Bolitho MD

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

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19Jan, 2017

Plastic Surgery Consultation: Plan Ahead

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Plastic Surgery Consultation: Plan Ahead

For some individuals, a new year means new possibilities. One pathway of possibilities may be aesthetics by way of plastic surgery. When one has located a board-certified plastic surgeon, the next step is scheduling a plastic surgery consultation.

It’s completely normal for a patient to feel a blend of excitement and nervousness at this appointment. Nevertheless, there are some things that a patient can do ahead of time to make the most of their consultation.

Karen Martindale is a patient concierge for San Diego plastic surgeon Dr. D. Glynn Bolitho. Dedicating more than 25 years in the cosmetic surgery industry, Ms. Martindale brings a wealth of knowledge to patients preparing for a consultation.

Ms. Martindale’s sage advice is to plan ahead.

Top plastic surgeons like Dr. Bolitho are going to be booked about four to six weeks in advance. So most of the time, a patient will not be able to walk in and request surgery the very next week,” Ms. Martindale said. “With that said, it’s never too soon to come in for a consultation.”

According to Ms. Martindale, some patients who want to learn more about liposuction or tummy tuck may think that they need to be at their ideal weight before their consultation. Ms. Martindale shared that potential patients do not need to wait.

“It’s always a great idea to come in for your consultation three or four months ahead of time so future plans can be made. Even though you may not be at your ideal weight, coming in and having your consultation is a great start,” Ms. Martindale said. “Many patients have also explained how the consultation served as a great incentive to help them achieve their weight loss goal.”

In other instances, achieving a certain weight loss for a particular procedure may not be necessary. Ms. Martindale shared an example such as for those wanting a neck lift or surgical facial rejuvenation procedure.

“If you’re within 10 to 15 pounds of your ideal weight, having a facelift may not make that much difference,” Ms. Martindale said.

Planning ahead is also needed if one is smoking traditional cigarettes or inhaling e-liquid nicotine while vaping.  Ms. Martindale wants potential patients to know that they need to stop smoking four weeks before and after surgery. And on a side note, Ms. Martindale happily reported how many of their patients never returned to their cigarette use.

Writing down questions ahead of time was also mentioned by Ms. Martindale.

“These questions can vary, but generally they range from recovery, when they can resume their exercise routines, and when they can fly,” she said.

For marathon runners readying for a future event, planning ahead on the opportune timeframe for surgery is important to address.

“Busy moms also need to coordinate their surgery time with their children’s schedules and possible childcare assistance,” Ms. Martindale said. “Another thing a patient will want to inquire is if their plastic surgeon will be out of town during the time they are interested in having surgery.”

In many respects, a plastic surgery consultation can help turn a possibility into a reality.

13Jan, 2017

Breast reduction recovery expectations

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Breast reduction recovery expectations

When women decide to undergo a breast reduction, more times than not, they have done their due diligence about the procedure. Even prior to their consultation with a board-certified plastic surgeon that specializes in breast surgery, they have put a great deal of consideration and thought into the procedure.

While this surgical decision is a personal one, women who choose to embark on this procedure do so for a variety of reasons. However, the one goal most agree upon is decreasing the size and weight of their naturally large size so they can achieve the following:

  • More balanced proportions
  • Lessen discomfort such as neck, shoulder, and back pain
  • Improve symmetry
  • Achieve aesthetic goals

A breast reduction surgery involves the removal of redundant skin, excess tissue, and fat. Also patient dependent is the repositioning of the nipple-areola complex to a more youthful position.

Typically done under general anesthesia, a breast reduction procedure is performed as an outpatient surgery. While most patients return home the very same day of their surgery, in some instances, it may be recommended for others to stay overnight at the hospital for extensive reductions or a medical condition that may need monitoring following surgery.

While patients will be mobile the same day of their surgery, it’s highly advised that they have assistance for the first 24 to 48 hours following their procedure. They may also need someone on hand to help them dress or assist them in caring for younger children for a few days.

Patients who have a desk job can expect to return to work in about a week whereas someone with more laborious responsibilities such as nursing may require a couple of weeks.

A breast reduction surgery is considered a common procedure, and patients are generally quite happy with their surgical outcome. It renews a person’s comfort level be it aesthetically or even physically.

Another postoperative guideline is to avoid heavy lifting which includes not taking on more than 10 pounds within the first couple of weeks. Aside from walking, most patients are required to wait four to six weeks before returning back to their normal exercise regimen. Between this time-frame, patients can gradually increase their activity levels. At six weeks following a breast reduction surgery, patients generally return back to their full and normal activities.

It’s important to stop a specific movement if there is any discomfort and relay this to your plastic surgeon. Following postoperative guidelines and having clear communication with a patient’s plastic surgeon is extremely advantageous.

While swelling generally decreases a couple weeks following surgery, it completely recedes in about two to three months. This is when a patient is able to visibly notice the final results of their procedure.

21Dec, 2016

Plastic surgeons recommend cessation of e-cigs prior to surgery

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Plastic surgeons recommend cessation of e-cigs prior to surgery

In a recent December publication of United Press International, Health Day News reported how two plastic surgeons stated in the Plastic and Reconstructive Surgery December issue how stopping the use of e-cigarettes prior to surgery was highly advised. The doctors highlighted in the piece included Dr. Alan Matarasso of Albert Einstein College of Medicine and Dr. Peter Taub of Mount Sinai Medical Center.

According to Health Day News, the doctors stated, “Based on our current best knowledge, it seems reasonable to advise plastic surgery candidates to cease e-cigarette use,” they said. The doctors continued, “Refraining from [e-cigarette] use four weeks before surgery is a prudent course of action, despite the fact that it has yet to be determined if the effects are similar to traditional cigarettes.”

While the health impacts of “nicotine vapor” continue to be researched, it appears the reason for this medical recommendation underscores patient care. The doctors referred to a study which revealed how stopping traditional smoking three to four weeks prior to a procedure could significantly decrease the risk of postoperative complications.

Blood flow and blood supply is essential following plastic surgery procedures, such as breast surgeries and abdominoplasties. Tissue healing following surgery requires this blood flow.

Erring on the side of caution, it’s believed that e-cigarette users should follow the same protocol as those who use traditional tobacco products. The reason behind this cautionary advice stems from the fact that the side effect of nicotine is best described as a vasoconstrictor.

According to the American College of Surgeons, traditional cigarette smoking does increase complications both during and following surgery. It’s their estimation that following the “no smoking rule” a few weeks prior and after surgery lessens the risk of wound healing by nearly half.

Many plastic surgeons also encompass the cessation of nicotine patches and gum in this medical protocol.

In addition to nicotine, carbon monoxide is also another concern.

While carbon monoxide withdraws oxygen away from the tissue area, as mentioned earlier, nicotine constricts blood vessels which deliver oxygen and nutrients to tissues. Again, this blood flow is vital to the healing process.

If the percentages in oxygen and nutrients drop during the recovery process, there is a risk factor following surgery in areas such as infection, increased chance of scarring, and additional complications.

While some plastic surgeons follow a smoking cessation of four weeks prior and after surgery, others have a more conservative approach of six weeks. A large gap of time is highly recommended and encouraged.

During a patient’s consultation with their plastic surgeon, it’s imperative to be candid regarding any smoking history. And this includes vaping. A surgeon’s top priority is the care of his/her patients and making certain, as a doctor-patient team moving forward, all can be done for an outstanding surgical outcome.

21Oct, 2016

Why a woman may seek a breast revision surgery

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Why a woman may seek a breast revision surgery

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

Excellent communication between plastic surgeons and their patients is imperative.

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

These reasons may vary and include the following:

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

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

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

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

Every patient is different as are their aesthetic needs.

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

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