Bolitho MD

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

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29Nov, 2016

Facial rejuvenation for the holiday season

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Facial rejuvenation for the holiday season

As 2016 comes to an end, an array of festivities will be in full swing. In the weeks ahead, holiday parties, family gatherings, and other celebrations will fill the calendar. With these social engagements some may wonder what facial rejuvenation treatments are doable during this time-frame — meaning, facial rejuvenation with little to no downtime. This is important because this is the hustle and bustle time of the year.

The good news is there is a roster of treatments which fit into this category.

Cosmetic Injections

While cosmetic injections are minimally invasive, treatments should be performed in a medical setting by a healthcare professional adept in facial anatomy such as a plastic surgeon or their aesthetic nurse specialist. Depending on the treatment chosen, results can be immediate such as a filler or appear days after the injection series such as Botox.

As one ages, they tend to lose volume around certain areas of their facial canvas such as their cheekbones. Created by Allergan, JUVÉDERM® Voluma™ is a cosmetic injectable gel which can help restore this volume in a subtle and natural-looking way. An injection series in the deep subcutaneous and/or supraperiosteal region provides cheek augmentation to the mid-portion of the face and Voluma patients note that their results can last up to two years.

Also by Allergan is JUVÉDERM®, another hyaluronic acid cosmetic injectable gel, which is a leading choice to lessen the appearance of nasolabial folds and marionette lines.

Quite new to the aesthetic world of cosmetic injections is JUVÉDERM VOLBELLA® XC. This injection series specifically targets lip rejuvenation by adding subtle volume and lessens the appearance of vertical lines that occurs with age due to repeated muscle movement and solar exposure. Volbella which promotes both a youthful and subtle fullness offers results for up to a year.

One of the most popular cosmetic injections is Allergan’s Botox — another excellent choice for facial rejuvenation by minimizing the signs of aging in the following areas:

  • Horizontal forehead lines and wrinkles
  • Frown lines and wrinkles
  • Squint lines such as crow’s feet

As previously mentioned, it’s highly recommended to see a medical professional for these injections series. During a consultation, they will give their own recommendation after hearing the aesthetic wishes of their patients. The goal of all these injections is to have patients look refreshed with natural-looking results.

Skin Resurfacing

Chemical peels do a fine job in resurfacing the skin in terms of minimizing lines, diminishing age spots, and evening out skin tone. A chemical peel is a good choice if one is not attending an event for about 10 days. However, if this is not the case, another option is to schedule a Break Time Peel.

A Break Time Peel is a combination of dermplaning and a light chemical peel. Dermaplaning removes vellus hair and dead skin cells via a stainless steel tool and prepares the skin for the upcoming peel. Results from a Break Time Peel include the following:

  • Smoother skin texture
  • Improved skin tone
  • Produces and promotes collagen

In less than an hour, patients can return back to their day.

During this very busy time of the year, there is indeed an array of facial rejuvenation choices.

22Nov, 2016

Volbella makes a rejuvenation splash

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Volbella makes a rejuvenation splash

A new cosmetic injection recently entered the aesthetic market. Created by Allergan, Volbella affords patients a non-surgical option for lip rejuvenation with immediate results which lasts up to a year.

Elizabeth Reed, an aesthetic nurse specialist who works alongside San Diego plastic surgeon Dr. D. Glynn Bolitho, shared how a patient may be a candidate for different reasons.

This may include one or more of the following:

  • To add subtle fullness to the bottom and top lip area
  • To promote a natural-looking appearance of youthful lip volume
  • To decrease the appearance of vertical lip wrinkles around the mouth

“Until now, there really has not been a product out there to specifically target perioral wrinkles (lines around the mouth),” Reed said. “Volbella, which is part of the Allergan and Juvederm family, is a product that can be used specifically for that purpose.”

Reed went on to say how Volbella also provides outstanding results for lip rejuvenation. Rather than increasing the size of one’s lips, it adds natural-looking fullness and a slight pout when delivered appropriately by a medical professional whose expertise is in facial aesthetics.

“This is an exciting aspect because many women don’t want to add filler to their lips so Volbella is a wonderful option,” she said.

According to Reed, patients report minimal swelling following treatment. The reason behind this is because Volbella does not draw in as much water as other products.

Still in an effort to minimize swelling, Reed recommends periodically icing the area following the injection series.

Reed explained that as one ages, the lip area will be prone to fine lines like other areas of the face due to age, muscle movement and solar exposure. In addition to lines, a loss of volume will also occur. When a medical professional such as a plastic surgeon or an aesthetic nurse delivers Volbella to the lip area, these wrinkles will become less apparent. The optimal results should always be subtle and never obvious.

Before a patient undergoes Volbella, a numbing agent is applied topically to the lips. As well, Volbella also has a numbing medication in its ingredients.

About 10 to 15 minutes following the topical numbing agent, the injection series begins lasting 20 minutes or less. Methodically, the medical professional will take great care in delivering the product while assessing when the best aesthetic results have been achieved.

Most patients agree that they experienced little to no discomfort with their Volbella treatment.

“I’ve had very positive patient feedback,” Reed said. “Volbella is really a nice way to rejuvenate the lip area.”

 

17Nov, 2016

Patient gives chemical peel kudos

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Patient gives chemical peel kudos

A month ago our patient visited the office and had a Voluma treatment with our aesthetic nurse specialist, Elizabeth Reed. Two weeks following her injection series, she made plans to return for her Juvederm treatment.

But that didn’t happen.

“I was expecting to get Juvederm, but Elizabeth was so honest with me by saying how I didn’t need it since the Voluma injections I received a couple weeks before to add volume to my cheek area had actually resolved my nasolabial folds,” Christina said. “As I was sitting there, Elizabeth asked when I’d be available to do a chemical peel because she thought I’d benefit from it.”

For Christina G., 50, a TCA peel (trichloroacetic acid) was going to be different than the type she had with Elizabeth months ago during a Break Time Peel. That one was a very light peel and Christina could immediately resume back to her day’s activities, and she didn’t experience any peeling. She didn’t know what to expect from a TCA peel.

“To be honest, I was a bit concerned about how I would look following a chemical peel. I had no idea how much and for how long I’d be peeling,” she said. “That little voice in my head wanted to put it off, but I hadn’t had any special events planned in the next few days so I had no reason to delay it. Besides, this was Elizabeth. She is specially trained as an aesthetic nurse, and I completely trusted her with my skin and cosmetic injections.”

Reed used a medium grade TCA peel. After she prepared Christina’s skin, she applied one layer at a time. Overhead, Reed had a handheld fan to keep Christina comfortable while assessing her skin.

“In typical Elizabeth fashion, her communication skills yet again exceeded my expectations. It was important to her that she knew what ‘tingle level’ I was at,” she said.

Once Reed determined it was time to neutralize the peel, she did so. Reed also instructed Christina to only use her SkinMedica Cleanser and SkinMedica TNS Ceramide Treatment Cream for the next five days. Following that time, she could then go back to her normal skin care routine which included her prescription Retin-A topical at night.

According to Christina, the chemical peel aftermath was completely doable and not at all what she thought it would be like.

“For the first two days, I didn’t have any peeling. On days three, four and five, I had flakiness around my whole face, particularly around my mouth. When the peeling was visible, I just applied my post-treatment cream and that lessened the appearance considerably,” she said.

Two weeks after her first chemical peel, Christina now raves about the results. Her skin is smoother, more even toned, and her brown spots have diminished considerably. And she agrees with Reed that completing a series would be optimal.

“It’s as if the chemical peel boosted my skin to a whole new level. It’s amazing,” Christina said.

 

11Nov, 2016

The arrival of JUVÉDERM VOLBELLA® XC

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Dr. D. Glynn Bolitho is delighted to introduce JUVÉDERM VOLBELLA® XC to his San Diego plastic surgery practice. The cost of this lip augmentation is $600 per syringe with Dr. Bolitho or $400 per syringe with his aesthetic nurse specialist, Elizabeth Reed.

According to the creators of JUVÉDERM VOLBELLA® XC, “Some women may wish to add subtle volume to their lips; others may want to soften the appearance of the vertical lines above them. Lines such as these are often caused by factors such as sun exposure or repeated muscle movement.” They also noted, “Fortunately, there’s JUVÉDERM VOLBELLA® XC the first and only FDA-approved filler proven to increase lip fullness and soften the appearance of vertical lip lines for up to 1 year.

According to the manufacturer, JUVÉDERM VOLBELLA® XC may be helpful with the following:

  • Increasing subtle volume to the lip area
  • Lessening the appearance of vertical lines along the lip area
  • Adding natural-looking fullness that may last up to a year

To learn more about this revolutionary product call our office at (858) 458-5100 or email us at info@bolithomd.com

5Nov, 2016

Fall into Beautiful Skin

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Fall into Beautiful Skin

Goodbye Summer. Hello Autumn. While many had the best of intentions to protect their skin during the summer months, they still may have had a little bit too much sun exposure.

With the season of fall officially here, there are ways to restore and rejuvenate the skin.

“I love to start with a series of chemical peels,” said aesthetic nurse specialist Elizabeth Reed, who works alongside San Diego plastic surgeon Dr. D. Glynn Bolitho. “I think that’s a great way to remove some of the dead skin that we’ve accumulated during the summer.”

Reed shared that typically skin care professionals don’t do chemical peels during the summer months because people retreat outdoors. Now is the perfect time to start that series.

According to Reed, a great way to see real improvements in one’s skin is by implementing a series of three chemical peels which are tailored to a person’s skin type.  These peels would be done every month.

“During this time, we’d also talk about a person’s skin care regimen and see what changes, if any, would be recommended,” she said. “And if someone is interested in Botox to address their fine lines and wrinkles, we would assess that to determine if they would be a good candidate. But really, starting with a series of chemical peels is a great way to fall into beauty.”

While people begin to change their skin care routine for the new season, Reed shared that there are three skin care staples that never changes. They are the following:

  • Vitamin C
  • Retin-A
  • Sunscreen

An application of Vitamin C in the morning and throughout the day helps hydration and photoaging protection from the sun.

“It also helps with pigmentation challenges such as dark spots, age spots or sun damage,” she said.

Reed’s second go to product is Retin-A which is a medical grade form of Vitamin A.

“Retin-A actually helps reduce some of the effects of sun damage and helps stimulate collagen,” she said. Reed added, “It will help with fine lines and wrinkles as well as exfoliating the skin to help rid it of brown spots.”

Retin-A comes in different grade levels. Reed likes to start patients off with a lower dose, and as one’s skin becomes accustomed to it, the dose level is increased.

The third item on the list is sunscreen which should be tailored to a person’s specific skin care type. A solar protection is imperative to help ward off future damage and help maintain the skin care treatments a person is receiving.

“I usually pick something that has a high percentage of zinc, because zinc oxide is our physical sunscreen,” she said.

27Oct, 2016

New study reveals breast reconstruction psychosocial effects

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New study reveals breast reconstruction psychosocial effects

While the month of October marked Breast Cancer Awareness Month, this month’s issue of “Plastic and Reconstructive Surgery,” a medical journal published by the American Society of Plastic Surgeons, highlighted a study regarding women who underwent a mastectomy. The premise of the study was to see if there was a difference in psychosocial issues between those who had immediate breast reconstruction (IBR) to those who had delayed breast reconstruction (DBR).

It’s important to note that it’s a woman’s personal choice as to whether or not she wants to undergo breast reconstruction. While some may not want to pursue it, others do. With that said, it’s imperative for those diagnosed with breast cancer to know of the reconstruction options available to her when a single or bilateral mastectomy is surgically recommended.

According to Science Daily, the study was conducted at the University of Toronto. It was also cited that when compared to the USA, breast cancer medical centers based in Canada tend to perform more DBR than IBR procedures.

It was correctly noted that sometimes not all patients are candidates for immediate breast reconstruction due to a treatment protocol. It’s indeed individualized.

Participants from the study consisted of 106 patients who underwent an autologous breast reconstruction. From this group of patients, 30 patients had IBR following their mastectomy while 76 patients had their DBR roughly three years later.

Science Daily reported, “Before and at six, 12, and 18 months after mastectomy, the two groups completed questionnaires assessing a range of psychological factors. Scores were compared to assess differences in the psychosocial impact of and recovery from mastectomy with IBR versus DBR.” The news source added, “In both groups, anxiety decreased after breast reconstruction.”

In terms of “health-related quality of life,” women who underwent IBR were able to rebound back into this category earlier than those undergoing DBR. However, roughly six months following their reconstruction surgery, DBR patients had a restored sense of “health-related quality of life.”

Science Daily went on to note, “Lessening the psychosocial impact of breast cancer and its treatment is an important goal of breast reconstruction. While the study is not the first to show psychological benefits of IBR, it provides new information on the course of recovery, compared to DBR.” The article continued, “The results suggest that, when appropriate, IBR can avoid a period of psychosocial distress associated with mastectomy.”

While this study offers insight between the differences of IBR and DBR, it’s important to underscore the support a woman should have following her breast cancer diagnosis. In addition to her medical team, including a board certified plastic surgeon if she so chooses, other areas of support also include family and friends. And support such as this will help carry a patient to that finish line called hope.

21Oct, 2016

Why a woman may seek a breast revision surgery

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Why a woman may seek a breast revision surgery

When a woman considers a breast augmentation surgery, it’s important that she is thoughtful about the decision. During her appointment with a board certified plastic surgeon, she can inquire about the procedure, the recovery and the outcome. Also at that time she can be candid in regards to why she wants this surgery and her expectations following it.

Excellent communication between plastic surgeons and their patients is imperative.

While a patient may have done their due diligence before undergoing their breast augmentation procedure, there are cases when she may very well consider a breast revision surgery based on either a desire or need. This can occur months or even years later.

These reasons may vary and include the following:

  • Challenges with breast asymmetry
  • Capsular contracture (scar tissue surrounding the implant has tightened)
  • Symmastia
  • Removing and replacing an implant(s) which has ruptured
  • Deciding on a new implant size
  • Implant rippling
  • Interchanging saline with silicone implants (or vice versa)

It’s entirely up to the patient as to whether or not they want to return to their original plastic surgeon for the revision or seek another. If the choice is the latter, it’s highly recommended to research only board certified plastic surgeons that specialize in breast surgery and ones who are adept in breast revision surgeries.  Once more, this is a personal decision. In addition to this, other surgeries they should excel in may consist of a breast lift, breast reduction, and breast reconstruction. Surgical aptitude in breast surgeries can help patients achieve a positive surgical outcome.

As mentioned earlier, there are various reasons as to why a woman may seek a revisionary breast surgery.  Some patients may discover over time that the original size implant they chose years ago no longer fits their lifestyle. For example, when a woman has completed having her family in her forties, she may come to the realization that the implant size she chose in her twenties may no longer be aesthetically appealing to her.

In the same breath, her skin tissue may have transformed over time due to weight gain, breastfeeding and weight loss.

Every patient is different as are their aesthetic needs.

For whatever reason a woman decides that she is interested in pursuing breast revision surgery, always remember that locating a board certified plastic surgeon should be at the top of the checklist.

And truly, this certification cannot be understated. A doctor certified in plastic surgery can help ensure a positive surgical outcome while keeping patient safety in the forefront.

13Oct, 2016

Facial rejuvenation after weight loss

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Facial rejuvenation after weight loss

As many can attest to, making the decision to lose weight takes patience and dedication. Reaching those weight loss goals is truly a celebratory milestone.

For those who have attained their goal by losing 20 to 25 pounds, while they have redefined their silhouette, they may also notice that their face has lost volume.

“Anytime you lose a significant amount of weight, there is a concern about volume loss and perhaps the change of laxity in your skin,” said Elizabeth Reed, an aesthetic nurse specialist who works with San Diego plastic surgeon Dr. D. Glynn Bolitho. “So what we want to do first is to restore that volume.”

Reed mentioned the optimal products she uses are Juvederm and Voluma.

While Juvederm is used to lessen the appearance of nasolabial folds and marionette lines, Voluma addresses the mid-portion of the face. According to Reed, beginning rejuvenation at the mid-face is a great starting point.

This usually begins with using one syringe of Voluma. Generally, Reed likes to deliver the Voluma first and wait a couple of weeks for the product to settle before addressing nasolabial folds. In some cases, this area may resolve itself due to the Voluma, or a patient may need a lesser amount of Juvederm.

When teaming up with patients for their skin care needs, Reed will also assess whether or not they would like to reverse any premature skin aging caused by sun damage or even brighten their skin tone with a series of chemical peels.

And for those who want to lessen the appearance of wrinkles along their forehead, around their eyes and in between their brows, Botox is the “go-to” cosmetic injection.

“The goal is to tailor a skin care regimen for every person’s specific needs,” Reed said.

Reed wants everyone to know that it’s best to be within five pounds of a weight loss goal before seeking a Juvederm or Voluma treatment. The reason behind this is that when someone is close to their goal weight, a professional such as an aesthetic nurse or plastic surgeon, can glean better insight into a person’s facial structure.

“For me, it’s about a patient investing in something at the right time so they achieve the overall result that they are looking for,” she said. “When you are within five pounds of your goal weight, I think that’s a great time to make an aesthetic care plan.”