Bolitho MD

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

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26May, 2016

Considerations for revisionary breast surgery

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Considerations for revisionary breast surgery

Through many years of practice, revisionary breast surgery has evolved into a specialty.  Those who have undergone a breast enhancement procedure will sometimes want–or sometimes need–a revision surgery. Implants may be used in procedures such as a breast augmentation, breast lift, or breast reduction.

It’s important to note that not all patients who undergo a lift or reduction may require an implant – it’s a personal choice that can be discussed at a consultation with a board certified plastic surgeon.

While some patients may be displeased with the aesthetic outcome of their initial procedure, there may be other factors which lead them to seek a revision. These reasons, both personal and medical, may include the following:

  • Symmastia
  • Capsular contracture
  • Implant rupture
  • Bottoming out
  • Symmetry issues
  • Implant disappointment
  • Downsizing implants
  • Replacing implants

 

In some instances, women who are finished having their families may have chosen to have implants placed without undergoing a breast lift. While some patients are content with the results, others may be dissatisfied with the position and want to improve their appearance with a revision.

For mothers who had an enhancement prior to bearing children, undergoing a second augmentation after building their families is also another aesthetic scenario. The effects of bearing children, such as weight gain and breastfeeding, may alter the appearance of woman’s bust line. In some instances, a lift may be recommended to address skin redundancy

Another motive may be when a woman decides that the upper silhouette she wanted to achieve many years ago through implants is not a current aesthetic goal at this point in her life. In these instances, she may decide to downsize.

As one can imagine, revisionary breast surgeries are performed for a variety of reasons.

When electing to undergo a revision for aesthetic purposes, it’s generally advised to wait four to six months following the initial surgery to ensure all healing is complete–this includes any residual swelling. If a patient decides that she does not want to return to her original surgeon for a revision, it’s highly advised that she seeks a board certified plastic surgeon that specializes in breast revision surgery. Surgeons at this level have mastered their craft.

During a consultation with a new cosmetic surgeon, be candid with the doctor when it comes to the reason, or reasons, behind the revision. At this first appointment, clear communication is necessary. It’s important that the surgeon doing the revision surgery and the patient have an excellent rapport.

Following an exam, the doctor will convey their thoughts regarding a revision. The details of the surgery, the recovery process, and realistic expectations will also be discussed.

Before or during the consultation, make it a priority to review their patient gallery photos of women who have undergone a breast revision surgery. If possible, ask the doctor if they have any “before or after” images of patients who were in a similar circumstance(s). This will provide an excellent gauge as to whether or not the surgeon’s talents are aligned with a patient’s goals.

18May, 2016

Men are affording the benefits of cosmetic procedures

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Men are affording the benefits of cosmetic procedures

Over recent years, a number of men are not only learning more about minimally invasive facial rejuvenation procedures, but they are undergoing them. According to recent statistics retrieved from the American Society for Aesthetic Plastic Surgery, in 2015 noninvasive procedures soared over the last five years. It was estimated that one million men underwent these procedures.

While some may have their own theories on why this is so, psychology Professor Miles Groth of Wagner College in New York had his summation. His area of expertise is in gender studies for men. In his interview with the New York Times he shared with reporter, Alix Strauss, his own beliefs on how the views of men have shifted.

The article was entitled, Till Wrinkles Do Us Part: Introducing the Brotox Groom, because many men who are ready to wed want to look their best on their big day. It was cited that millennial grooms are older these days.

“For a very long time, emphasis was placed on what a man did, not how he looked, while women were judged on the opposite,” Groth said. He added, “We’ve gone away from that. Today there’s as much pressure on men to look good and take care of themselves as there is on women. That’s a new phenomenon.”

And they are feeling their own share of pressures as well.

“Men are now being judged on their job, on the quality of the bride, and on how they look, which is why these kinds of enhancements have become more acceptable and almost expected,” Groth said.

The article also highlighted how grooms-to-be are also seeking the help of facial rejuvenation before their big day. Like their female counterparts, areas that many want to rejuvenate appear to be squint lines around the eyes, lines along the forehead, marionette lines, the jawline and underside of the chin.

Many men are turning to Botox®, also referred to as ‘Brotox’ for men.

Understanding that more men are seeking these treatments to help maintain their youth, the recommendations of locating an individual such as a plastic surgeon or registered aesthetic nurse who understands the facial anatomy is still at the forefront. And following the “less is more” theory is also important when undergoing cosmetic injections.

The goal is to capture a natural appearance which makes the patient look refreshed. Conscientious medical professionals will deliver modest amounts of Botox. If after two weeks a patient desires a bit more, they can return for a cosmetic injection touch-up.

And this same protocol holds true for women as well.

During the consultation portion of the appointment, patients can convey what they want to rejuvenate. Many times, digital photos will be taken by a nurse and uploaded to a touch screen in the examining room so both the patient and plastic surgeon (or nurse) can exchange pertinent dialog relating to aesthetics.

Although these are minimally invasive procedures that many gentlemen seek, they must remember that these are still medical procedures. And the procedures should be performed in a medical setting to ensure safety and adeptness from a medical professional whose expertise is in facial anatomy.

11May, 2016

Skin care treatments following a facelift

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Skin care treatments following a facelift

Over the years, operative facial rejuvenation procedures have become incredibly refined. Be it a facelift or lower limited facelift, a board certified plastic surgeon can adeptly create both youthful and natural looking results. Operative facial rejuvenation is a blend of sheer artistry and skill. It requires years of dedication for a plastic surgeon to reach this level of perfection.

When a patient embarks on the operative facial rejuvenation journey, they will be delighted with their refreshed appearance. However, skin care treatment is an important part in maintaining those youthful results since a facelift does not alter the skin per se.

Different ways to enhance those facial features may include the following:

  • Chemical Peels
  • Dermaplaning
  • Botox

As mentioned, one way to rejuvenate the skin is by way of a chemical peel.

According to Elizabeth Reed, a registered aesthetic nurse who works for San Diego plastic surgeon Dr. D. Glynn Bolitho, a chemical peel can also help prepare the skin prior to surgery.

And following surgery, it can be an excellent protocol in controlling fine lines, wrinkles and brown spots.

“A chemical peel can give patients a nice healthy and youthful glow to their skin,” Reed said.

This type of luminosity is a skin care goal. According to Reed, following an operative facial procedure, she typically recommends a series of three chemical peels.

“You can space those about a month apart, and then the maintenance can be once every three months,” she said.

Another popular procedure that Reed likes to employ for patients is dermaplaning. Gently, she utilizes a stainless steel tool and delicately glides it along the face to remove both dead skin cells and vellus hair.

There is no downtime to dermaplaning and it can be performed on a monthly basis. With the right type of skin care navigation, an aesthetic nurse can map out the right anti-aging regimen. A few times a year, it may be suggested to combine both a dermaplaning and chemical peel. Performing a dermaplaning prior to a chemical peel will allow for better product penetration and optimal results.

“Following a dermaplaning, your skin is super soft,” she said. “So when you’re washing your face or you are putting on your makeup, you are noticing a wonderful smoothness to your skin.”

Another pathway for maintaining facial rejuvenation following a facelift or lower limited facelift is by implementing a regimen of cosmetic injections. Botox is highly sought after since it helps diminish the appearance of fine lines.

Every patient is unique and their skin care should be just as distinct. Prior to starting skin care treatments, an aesthetic nurse should thoroughly examine a patient’s face while listening to their patients’ skin care goals.

For Reed, this begins with makeup removal and then utilizing a bright magnifying light to afford a better skin care analysis. And then a suggested customized treatment plan can begin.

“It’s based on what the patient is looking for, and then I tailor the treatment for you,” she said. Reed added, “And it’s not always the same for everyone.”

Partnering with an aesthetic nurse can help achieve and maintain a youthful facial canvas.

5May, 2016

Anti-Aging education promotes youthful beauty

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Anti-Aging education promotes youthful beauty

In a time where various anti-aging techniques are making headway, the importance of partnering with an aesthetic nurse is incredibly important to meet those personal skin care goals. While mainstays such as Botox and fillers are part of this equation, continuing education and refining one’s skills in this “beauty arena” raises the bar in relation to the level of care for facial rejuvenation.

Recently, aesthetic registered nurse Elizabeth Reed attended a Las Vegas conference for the Society for Plastic Surgical Skin Care Specialist. Additionally, Reed works alongside the highly regarded Dr. D. Glynn Bolitho, chief of plastic surgery at SCRIPPS Memorial Hospital, La Jolla.

In tandem, Dr. Bolitho was in attendance at the annual convention for The American Society for Aesthetic Plastic Surgery (ASAPS).

Reed enjoyed the educational ambience which immersed her in lectures about the novel technologies emerging in the near future as well as keeping medical professionals up to date on new products.

“It’s such a great learning experience for me by ensuring that I’m on top of the newest things that are going on in facial rejuvenation,” Reed said.

Reed admits that her favorite part of the conference was taking part in an “injectables” course to further polish her technique. In essence, the hands-on training was an exceptional way to refresh her knowledge on the facial anatomy so patients can receive optimal results for various fillers such as Voluma and Juvederm.

“Voluma is an ideal selection used mostly for facial volume restoration while Juvederm acts as a great filler for the lips and nasolabial folds to smooth out smile lines around the mouth,” she said. “It was really a useful course for me.”

Top tier individuals who perform cosmetic injections have an in-depth background and education in the anatomy of the face.

“You really have to know the facial anatomy because it’s the key to safety, outcome and the end result for a patient’s aesthetic satisfaction,” she said.

As a whole, the conference afforded Reed an opportunity for valuable educational knowledge which in turn would benefit patients at the practice. And it’s knowledge such as this which patients seek.

Reed pointed out that when a medical team from a plastic surgery practice attends these types of conferences that it speaks volumes to their dedication. A quest for education also means fulfilling and exceeding the needs of their patients.

“It is all about creating an outstanding outcome for patients both surgically and non-surgically,” Reed said. She added, “And that also includes maintaining a youthful appearance to one’s skin even after surgery so they can continue to age gracefully.”

 

4May, 2016

Give Mom the Gift of Beauty

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Give Mom the Gift of Beauty

In honor of Mother’s Day and for the entire month of May, Dr. Bolitho’s office is giving the opportunity to receive a complimentary “Dermaplaning ($150 value) when you book one of the following treatments:

Botox

* Juvederm 

* Voluma

* SkinMedica Chemical Peel

 

For those unfamiliar with dermaplaning, it exfoliates the skin revealing a luminous facial canvas.

Additionally, the medical practice is also offering a “Gift Certificate Bonus.” For the first 12 individuals who purchase Mom a gift certificate for $150 or more, you’ll receive a “free” SkinMedica Lip Plump system ($60 value).

Our aesthetic nurses, Elizabeth and Nicole, look forward to performing a facial rejuvenation service for you or a loved one today.

Schedule your May treatment today  by calling (858) 458-5100 or emailing us at info@bolithomd.com

 

 

 

 

 

29Apr, 2016

When to begin exercising after breast augmentation surgery

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When to begin exercising after breast augmentation surgery

Plastic surgery is an exciting time to embark in one’s personal aesthetic goals. However, like with any surgery, the decision to undergo such a procedure takes much thought and consideration.

And that includes deciding to move forward with breast augmentation surgery.

Today is an era where a healthy diet and exercise are prominent in the culture. With that said, many women who have breast augmentation would like to know when they can resume their physical activity.

During a consultation with a board certified plastic surgeon, both the surgery and consultation phase will be reviewed. While this will be discussed, it’s important for patients to be empowered with knowledge including the realistic expectations of their recovery.

Spring boarding into a fitness routine needs a doctor’s approval, and one must not hurry back to resume those activities. And this is why.

The most important part of the healing process is to give one time to heal. And as a patient begins to become more active, they must avoid exercises or movements which could make them vulnerable in hindering recovery.

A routine method for breast augmentation is to place the breast implants under the pectoralis major muscle. While every plastic surgeon has their preference, those who opt for submuscular placement do so because the likelihood of a rippling effect from the implant is less likely to occur. Additionally, some surgeons also believe that implants placed under the muscle may also decrease the chances of capsular contracture.

Respectively, every plastic surgeon has their theory.

For patients who have undergone a submuscular breast implant placement, the healing portion of the surgery requires the pectoral muscle. Many doctors agree that the pectoral muscles should not be stressed for roughly a four-week period.

Activities to avoid include the following:

  • Avoid lifting anything that is more than 10 pounds
  • No upper body resistance training
  • Swimming moves that promote arm and chest strain
  • Avoiding sports such as tennis
  • Avoiding stretches for the chest area
  • Not attempting open chest positions in Yoga such as the Camel and Fish poses

And more….

In other words, it is advisable to avoid any workouts involving the upper body, including the arms and chest.

For exercise enthusiasts, they can most certainly resume a different level of activity such as walking, stationary bicycle, lunges, and any type of exercise equipment focusing on the lower half of the body.

And for those with small children, mothers need to confirm with their doctors as to when it is safe to lift them. For those with younger children, it may be advisable to have some assistance while one heals as well as with some help with any household chores which may impact the pectoral muscles.

Do remember that following a doctor’s guidelines on when to start incorporating exercises and certain activities is incredibly important in order to achieve optimal healing.

21Apr, 2016

How to get beautiful eyes

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How to get beautiful eyes

Even in the Old Hollywood era, beautiful eyes were an asset for the silver screen. Decades later, gorgeous eyes are still a sought after commodity. While many beauty experts have touted their own secrets, the truth of the matter is that there is a three-step protocol to rejuvenate the eye area. The burning question, “How to get beautiful eyes?” can be answered with these simple and valuable steps.

 

Fabulous Lashes with Latisse

According to Elizabeth Reed, an aesthetic nurse who works with board certified plastic surgeon Dr. D. Glynn Bolitho in San Diego, lashes are the first ingredient to beautiful eyes.

“Latisse can help lengthen, strengthen, and achieve darker eyelashes. Long, healthy lashes frame the eye area better and attract attention to the eyes,” she said. “I use Latisse, and a lot of the ladies here in the office use it, too. We just love the results.”

According to Reed, users will start to see lash improvement within the first month. However, the incredible results will start to grow in within two to three months.

Applied on the upper lashes every evening, Latisse is incorporated into a nighttime skin care regimen.

 

The Wonders of Botox

Over time and with repeated muscle movements, fine lines begin to emerge around the outer corners of the eyes. Some call these lines crow’s feet while others describe them as squint lines. But one thing that can be agreed upon is that most women would prefer them to disappear.

And that aesthetic wish can be achieved with Botox.

Reed delivers small amounts of Botox into these facial crevices to help smooth out those lines. She was also quick to point out that Botox for this very reason is not meant to change the shape of the eye nor should it. The goal is to minimize the appearance of fine lines around the eyes.

“I believe less is more and I am definitely a more conservative injector because I really don’t want someone to know that you’ve had Botox,” she said. Reed continued, “I want patients to look refreshed.”

Reed wants people to know that the amount of Botox used is dependent upon a person’s muscle movement. In other words, there is not a standard amount for everyone – instead it’s an incredibly tailored procedure.

 

SkinMedica TNS Eye Repair

While Latisse can help create gorgeous lashes and Botox can erase squint lines around the eyes, a daily topical skin care treatment can help rejuvenate this fragile skin area with complete hydration. The goal is to locate a topical which can gently help erase imperfections while improving the quality of one’s skin.

Reed describes SkinMedica TNS Eye Repair as an amazing product offering an anti-aging component to achieve the three-step process to attain beautiful eyes.

“This product is really great in minimizing those fine lines and wrinkles around the eyes,” Reed said. She added, “It has a high concentration of Vitamin C and E and hyaluronic acid to increase the hydration.”

A results-driven formula used on a daily basis can offer maximum benefits which help create and maintain healthy and beautiful looking eyes.

 

13Apr, 2016

Facial Rejuvenation Through Dermaplaning

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Facial rejuvenation through dermaplaning

For those who are looking for a safe and optimal way to exfoliate their skin, dermaplaning is an excellent pathway toward facial rejuvenation. Aesthetic nurses with a skilled hand in cosmetic injections and chemical peels are excellent choices for this treatment.

Elizabeth Reed, an aesthetic nurse for chief of plastic surgery Dr. D. Glynn Bolitho at Scripps Memorial Hospital in La Jolla, performs dermaplaning regularly. Describing it as a safe procedure, a stainless steel tool gently glides across the facial canvas, exfoliating dead skin cells along the top layer of skin. In tandem, it also removes vellus hair, also known to many as peach fuzz.

According to Reed, any age group can benefit from dermaplaning. Women ranging from their twenties into their sixties and above enjoy the rejuvenating results. Ladies who are getting ready for a special event find that dermaplaning helps them look refreshed allowing their makeup to look incredibly smooth.

And the ridding of this vellus hair helps achieve the aesthetic goal.

The reason why the removal of vellus hair is so important for rejuvenation is because dirt and oil have a natural tendency to adhere to these hairs. When eliminated, the results are healthier and more radiant looking skin.

And it’s not just brides undergoing this treatment. Those who have tried it actually continue with the regimen because the results are that fantastic. Many share that it is also quite relaxing, too.

For a first visit, Reed generally likes to take more time talking with her patients regarding their skin care routine and their skin care goals. From there, the treatment begins.

“Basically, I’m just removing the hair and the top few dead layers of skin so that the skin can just glow and makeup can go on easier,” she said.

The treatment lasts under 30 minutes. However, the best news of all is that there is little to no downtime. Women who are pregnant or plan to become pregnant may be wary about chemical peels. If that is the case, they invite dermaplaning into their monthly beauty routine.

According to Reed, many of her patients like to book their appointments for a treatment every month.

It’s also important to note that there is no relationship between dermaplaning and dermabrasion. While the words may seem relatable, they are entirely two different procedures with a dermabrasion being defined more as a medical treatment.

Reed did admit to a myth about dermaplaning that she quickly debunked. While the stainless steel tool removes vellus hair, by no means does it trigger more aggressive regrowth with darker hair. Vellus hair is considered by medical aesthetic professional experts as superficial.

“I’m doing nothing to increase the rate of growth with dermaplaning. I’m just taking away the hair that will return to how it was originally in time,” she said.

Reed shared that the hair will not grow in thicker or darker. However, it will grow back.

A few times a year, Reed said, patients might like to incorporate a light chemical peel with the dermaplaning for optimal results. However, some patients may prefer just the dermaplaning.

Every patient is unique as are their skin care needs.

6Apr, 2016

Millennials Considering Botox

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Millennials Considering Botox

It seems that ever since the American Society of Plastic Surgeons released its impressive numbers regarding Botox recipients, various articles following the announcement have highlighted the procedure. While the majority views Botox as a procedure for those in their late thirties, forties, and fifties, it appears that millennials are considering and undergoing the injections.

However, their reasoning behind it is different among millennials. Yes, while ASPS reports that over 6.7 million treatments were performed in 2015, a percentage of those patients were those in their mid to late twenties. And that percentage appears to be increasing.

This raises the question if one in their twenties is too young for Botox? And that’s a reasonable query.

For the most part aesthetic nurses certified in delivering Botox, as well as plastic surgeons, look at this age range undergoing Botox treatments as preventative measures. So the delivery of Botox units will be lower, and the goal is to minimize wrinkles in the future. Some professionals agree that wrinkles along the forehead, in between the brows, and crow’s feet will be oppressed if the Botox delivery is done correctly and at a younger age.

While following the manufacturer’s directions is always the protocol, the individual performing the cosmetic injections must be skilled and medically trained in the anatomy of the face. As many know, Botox injections can be offered in an array of facilities, but the one which is highly recommended is in a medical setting.

While Botox is minimally invasive, it should not be overlooked that it is still a medical procedure. And viewing it as such will help ensure that individuals receive the right dosage amount and in the right area. Professionals agree that when someone in their younger years decides on a Botox regimen, if they receive too many units in various areas of the face, it may cause someone to appear older than they are in done incorrectly. The goal is to achieve a youthful and natural looking result, and the outcome should be a soft facial canvas.

For those in their twenties, utilizing Botox can help in their future anti-aging goals. It can be viewed as an excellent head start in stopping those wrinkles before they surface. And studies have been underway for a decade or more releasing promising results.

But as always, the recommendation is never to “overdo” the injections and to follow the “less is more” theory.

A slow, methodical delivery is what’s needed for people of all ages, including those in their twenties. When partnered with an aesthetic nurse or plastic surgeon, the anti-aging goal is to map out a regimen. For example, a patient may not need Botox every three months. Instead, they may respond well to only two to three treatments per year.

Moreover, this anti-aging partnership will not only work well with cosmetic injections for wrinkle protection but will also serve as a great skin care educational platform which will include in-depth knowledge about the following:

  • Sunscreen application and reapplication
  • At home skin care routines
  • Chemical peels

And more…

As with any medical procedure, do view Botox as a medical one and find the right doctor or aesthetic nurse who knows every layer of the facial anatomy so an outstanding aesthetic outcome can be achieved.

29Mar, 2016

Chemical Peels for Skin Rejuvenation

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Chemical Peels for Skin Rejuvenation

Implementing a skin care routine is imperative if one wants to maintain and promote healthy skin. While sunscreen is at the very top of the list, the application of Retinol is also on the aesthetic checklist. It should be noted that Retinol should be prescription strength based on percentages and issued by a healthcare professional. Based on one’s skin care needs, a professional will choose the right percentage for the patient.

With a skin care regimen in place, another treatment for consideration is a chemical peel. Once again, this treatment should be done in a medical facility performed by an aesthetic nurse.

Nicole Dowler, who is an aesthetic nurse who works with plastic surgeon Dr. Glynn Bolitho in La Jolla, is a major proponent of chemical peels.

“It’s really important to have cellular turnover with your skin,” she said, adding how a chemical peel can promote this.

Dowler also went on to say that if one is not exfoliating or doing peels on a regular basis, dead skin cells build up on the facial canvas and naturally slough off at a slower pace.

A routine exfoliation helps encourage cellular turnover and recommended at least twice a year.

However, each individual is unique with their skin care goals so an individual plan needs to be mapped out. If one is doing light chemical peels then they may be able to have a few or more per year. Again, it all depends on the patient.

According to Dowler, chemical peels can help with the following:

  • Diminish the appearance of wrinkles
  • Balance skin tone
  • Lessen the appearance of brown spots
  • Lessen the appearance of sun damage

“Each person is going to have an individualized treatment plan, and that’s the beauty of all these different options,” she said. “If somebody is not ready for cosmetic injections, they may opt to do a couple chemical peels.”

When Dowler consults with a new patient for the very first time, she assesses their skin for the most optimal peel. For example, if an individual has never had a chemical peel or has used Retinol, she will start the regimen with a really light peel.

For a more seasoned patient who has undergone previous peels and a daily use of Retinol, then pursuing a more potent chemical peel may be a consideration.

Dowler mentioned that some patients who may want to want a chemical peel the day of their consultation do need to be advised to stop their Retinol regimen 72 hours in advance especially if the percentage of Retinol being used is a higher percentage, such as 2 percent.

Dowler also noted how patients do need to be prepared for chemical peel aftercare in terms of what to expect.

“Right after a peel, your skin looks really great for about two to three days, and then it starts to peel. Peeling is a side effect and it may not affect everybody,” she said. “If someone doesn’t peel, it doesn’t mean that the peel’s not working – it’s just individualized.”

However, if one does experience peeling it will begin a few days after the peel and ends about a week later.

Dowler said on a personal level, it takes her up to two weeks for all the flakiness to disappear.

“If someone is doing a peel before a big event like a wedding, I recommend the treatment at least four to six weeks before,” she said.