Bolitho MD

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


24Apr, 2015

Buttock Implantation Surgery Reaches New Highs

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While breast augmentations continue to be highly sought after, there is another augmentation taking top billing in the media: Gluteal augmentation otherwise commonly known as butt implants.

Here is a glimpse into why there has been a shift.

For starters, Google searches are a clear indication as to what the new trend is in society, including plastic surgery queries. Just last month, the term “butt implants” was typed into a Google search more than 40,000 times. Around last year at this time, that monthly search number was around 27,000.

Just like couture changes with the decades, so does the silhouette and body type. Currently, a more voluminous bottom is ranking higher. Celebrities such as Jennifer Lopez, Nicki Manaj, and Kim Kardashian are changing physical fashion, not to mention aesthetic requests in a plastic surgeon’s office.

Women who generally seek gluteal implants want to enhance their backside appearance. They are often dissatisfied in how they look in their wardrobe. Their hope is that this type of procedure can transform their body and reveal a shapelier back end.

The implants utilized are oftentimes silicone filled. A skilled plastic surgeon can help add more curvature to the area by specific placement. Just like breast augmentation, the selections of implants truly come in an array of sizes and shapes.

The implant variations are critical so a woman’s body type matches proportionately with the augmentation. Each patient is different and so are their aesthetic goals.

Some women who undergo a buttock augmentation also may combine a lift, if aesthetically needed.

For those who are interested in this type of plastic surgery, it’s important to be thoughtful about pursuing it. One must make certain they want the surgery for all the right reasons, while understanding that plastic surgery is indeed a personal decision.

A potential patient must seek a board certified plastic surgeon that specializes in this procedure.

During a consultation, a woman must ask pertinent questions such as how the surgery is performed, double check on the surgeon’s qualifications, and request to see a patient gallery for those who underwent the procedure.

Above all, safety is a primary concern. If the surgery is being performed in a surgical suite, be certain it is accredited by an agency such as the American Association for Accreditation of Ambulatory Surgery Facilities.

Also during the consultation, be sure to ask about recovery time which may last up to six weeks as well as surgical and health risks.

It’s critical for plastic surgeons to inform their patients about every aspect of a surgical procedure so the patients can make informed decisions.

For those who have done their homework and have chosen the best plastic surgeon, they have been very delighted with their surgical outcome.

18Apr, 2015

A Quick Guide Into Breast Implants

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woman nose

While breast augmentation surgeries continue to be a sought after procedure for women of varying ages, it is important to glean a better understanding regarding breast implants. The size of the implants will invariably influence how a woman appears as well as what their daily lifestyle is, including sports and activities.

First and foremost, it is highly important that a woman does her due diligence in terms of researching the right plastic surgeon. They must be board certified in plastic surgery and specialize in surgeries of the breast.

As mentioned earlier, women seek this surgery at different ages and timeframes of their lives. For example, a woman in her twenties may want to increase the volume in her breasts, while others who have had children and breastfed, decide to have a breast lift and augmentation with implants.

It’s important to note here that a breast lift may not always need an implant. This decision is made between the doctor and their patient.

Despite the original aesthetic goals, this surgery will increase breast volume and projection. The goal for a plastic surgeon is to make certain that the augmentation improves a woman’s silhouette; in other words, balance her proportionately.

Breast implants are measured by cubic centimeters. The larger the implants, the greater the cubic centimeter numbers. Implants are filled with either silicone or saline, and its shell is almost always made of silicone.

So how many cubic centimeters does it take to go up a bra size? This popular question is answered with 150 to 200 cubic centimeters. When looking at breast implants, it’s difficult for a patient to determine by mere sight alone what size would be best. However, when she explains during a consultation she would like to increase her cup size by one or two, this can help a surgeon hone in on her aesthetic wishes.

Nevertheless, before deciding on what cubic centimeters is best, a doctor and patient must be mindful of the following:

  • The implants match breast width
  • Implant size matches a woman’s lifestyle in terms of exercising and sports
  • The implants are proportionate with a woman’s frame and do not make her heavier in size

For some women, their reaction into getting an augmentation is to have larger, fuller breasts. But the best plastic surgeon will explain any risks which may be involved in going “too large.” A handful of these risks may include:

  • Atrophy caused by the weight of the implants
  • Muscles and tissues start to thin out
  • Stretch marks caused by the implant weight
  • Large implants may cause rippling appearance
  • Bottoming out from the implant weight

And more…

There are instances where a woman decided to undergo a drastic augmentation with very large implants, and within a year, decided to replace them with a lower cubic centimeter number. If a patient waits too long to replace them and the skin is stretched, a breast lift may need to be implemented with the new augmentation procedure.

Plastic surgery is a personal decision, especially that of a breast augmentation. Much thought and consideration needs to be made and working with a skilled plastic surgeon is essential during the process.


11Apr, 2015

Plastic Surgery Study Emerges With Interesting Data

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In the 21st century, the advent of skilled microsurgical techniques has afforded many with the option of undergoing operative facial rejuvenation. Known to many as a facelift, surgical advances have enabled patients to reap great rewards, not only with a full facelift, but also procedures which are less comprehensive such as a limited lower facelift or a simplicity neck lift.

While many are celebrating this new fountain of youth via plastic surgery, a recent study emerged and was reported by Medical News Today. The study claims that plastic surgery is not defined solely by youth.

There’s more to it.

The research study was recently published in JAMA Facial Plastic Surgery. The premise of the study was using before-and-after pictures of ladies who had undergone a particular type or types of facial rejuvenation surgery. A handful of these procedures included:

Part of the study was analyzing these photos and determining in a control study group whether or not any specific personality traits were present for the viewer. These personality traits consisted of the following:

  • Likeability
  • Aggressiveness
  • Extroversion
  • Trustworthiness
  • Social Skills
  • Risk Seeking

These supposed “traits” were all based on the perception of others for an individual before and after their facial procedure.

Reporter, Markus MacGill of Medical News Today wrote that the aim of the study was to, “introduce the concept of facial profiling to the surgical literature and to evaluate and quantify the changes in personality perception that occur with facial rejuvenation surgery.” He continued, “The relationship between facial features and personality traits has been explored ‘by social scientists for many years’ but so far left out of the journals read by surgeons.”

The goal of the study was to branch out further than looking more youthful. That was only one element. They delved into the different degrees of features following surgery and discovered if they were impacted in any way.

The study included 30 women who underwent a type of facial rejuvenation surgery which were subject to evaluation. These ladies had undergone surgery between the years of 2009 – 2013.

Plastic surgeon, Dr. Michael Reilly of Medstar Georgetown University Hospital in Washington DC, championed the study along with other coauthors. Unveiled was a “significant improvement” in the traits of likeability and social skills.

On the flipside, however, there was a moderate to slight improvement for the traits of extroversion, aggressiveness, risk-seeking and trustworthiness.

MacGill extracted from the study that, “The comprehensive evaluation and treatment of the patient who undergoes facial rejuvenation requires a broader understanding of the many changes in perception that are likely to occur with surgical intervention. The face is not defined by youth alone.”

This study affords the best plastic surgeons pathways for their patients not only to look more youthful but to also rein in other personality traits which may impact other facial features following surgery. The goal of plastic surgery is to achieve aesthetic harmony on many levels.

4Apr, 2015

A Different View On Tummy Tucks

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couple 1

Body contouring procedures can redefine an individual’s silhouette in a variety of ways. From liposuction, thigh lifts to arm lifts, people are looking at these procedures with a newfound interest and above all, hope.

Over the years, tummy tucks have garnered a great deal of attention for women undergoing a procedure called, “mommy makeover.” But there is another group who are looking into tummy tucks, also medically known as an abdominoplasty.

Those who have undergone a dramatic weight loss have sought out more information on tummy tucks. With the advent of weight loss surgeries and operative treatments, there has been a demand for after weight loss body contouring surgery.

And here’s why this is the case for both men and women.

When an individual gains a significant amount of weight, their skin stretches to accommodate it. However, when weight loss occurs in the numbers of 50 to 100 pounds, the skin is unable to recede to a person’s new shape.

When people reach their goal weight, excess skin cannot be eliminated with exercise. It will continue to sag. Instead, it must be excised in areas of the arms, thighs, and abdomen.

Tummy tucks can address redundant skin issues while removing any fat deposits. It’s advised, however, to undergo such a surgery after someone has maintained their weight anywhere from six months to a year. This way, one can be certain they are at the ideal manageable weight.

For many patients, the after weight loss body contouring surgery is the final step in their weight loss journey. It’s a time for celebration following so much commitment, diligence, and willpower.

Another point worth mentioning are the health benefits coupled with this cosmetic surgery.

Researchers have discovered that patients who undergo this body contouring surgery are more successful in maintaining their weight. Those who had the surgery were able to stay quite close to their goal whereas those who didn’t were more likely to gain weight.

While different studies have been executed around the globe, the median pounds gained per year for patients who had the surgery was one pound per year versus four pounds per year for those who elected not to have the procedure.

Seemingly, the surgery served as another level of motivation to eat well, exercise, and maintain a stable weight. And invariably this led to leading a healthier lifestyle which benefited the patients.

It’s vital to note that plastic surgery is a personal decision. It requires consideration and research.

With that said, majority of the patients who opted for this procedure did their homework and due diligence. In the same breath, it’s important for candidates to choose the right medical doctor who is board certified in plastic surgery and has expertise in after weight loss body contouring surgery.

Visiting a doctor’s patient online gallery, having a consultation, and researching patient reviews are part of the protocol.

Plastic surgery requires patience. This is why it’s important to team up with a surgeon where there is an excellent rapport. This procedure is the last step in the weight loss journey so it’s critical to have the best plastic surgeon.


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.