The Right Pain Management Eases Mommy Makeover Recovery

Moms see positive improvements with rejuvenation surgery.
Moms see positive improvements with rejuvenation surgery.

A Mommy Makeover is a term used by many people for women wanting body rejuvenation after having their babies. This surgery is recommended when a mother has decided she has completed her family.

According to percentages by the American Society of Plastic Surgeons (ASPS), Mommy Makeovers are steadily increasing. In the lead, is a tummy tuck increase of more than 80 percent since 2000, followed by breast lifts in the same timeframe at around 70 percent.

San Diego Mommy Makeovers are a popular procedure.

While mothers adore their children, many yearn to have their pre-pregnancy day physique back.

And they can, with a mother rejuvenation procedure which includes a tummy tuck, breast lift and/or breast augmentation surgery.

Generally, these rejuvenation surgeries for the abdomen and breasts are combined during one procedure.

While women adore the idea of having these areas of their bodies renewed, naturally, they are concerned about their recovery time.

A board certified San Diego plastic surgeon will tell patients that recovery varies with each patient.

For those who only require a breast lift or breast augmentation, recovery may last about 7 to 10 days. However, if a tummy tuck is included, recovery may take two to four weeks.

Also known as an abdominoplasty, healing could vary, as well. Some patients may only need redundant skin removed, while others, may need muscle repair which takes more recovery time.

In any event, pain management is the most important role in recovery, especially regarding a tummy tuck.

The good news is pain management has vastly improved. Conversely, when pain management starts in the operating room, it has a direct correlation in terms of patients doing well in the long term.

There are three top-tier management methods which are being utilized:

One-Stick: This long-lasting opiate is injected into the spine, via a one-stick. For up to 18 hours pain is well managed. A one-stick requires less general anesthesia during the course of the surgery which means patients awaken more lucid, less nauseated, and are in limited discomfort. Hospitalization for one night is required with the one-stick.

TAP Block: A TAP Block delivers local anesthesia into the abdominal wall, thereby anesthetizing the intercostal nerves. This anesthesia can be administered during or immediately after the surgery. A TAP Block can last up to a few hours, however, if Exparel is utilized, pain management may last a few days.

Local Anesthetic Pump: Local anesthesia is administered by a catheter and directly to the surgical site. Typically, these pumps are used for a few days.

Do discuss pain management options with a board certified plastic surgeon, and by doing so, choose the best one for a particular procedure.

It’s also important to point out that if liposuction was used during the tummy tuck, a compression garment will be worn for a few weeks.

During the recovery phase, it’s highly recommended for mothers to get the assistance they need by means of a certified nurse’s assistant, friend, or family member for a few days. Proper healing will allow a patient to make great strides in their recovery.

Study unveils a link between cosmetic eyelid surgery and migraine relief

The world of medicine is ever-changing which continues to make it fascinating in terms of new studies. And in this particular case, there was a correlation between a reduction in migraines following eyelid surgery, also known as a blepharoplasty.

Please note this was just an initial study and more research needs to be done.

The study was conducted at the Louisiana State University Health Sciences Center, and the article in Science Daily entitled, “Surgeons report significant migraine relief from cosmetic eyelid surgery technique.”

The summary of the report highlights, “Plastic and reconstructive surgeons report a high success rate using a method to screen and select patients for a specific surgical migraine treatment technique. More than 90 percent of the patients who underwent this surgery to decompress the nerves that trigger migraines experienced relief and also got a bonus cosmetic eyelid surgery.”

The results of this study were published in the journal, Plastic and Reconstructive Surgery.

Championing the study was Dr. Oren Tessler, Assistant Professor of Clinical Surgery at LSU Health Sciences Center New Orleans School of Medicine.

The article indicated that he was part of the plastic and reconstructive team of surgeons who reported using a particular method to screen and select patients for this surgical migraine treatment.

It was written, “The technique offers an alternative to the commonly used endoscopic approach which works down from the scalp under the skin. There are many cases that are not suitable for this approach, ranging from the patient’s anatomical issues to some surgeons’ lack of access to endoscopes or experience with them.” It continued, “The research team found that, in a select group of patients, incisions through the upper eyelid resulted in equally effective release and deactivation of the nerves involved in migraines.”

The article went on to say that other surgeons which were part of the study included doctors from Massachusetts General Hospital and Harvard Medical School.

Likewise, they unveiled a positive feedback of 90.7 percent.

“Migraine headaches were totally eliminated in 51.3% of the patients, with about a fifth of them experiencing an 80% reduction of symptoms. Nearly a third of the patients had between 50 and 80% of their symptoms resolved,” the study indicated.

A total of 35 patients, who suffered from chronic migraines, took part in the study.

Dr. Tessler said, “Surgery is a valid treatment for migraines in certain patients.” He went on to say, “We believe that these patients should have ready access to migraine trigger site decompression surgery. Although larger studies are needed, we have shown that we can restore these patients to full and productive lives.”

Why it may be a good idea to have in-home nursing options following surgery by Marin by Marin

After cosmetic plastic surgery, it might be a good idea to get a little extra attention from a certified nurse’s assistant (CNA) for a few days. A CNA can go a long way in helping a patient rest and making sure they are receiving the proper care they need.

While some procedures require a short hospital stay, many others may not. Nevertheless, it’s nice to know there are options a board certified San Diego plastic surgeon may offer in regard to having temporary at-home postoperative care.

In many cases, these nurses will drive a patient home after their procedure, and then once again the following day, for their first post-operative appointment. Likewise, the nurse will work with the surgeon to determine what services and special care will be needed.

For example, this healthcare professional can make certain a patient takes their required medications and antibiotics, provides frequent icepack sessions, helps with dressing changes, assists the patient to the bathroom, cares for any post-operative drains, makes the patient comfortable in bed and most importantly, alerts the doctor of any issues.

Duties of the nurse can also include shopping, cooking, running errands and light housework. The nurse will make sure to monitor the patient so that they do not over exert themselves, especially if there are young children in the household.

Every doctor handles post-operative care differently, so a prospective patient should ask the surgeon how he or she deals with post-operative care.

If having a CNA appeals to the patient, it’s important to speak with the surgeon regarding a nurse’s expertise in the procedure they are having, such as a breast reduction, tummy tuck or facelift.

Times have changed in terms of overnight hospital stays. Surgeons are recognizing that patients may recover better in their own home environment or even a hotel room.

It’s important to note, however, that there are patients who require a hospital stay after surgery and a surgeon will make that determination in the best interest of their patient.

Either way, the surgeon still wants patients to have individualized care the first 24 to 48 hours after the surgery. And if needed, the nurse can stay with the patient a few more nights, if desired.

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.