The Medical College of Georgia reports on operative facial rejuvenation by Imagery Majestic by Imagery Majestic

The advancements of operative facial rejuvenation are quite profound. With that said, the Medical College of Georgia at Georgia Regents University championed a study which proved that multiple procedures could be performed during a single surgery with optimal results.

This is what their study showed, which can be read in The American Journal of Cosmetic Surgery. A summary of it was also found online at Science Daily.

“Total facial rejuvenation, which combines an extensive facelift to tighten skin and muscle; specialized, mid-face implants to restore fullness; and laser resurfacing to reduce skin’s irregular texture and discoloration, can be safely performed at one time,” reported Dr. Achih H. Chen, a facial plastic surgeon.

The aim of the study was to help guide surgeons in whether or not to simultaneously have a patient undergo procedures to the neck and face would be beneficial. While patients appreciate the one-time surgery and single recovery period, board certified plastic surgeons have often wondered how underlying tissue and skin loss may be impacted.

The study included 21 women, ranging from 58 to 71 years of age.

The patients, “…experienced normal wound healing, producing a new top layer of skin and wearing makeup again within two weeks. There were no reported complications related to the more extensive surgery Dr. Chen performed on these patients.”

In the study, Chen went on to say, “In a quest for a more complete or total facial rejuvenation, we started pushing the envelope a little bit and have found that combining techniques is a really safe approach.” He continued, “Young faces don’t look tight. They don’t have sagging, so tightening is a component, but just tightening and tightening does not really achieve a more youthful appearance. In fact, too much tightening can make you look very unnatural, and I don’t think most people are looking for that as an end point.”

While tightening works well for the neck and jawline, he said, the mid portion of the face needs to be addressed differently. It is here, where volume needs to be added.

Incorporating non-ablative lasers in addition to other exfoliation treatments, helps rejuvenate the skin by buffing away sun damage. An improved skin texture can be achieved, he said, and removing just the very top of the skin, has reduced recovery time and increased results.

The many benefits of Botox®

Google Images
Google Images

When Botox® appeared on the market to help erase superficial wrinkles, the feedback was tremendous.

And it still is.

A derivative of Clostridium Botulinum, the laboratory produced, Botox®, was originally created to help treat patients with muscle spasms. Specifically, eye spasms and eye twitching, also called blepharospasm.

It didn’t take long for researchers and doctors to notice how the injections were decreasing the appearance of superficial wrinkles around the eyes.

Hindering the muscle from moving meant that the wrinkle could not contract.

In the world of non-operative facial rejuvenation, Botox® is ideal for crow’s feet, and frown lines along the forehead.

For cosmetic purposes, Botox® is usually repeated every three to four months. For some patients, the effects may last up to six months. Although the duration of Botox is short, many people routinely go in for cosmetic injections to help keep the wrinkles away.

Plastic surgeons consider it an excellent application for lines that are created by muscle over-activity.

However, it’s important to note that Botox® may not give optimum results for very established lines since it may not completely eradicate weakened muscles.

In essence, the more prominent the muscle, the Botox will have a lesser effect or the muscle contraction may occur sooner than anticipated.

When seeking a Botox® cosmetic treatment having a board certified plastic surgeon or dermatologist perform the injections offers the best outcome. A doctor who is educated in facial features and the muscles in the face can expertly place the injections in areas which will rejuvenate the facial canvas, including lifting the brow.

Aside from facial rejuvenation, Botox® has provided great results for those who suffer from migraines. Those who have exhausted all oral medications and still have numerous, debilitating headaches every month, some of these patients have sought a neurologist for Botox injections. The injections may start at the shoulders, work its way up to the neck, around the head, forehead, and corners of eyes.

Some patients have claimed that their migraine occurrences have been slashed in half or less.

After one year, typically, patients will go in for injections every six months.

Lastly, Botox® has also been of great benefit to those who suffer from excessive sweating under the arms.

Simply put, this injection can do a host of things including erasing years around the eyes and forehead.

Top San Diego Plastic Surgeon debuts new website design

Dr. Bolitho
In tandem with receiving notification that Dr. Glynn Bolitho has once again, for the third year in a row earned “Top Doctor” in an upcoming special edition of San Diego Magazine, he has also launched his new user-friendly website design.

Taking his website to a higher level, visitors will be immersed in a site rich with information.

Easy to navigate, new and existing patients can learn about the array of techniques Dr. Bolitho performs such as operative facial rejuvenation techniques, body contouring procedures, reconstructive surgeries, cosmetic injections, and non-operative facial rejuvenation.

So far, the site has received positive reviews.

“It was a great time to move our web presence to a whole other level by giving our patients easier access to the treatments and techniques Dr. Bolitho and his skin savvy team perform,” the spokesperson said. “For each treatment or surgery, we have detailed information about the procedure to help educate patients prior to their consultation.”

As well, the site offers a robust blog filled with helpful information regarding treatments, surgeries, patient testimonials and skin care tips. And its social networking links will transport visitors to other helpful, and sometimes, fun information.

“Our new website really does offer easy access to essential information people want to learn about,” she said. “And above all, our friendly team is only a phone call away for a personal connection which is what we look forward to most.”

To visit Dr. Bolitho’s new redesigned site visit:

3 Simple Skin Care Tips Not To Overlook

By David Castillo by David Castillo

While so many of us are skin care diligent with sunscreens and treatments, there are a few tips worth mentioning to help promote smooth sailing on the
anti-aging pathway.

Beauty Sleep Caution
The best position to sleep in through the night is on the back. Any other position will surely press and crease the face such as on the stomach or on the side.

While in a deep sleep, it’s nearly impossible to gauge oneself on their sleeping position. With that said, investing in a high quality, soft pillow case is the next best option. Top picks are silk and satin.

And for those who detest sleeping on their back, buying a new pillow case is really important.

If cotton is a must, purchase the highest thread count available.

Picking A Moisturizer
An anti-aging moisturizer loaded with antioxidants to ward off free radical damage and peptides which stimulates collagen is usually at the top of an anti-aging arsenal.

However, dismissing the basics of what a regular moisturizer can do shouldn’t be ignored, either. Keeping skin hydrated with ingredients such as shea butter helps skin repair itself. When skin is hydrated and supple, repeated facial muscles aren’t as harsh because the skin has, if you will, a protective barrier.

A basic moisturizer can work well when combined with a prescription strength Retin-A program from a San Diego board certified plastic surgeon to help restore youthful skin and combat sun damage.

However, if Retin-A is not part of the daily treatment regimen, then buying an anti-aging moisturizer packed with antioxidants and other skin care “must haves” may be a better way to go.

Water Hydration
Drinking the daily amount of allotted water is incredibly important. How to drink it, though, is a different story.

Using a straw or sipping from a bottle can actually trigger more established wrinkles while creating new, fine lines.

If one must drink from a bottle, be sure it has a spout where the water can be poured into the mouth.

While there is an array of skin care direction out there, making simple changes to one’s lifestyle can truly help slow down the hands of time.

Don’t Toss Away The Sunscreen


Just because the Labor Day Holiday has come and gone, doesn’t mean it’s time to toss away the sunscreen.

Sun overexposure and burns happen even after Labor Day.

The reality is the sun doesn’t care if it’s hot outside or even overcast. It will expose you to its rays each and every day.

Sunscreen isn’t just for the beach or poolside.

Apply it when walking your dog, taking a swing out on the golf course, and really, anytime you are outdoors.

If you find that your outdoor time has decreased following summer, then consider wearing a tinted moisturizer. A top-tier product can offer anti-aging benefits in terms of hydration, coverage, and a sun protection factor of 40 or more.

And let’s not forget how the sun’s UVA rays can seep through a car, office or home windows, too.

Although we’ve been through it before, here is a breakdown between UVA and UVB rays and the need to wear a broad spectrum sunscreen when outdoors every single day of the year.

• UVB is known by healthcare professionals to be the ray which causes sunburns
• UVB rays are the primary cause of skin damage
• UVB rays are the leading cause of skin cancer

• UVA rays intensely penetrate the skin
• UVA causes skin damage such as wrinkles, age spots, loss of elasticity, and breakdown in collagen.
• UVA causes skin cancer

Once again, make certain that a sunscreen is listed as broad spectrum for full UVA and UVB protection.

Some other great solar protection tips include:

• Apply more broad spectrum sunscreen to sun spots and freckles
• Be watchful of any unusual moles or growths on the body, especially if you suffered from summer sunburns as a child.
• Get annual skin checkups with a dermatologist or board certified plastic surgeon
• Be extra wary with additional sunscreen going outdoors between 11 am and 3 pm when the sun is most powerful

Just think, now that you had such great practice being sunscreen diligent during the summer months, you’ll be ready for this regimen all year round.

And remember, put more on than you think you need – because so many of us use too little of it.

Labor Day Weekend Packing List

FreeDigitalPhotos by Sura Nualpradid
FreeDigitalPhotos by Sura Nualpradid

Labor Day weekend is right around the corner.  Where did the summer go?

Before packing the suitcase, don’t forget grabbing the essential products for taking care of those skin needs. So many times, people dismiss this, and then regret it at their destination, because their skin feels so dry.

Also think of it as a jumpstart to your post-summer skin recovery time.  That’s around the corner, too.

Here is a check-off list:

Anti-Skin Care Regimen: Don’t forget the gentle cleanser, moisturizer, and any serums you apply at nighttime.

Body Care: At the end of summer, skin is craving for moisture so don’t forget the body lotion. If lotion is not hydrating enough, then look into body butter for an extra boost of hydration.

SPF Tinted Moisturizer or Sunscreen: While outdoors, apply that tinted moisturizer and/or sunscreen often to keep the harmful rays off the skin.

Body Sunscreen: Apply a broad spectrum sunscreen of SPF 30 or higher often and don’t forget the tops of hands, tops of feet, back of neck, and ears. After water sports, reapply.

Outdoor accessories: When outdoors, don’t forget a brimmed hat and sunglasses.

Shade: Be it an umbrella or canopy, give skin a break. Remember, though, not all shade is equal – some offers more protection than others. If outdoors, be sure that the shade offers protection against UVB rays. To be certain, apply a broad spectrum sunscreen.

Wherever the Labor Day Holiday takes everyone, be sure to stay both “safe” and “skin safe.”

End of summer skin repair

Photo ASTA
With the end of summer nearing, it’s the opportune time to undergo some facial rejuvenation and repair in preparation for the fall months.

Here are some quick tips to help restore your skin for a more luminous glow.

Chemical Peels:

A series of chemical peels can do wonders for the skin. But it’s important to note that not all chemical peels are the same. We recommend Environ’s Cool Resurfacing System at the end of summer.

A series of this non-invasive and painless peel can help with the following:

  • Lessen the appearance of fine lines and wrinkles
  • Fade age spots and freckles
  • Smooth out skin texture
  • Promote the production of collagen

Retin A®:

While so many skin care products on the market have Retin-A® in its ingredients, the goal is finding prescription strength Retin-A®. This derivative of Vitamin A has been known to help people achieve more youthful skin.

When prescribed by a doctor, it aids in reversing sun damage and encouraging collagen.

We partner with our patients to determine what prescription strength will meet their aesthetic goals.

Retin-A® offers the following skin benefits:

  • Lessens fine lines and wrinkles
  • Fades age spots and evens out skin tone
  • Improves skin texture


Anti-Aging Skin Care Routine:

Implementing and dedicating yourself to an anti-aging skin routine is extremely important to reach those youthful skin care milestones.

Dr. Bolitho’s office has an elite inventory of skin care lines which can help lessen the appearance of pigmentation issues, uneven skin tone, pore size, and fine lines. These skin care lines will also help hydrate the skin for a more luminous glow.


Last Post Summer Skin Care Tip:

Just because summer is ending, it doesn’t mean to discontinue sunscreen. We need solar protection year round, including on overcast days. Overexposure to the sun is the number one reason for premature aging, as well as skin cancer.

A study on aesthetic injectable procedures

Google Images
Google Images

Recently, there was a study on cosmetic injections. And it wasn’t about what injection was better than the other.

The title of the study says it all. Published in the journal of ISAPS Aesthetic Plastic Surgery, the report is entitled, Plastic surgeons or nurses: Who are the better injectors?

The report reads, “In recent years, minimally invasive aesthetic injectable procedures have grown in popularity as more and more men and women are seeking age-defying treatments. As Botulinum toxin — generally known as BOTOX® — use has increased, a growing number of non-aesthetic health professionals have emerged to perform procedures utilizing this and other injectables. According to a survey, plastic surgeons consider themselves the most capable injectors.”

Championing the study was Kevin Small, MD and Henry M. Spinelli, MD from the Division of Plastic Surgery Presbyterian Hospital in New York and Kathleen M. Kelly, MD from Columbia University in New York.

They and their teams performed the assessment and capabilities of those doing the injections.

The report went on to say, “Since studies have shown that patients identify training as the most important factor when considering these procedures, this study seeks to summarize the perspective of plastic surgeons regarding these paradigm shifts.”

Part of the study included an online survey. In 2013, during the summer months, more than 26,000 cosmetic surgeons received the survey.

A total of six questions helped determine the capabilities of those in the health and wellness field to administer fillers, Botox® and vaccines.

These healthcare practitioners included:

  • Plastic surgeons
  • Dermatologists
  • Dentists
  • Gynecologists
  • Nurses in the field of plastic surgery or dermatology
  • And nurses in fields outside of plastic surgery or dermatology

The report concluded, “Based on responses from over 880 plastic surgeons from around the world, plastic surgeons consider themselves and dermatologists the most capable injectors. However, they still believe nurses in other fields to be the most capable of administering vaccines.”

One of the head investigators of the study, Dr. Henry Spinelli shared his own thoughts on the findings. He added, “Since most of the growth in the field of cosmetic injectables is being driven by providers other than plastic surgeons and dermatologists, it appears that further clarification of training requirements and practice guidelines is necessary to ensure a consistent, reproducible, and safe experience for the patient.”

Researchers and administrators also hoped their findings would generate more discussion and investigation into injectable providers and perhaps reevaluate those standards.


What to expect from breast implant removal

FDP by Adamr
FDP by Adamr

Just like breast augmentation surgery is a personal decision every woman makes for herself, so is having her implants removed if she changes her mind even years after the surgery.

When performed by a San Diego board certified plastic surgeon, the removal of breast implants is generally safe and effective.

Women have given so much thought to this procedure before undergoing it.

Because of this, they are invariably quite happy with the results and the benefits they had hoped for.

Those who decide to get their implants removed do so for a variety of reasons.

They may include:

  • Weight gain
  • Discomfort
  • No longer wanted or desired

The most common question women ask when considering implant explantation is how they will look afterward. Many women are concerned with excess skin which may follow postoperatively.

There a variety of factors for this answer.

Ultimately, it’s relative based on the volume contribution of the implant to the breast.

More simply put, any extent of sagging is dependent on how much breast tissue a woman has. One contributing factor of excess skin includes the size of the implant. The larger the implant, the more likely the breast tissue has stretched.

Other redundant skin issues may be the result of significant weight loss and childbirth.

During a consultation with a board certified plastic surgeon, they will be able to determine whether or not a breast lift, to remove the excess skin, will be recommended following removal of the implants.

Here are two patient examples.

Let’s say three months ago a woman had breast augmentation surgery, changing her bra size from a C to a D cup, and now wants the implants removed. More than likely she would not need a breast lift to remove excess skin.

However, a breast lift surgery, medically known as a mastopexy, may very well be needed in this next scenario.

Thirteen years ago, a patient underwent breast augmentation going from a B to D cup. Since that time, she gave birth to two children, breast fed them, and her weight has naturally fluctuated over the years.

Implant removal from this patient would more than likely result in a breast lift in order to rejuvenate her appearance.

As mentioned earlier, a board certified surgeon will help guide a patient in her wishes for implant removal, which may also include a breast lift procedure for the most optimal aesthetic outcome.

It’s also recommended to see a surgeon’s photo gallery of implant removal procedures they have performed to give women a better visual picture.

Patient Testimonials

vivid_flowers-wideWe are so thankful for the time our patients give us testimonials.

It’s thanks enough they entrusted us to care for them and even more special when they put it into words for us.

And most of all, thank you for allowing us to share your comments.

“Excellent care from the very first appointment.  Dr. Bolitho listened to me, talked to me, and never rushed me.  Dr. Bolitho and his team were professional and caring. Thank you!” – Shelly, breast lift with implant

“I was very nervous about having surgery.  Dr. Bolitho explained everything in detail and he followed-up with a call after surgery. Kandie was fantastic to get my surgery done quickly.  Everyone was very caring and helpful.  A good experience and love the outcome.” – Holly, cosmetic ear surgery

“If I had known what a positive experience this would be to remove my implants, I would have removed them years ago.” – Laura, removal of implants with breast lift

“After 30 years of continual problems with breast implants and multiple surgeries with multiple surgeons, I finally have breasts that I love.  Thank you so much!” – Barbara, breast revision

“Everything about my experience was excellent.  Dr. Bolitho and his staff are professional, caring and attentive.  I will recommend you all wholeheartedly!  Thank you!” Cheryl, breast augmentation

“After having a breast reduction, I was self-conscious about the scars and size.  Dr. Bolitho fixed them beautifully and now I feel amazing!” – Kris, breast augmentation with scar revision