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Man by ambro

Step aside ladies. Cosmetic treatments and plastic surgery isn’t just for women anymore. Men are not only thinking about procedures, but they are scheduling them, too.

Cosmetic surgery is a personal decision, and something that one should be mindful about. It should not be done in haste. The journey should include consultations with various board certified plastic surgeons to ensure that a candidate is aware of the procedure they are interested in along with the recovery timeframe.

Recent numbers from the American Society for Aesthetic Plastic Surgery (ASPS) shows that approximately 8 percent of cosmetic procedures were performed on men. While that number may not seem large at first glance, it is when this percentage of male patients has increased over 88 percent in the last 10 to 15 years.

Upon closer inspection, more than 1 million men are taking part in surgical and nonsurgical rejuvenation procedures.

The most popular procedures for men are the following:

*Male breast reduction or liposuction for this area

*Body sculpting the waistline

*Rhinoplasty surgery

*Ear tucking surgery

*Eyelid surgery

Interestingly, when men reached a certain age they opted for one of these procedures mentioned.

Typically, men who were in their forties and fifties sought eyelid surgery to rejuvenate their eye contour area. Plastic surgeons removed excess and fatty tissue on the upper eyelids and reversed any bags underneath the eyes.

And rather than scheduling a consultation for a facelift, a consultation with a board certified surgeon often reveals that a minimally invasive lower facelift can improve the signs of jowls and lift the neck.

A quick procedure with relatively short downtime, this surgery defies age.

Younger men chose the male breast reduction, rhinoplasty, ear tucking and body sculpting procedures. They are realizing that not only women are afforded these aesthetic opportunities to look and feel their best. Features they have wanted to change over the years can now be done.

During a consultation, it’s important to remember that top candidates are the following:

  • Those who live a healthy lifestyle
  • Those who do not smoke
  • Those who have realistic aesthetic expectations and goals

Another area not to be overlooked is how men are also scheduling non-operative facial rejuvenation sessions such as Botox and Juvederm. These quick procedures are lessening the appearance of fine lines and wrinkles.

Men who live healthy lifestyles and remain in great shape want to look as young as they feel, and they have every right to do so.

They also want to look younger in corporate America and make a great first impression in a social environment, such as dating.

On the flipside, some husbands are choosing to have a procedure around the same time as their wives. Others are seeing the rejuvenation improvements after their significant other had a surgery which spurs their interest to learn more.

One thing is for certain, men are not inclined to talk about cosmetic surgery like women do; however, it is becoming a topic which is promoting more dialogue than ever before. It’s just a matter of time before this changes, too.

25Feb, 2015

Plastic Surgery Trends Emulate From East To West Coasts

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Happy Attractive Woman and Man Couple In Sunglasses At Beach

A recent article emerged from central New York citing the types of plastic surgery trends which are most apparent today in the world of cosmetic surgery.

Despite the miles between the east and west coasts, plastic surgery trends really are on point for both sides of the nation.

One inference was made which many San Diego plastic surgeons can agree with is that plastic surgery is not just for celebrities. It is available to all people of varying income levels. And what makes it more affordable is cosmetic surgery financing. This viewpoint really reinforces that cosmetic surgery is an investment in oneself.

For starters, majority of patients range from their forties to sixties; however, some patients may have their first visit in their thirties. These women come from all walks of professions including executives, teachers, health care professionals, real estate agents, and more.

Many are coming in to give themselves a youthful boost of self-confidence in the workplace and in a social atmosphere. There is a growing number of men who are following this pathway as well.

People are holding onto their careers longer and want to look their very best by living a healthy lifestyle and pursuing different avenues in plastic surgery.

The advent of liquid facelifts, also referred to as cosmetic injections, is delaying operative facial rejuvenation treatments. The most popular of these on the facial rejuvenation roster are the following:

  • Botox
  • Juvederm
  • Restylane

Both women and men are seeking these injections because they help smooth away fine lines and wrinkles without any downtime. It erases years when someone is in their forties and early fifties while also minimizing premature aging.

The side-effects are minimal bruising which can be camouflaged with makeup. Some even get these treatments during their lunch hour.

Rather than having a full facelift, many patients are welcoming minimally invasive lower facelift procedures where small, discreet incisions are made thereby redefining the jawline and lifting the neck area. Recovery time is very quick and the results are immediate.

Also on the surgical front trend list are mommy makeovers. Why is this so? Women who have completed having their families want the body they had before their days of pregnancy. A mommy makeover does a tremendous job in rejuvenating the breasts and abdomen.

Procedures included in a mommy makeover are a breast lift with or without implants and a tummy tuck. A tummy tuck can also correct the separation of stomach muscles so a woman can regain her abdominal strength.

While a mommy makeover is a comprehensive surgery, the recovery time is really dictated by the tummy tuck. Tummy tucks can either address the abdomen below the navel or below and above the navel. Also included in the procedure can be liposuction.

Generally, the recovery takes a few weeks and women are thrilled with the transformation.

So despite the miles between New York and California, it appears that plastic surgery trends are mirroring one another. The best part of all is both men and women are gratified with the results.

23Feb, 2015

Report Shows Positive Surgical Results For Bodybuilders With Gynecomastia

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Photo from

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The American Society of Plastic and Reconstructive Surgeons’ (ASPS) monthly publication, Plastic and Reconstructive Surgery®, provided some excellent results for bodybuilders who have gynecomastia.

Correcting overdeveloped breasts in men is done via cosmetic surgery and is often referred to as male breast reduction. Between 40 to 60 percent are diagnosed with gynecomastia and can be present in one or both breasts. It exists due to redundant glandular tissue growth or localized fat.

For some bodybuilders, the use of hormone supplements or anabolic steroids can play a role in gynecomastia.

Plastic surgeon and ASPS member, Dr .Mordcai Blau, and Dr. Ron Hazani co-authored this piece.

In the article, it highlights how Dr. Blau is considered an expert in breast reduction in men, having performed almost 1,600 surgeries for bodybuilders or other men in excellent physical condition.

The report highlighted more than 1,000 patients, ranging from 18 to 51 years old, had the surgery one to five years ago.

The men in the report did not have any indication of a disease which causes gynecomastia and were void of a hormonal disease. Gynecomastia is also caused by those who are overweight, too.

Rather than removing fat, the technique is different for bodybuilders.

The report states, “In contrast to other groups of gynecomastia patients, who tend to be overweight or obese, bodybuilders usually don’t need removal of excess fat or skin. It continues, “However, they do need special attention to prevent bleeding and scarring. Bleeding risk is higher because of increased blood flow in the highly developed chest muscles. Steroids and unregulated supplements including protein shakes, vitamins, and fish oils may also increase bleeding risk.”

In his report and analysis, Dr. Blau pointed out that bodybuilders are perfectionists in terms of body and structure. So the outcome and expectations of the surgery are quite high.

With that said, Dr. Blau shared how he performs the surgery through a mere one-inch incision, and the incision is located underneath the areola.

The report goes on to say how, “Dr. Blau highlights the need for complete removal of all breast gland tissue. After surgery, pathology reports usually show excessive development (hypertrophy) of the gland tissue, although a few patients had precancerous cells.”

According to Dr. Blau, most of his bodybuilding patients were “extremely satisfied” with the surgical outcome.

Dr. Blau also shared that the, “…vast majority of patients continued to use anabolic steroids. Because the gland was completely removed, there were no problems with recurrent gynecomastia.”

While every surgery has its own share of side effects for this particular procedure, complications were minor and infrequent. Only six percent experienced hematomas.

The article noted, “…these problems became less common after he [Dr. Blau] began providing stricter instructions regarding preoperative and postoperative care: stopping all use of steroids and supplements before surgery, and resuming exercise gradually after surgery.”

The article concluded that board certified plastic surgeons may begin to notice a surge in breast reduction surgery among male bodybuilders.


13Feb, 2015

Recovery Time for a Mommy Makeover Varies

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Woman  federico stevanin

When a woman completes her family and has given birth to her last child, she may begin to think of a rejuvenation surgery for her body. For many females, undergoing pregnancy can take a bodily toll on her abdomen and breasts.

While the numbers may drop on the scale, the excess skin generally remains and cannot return to its natural position. It’s all part of pregnancy.

The great news is that a rejuvenation procedure called a mommy makeover can help restore a woman’s body back to her pre-pregnancy days. While the procedure undoubtedly provides wonderful results including a flatter abdomen, a slimmer waistline, and more youthful looking breasts, the recovery time is indeed something to be mindful about.

Some women try comparing the recovery time of a mommy makeover to a C-section, but this isn’t quite accurate in terms of a tummy tuck, also known as an abdominoplasty.

While each woman recovers at a different rate, at the end of the day, what dictates the recovery time is what type of tummy tuck a surgeon has chosen for their patient.

A breast lift, with or without an implant, will cause some discomfort, but the abdominoplasty along with muscle plication is really the determining factor.

Liposuction is generally utilized during a tummy tuck as it truly sculpts the abdomen, hips and waist. The three types of procedures to choose from are the following:

  • Liposuction only: For patients with limited excess skin and small amounts of fat deposits
  • Mini-abdominoplasty: For patients who require below the belly button abdominal improvements
  • Full abdominoplasty: For patients who require both below and above the belly button abdominal improvements

As mentioned before, the more muscle plication involved, the longer the recovery.

The good news, however, is over the last few years the advent of longer acting anesthetics lasting up to four to five days has modernized healing.

San Diego board certified surgeons are discovering that by utilizing this along with spinal anesthesia during the time of general anesthesia, is providing patients different modalities to enhance their recovery.

In turn, patients are in less discomfort after surgery.

The revolutionary idea that pain management starts in the operating room has broken the proverbial glass ceiling and is making huge strides in the world of not only cosmetic surgery, but all operations.

Some surgeons are calling this movement preempted pain relief so that prior to even starting the surgery, local anesthetic is injected into the surgical field. This very well has proved to minimize a patient’s anesthetic requirements so they awaken more clearly while blocking the pain for a longer period of time.

Patients following this surgical protocol, including mommy makeovers, do much better.

In terms of recovery, while patients may be walking the day of surgery or on the very next day, total recovery takes about four weeks. And if a woman’s profession is not physically laborious, she can return to work sooner.

For the first few days following surgery, assistance will be needed especially if a patient has younger children. In advance, she will need to designate a caregiver, be it a family member or friend. It’s also recommended to have a nurse stay with her the first night or two following surgery to monitor her progress.

Plastic surgery takes patience because it is a journey with amazing results. And mommy makeovers afford ladies a lovely transformation.


4Feb, 2015

Looking Your Best With Cosmetic Surgery Financing

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Cosmetic surgery techniques have made impressive strides allowing one’s aesthetic wish list to become a reality. For those who thought they would have to delay a procedure due to a lack of available funds, there are a host of affordable options for every patient, and that way is through cosmetic surgery financing.

Karen Martindale, a patient concierge for board certified San Diego plastic surgeon, Dr. D. Glynn Bolitho, explains how there are an array of options. Giving oneself the gift of surgical or nonsurgical rejuvenation is a deserved treat.

“For especially women, we have had our children, stretched out tummies and lost the volume in our breasts. Now, it’s time for you,” Martindale said.

Likewise, both men and women are embracing the advent of state-of-the-art minimally invasive procedures. And for those who think they must save their dollars for cosmetic procedures, things have changed in the world of plastic surgery.

“One of the most reputable lenders is the CareCredit healthcare credit card,” she said, adding how it’s a simple sign-up process either online or by phone. “And they have plans up to $25,000 with 24, 36, 48 or 60 months at 14.9% interest. There’s no penalty for early payment.”

A procedure someone has wanted to have to look their very best is within reach with financing such as this. Over time, a patient can pay what is comfortable in their monthly budget.

According to Martindale, one can get a cosigner who doesn’t even need to live in the same household.

“Once a person is issued with their new credit card information we can move forward with your procedure,” she said.

Another option to enable people to look and feel their best through surgery is with the Point Loma Sharper Image Loan. Like CareCredit, Martindale said, a loan can be issued for up to $25,000. To date, those terms are 60 months for a pay-off and for those who qualify, an 8.49% interest rate.

“You become a member at a local Point Loma, and once that is complete, you have the opportunity of sitting down with someone and explaining your situation,” she said.

While cosmetic surgeries have revolutionized, so have the prospects to receive them through financing. Many can finally have the rejuvenation procedure they have always wanted such as:

And more….

Martindale also wanted to remind everyone that respected surgeons take most major credit cards, too.

“You can also do something that I call, ‘surgery on layaway,’” she said. “How this works is after you come in for a consultation and you receive a quote, after putting down your 10% deposit, you can make monthly payments that we apply to your account. And once it’s paid you can then have your surgery.”

There are many creative ways one can have the cosmetic procedure they truly desire. Cosmetic surgery offices, such as Dr. Bolitho’s, pave different roads for patients.

“We are always flexible with our patients, and we truly wouldn’t have it any other way,” Martindale said.

In many respects, cosmetic surgery is an investment in oneself and that really is the best investment of all.

31Jan, 2015

The Gratification From After Weight Loss Surgery

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A person has done the work and has lost a large amount of weight. That should be enough, but sometimes it is not. After a significant weight loss, there may be leftover excess skin still remaining around a person’s entire body.

A person may decide to have a body contouring after weight loss surgery by a board certified plastic surgeon that removes excess skin, which provides a more firm and shapely silhouette. For many this surgery is the final step of their weight loss journey which will give them a huge boost in self-confidence.

The best candidate for this procedure is someone who has reached their ideal weight and has remained firm on the scale. If a person had bariatric surgery, surgeons would like them to stay at a stable weight for a period of time. That may be from six months to a year.

There are two reasons doctors want their patients to maintain their weight loss before the surgery. One is that if there is a weight gain after the procedure, there could be an increase in stretch marks and post-surgical scaring. The other reason is if a person gains weight after the surgery and loses it after the procedure, more sagging can occur.

To maintain the weight a patient should be diligent in establishing a healthy lifestyle and a habit of eating a well-balanced diet.

Areas of slack skin that may need attention after a large weight loss are upper arms, abdomen, thighs, buttocks, groin and breasts.

Some patients might need more than one surgery to address these areas.

The best candidates are nonsmokers, have no medical history that could interfere with the surgery and have maintained a healthy lifestyle since the weight loss. They also need to have realistic expectations and goals.

A patient’s doctor works closely with the plastic surgeon. Together they decide when is the right time to do the body contouring surgery.

30Jan, 2015

New Study Reveals Thigh Lift Complications Are Minor

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Woman  federico stevaninThigh lift surgery is a procedure highly sought after from those who have lost a significant amount of weight. The surgery removes redundant skin making a patient’s thighs firmer and shapely.

Also called a medial thigh lift surgery, this procedure is under the body contouring surgical umbrella. A study recently revealed while some complications do exist, they are minor.

The research was performed by ASPS member surgeon, Dr. Jeffrey Adam Gusenoff and his colleagues at the University of Pittsburgh. Their findings were published in the January issue of Plastic and Reconstructive Surgery®. This publication is the official medical journal of the (ASPS), also known as the American Society of Plastic Surgeons.

The beginning of the report stated, “Wound complications in medial thighplasty are common, but most are minor and can be managed without reoperation.”

The study included 106 patients who underwent a medial thigh lift. From these patients, 90 were female and the remainder patients were male. Their median age was 45. The report indicated that these post-bariatric surgery patients had saggy and excess skin.

“Overall, 68 percent of patients experienced some type of complication after thigh lift surgery. The complication rate varied with the extensiveness of surgery: from 43 percent for patients undergoing the least-extensive ‘horizontal thighplasty,’ to 64 percent with an intermediate ‘short-scar thighplasty,’ to 74 percent with the most-extensive ‘full-length vertical thighplasty,’”

the authors wrote. They continued, “But while complications were frequent, they usually weren’t serious. The most common issues were minor wound healing problems: problems with wound closure (dehiscence) and fluid collections (seromas). Most of these were managed without any further surgery.”

It was estimated that in this study only 6 percent of these patients required another surgery. Additionally, more than 10 percent of patients elected to have additional surgery to enhance their aesthetic goals.

Body Contouring After Weight Loss Surgery is a popular procedure given the fact that medical science has introduced a variety of procedures to help individuals lose excess weight of 100 pounds or more. For many, this surgery is indeed the last part of their weight loss journey. With that said, many have done their research along with taking part in online forums for support, encouragement and education.

The report also clearly points out, “With the increased use of bariatric surgery, the numbers of patients seeking body contouring surgery after massive weight loss have increased sharply.”

When consulting with a board certified plastic surgeon, one will not only receive a better understanding of the surgery but will also be more informed of any possible side-effects. Every surgery has its own set of risks. With that said, when a patient follows their postoperative guidelines, such risks may be minimized.

“Despite these considerable challenges, massive weight loss patients also stand to benefit immensely from contouring procedures,” Dr. Gusenoff and colleagues conclude.

Nevertheless, this report was outstanding in terms of the research and indicating while complications may be present, they are minor.