Bolitho MD

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

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23Feb, 2017

The Trend of Modern Aesthetics

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The Trend of Modern Aesthetics

In a world of minimally invasive nonsurgical facial rejuvenation procedures, striking a balance between trend and what’s aesthetically attractive remains the goal. The advent of cosmetic injections such as Botox and fillers has afforded patients with numerous aesthetic possibilities. While this is true, finding the right medical professional such as a board-certified plastic surgeon or their handpicked aesthetic nurse specialist to deliver these injection series is of the utmost importance since their in-depth understanding of the facial anatomy is superb.

Unwavering commitments among these medical professionals, particularly plastic surgeons who are considered excellent by their own peers, have to balance ethics when facial trends emerge. Their Hippocratic Oath bounds them to uphold professional and moral principles which encompass the best care for their patients.

In a patient consultation, doctors will listen to the aesthetic wishes of their patients. If a patient requests a procedure which a doctor believes would not be advantageous to their appearance, a candid discussion will take place on why this is so.

An example of this would be lip augmentation via fillers. Lip enhancement is considered one of the top leading trends. Candidates for lip augmentation may inquire about a treatment for one or more of the following reasons:

  • Naturally thin lips
  • Lips which have lost volume with age
  • Correct the appearance of uneven lips
  • Quick recovery following an injection series

In a consultation, a doctor will determine if enhancing a patient’s lips will help balance one’s facial contours. If a doctor feels as if a patient is a good candidate for the procedure and moves forward with the treatment, a collision between ethics and aesthetics may collide if a patient requests more filler which would outsize their lips following the procedure.

It’s important to note that this just doesn’t pertain to lip enhancement. This applies to “over injecting” other parts of the face, such as augmenting the cheeks or minimizing wrinkles via Botox. It all falls into the same aesthetic category.

The results of cosmetic injections should be subtle and undetectable by others.

While trends do shape culture, it’s ultimately the responsibility of a board-certified plastic surgeon to provide their patients with timeless beauty in a natural looking way.

Even though a patient may have their own particular view on how their nonsurgical facial rejuvenation should look, it’s important to discuss it in detail if a medical professional may not fully agree. If the reasons aren’t totally understood, do ask for more explanation and clarification.

Above all, doctors in this aesthetic field have a distinct vision and don’t want to compromise it based on trend.

6Oct, 2016

Methods to help reverse the signs of facial aging

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Methods to help reverse the signs of facial aging

As one becomes mature with age, they may notice over time that their skin appears less hydrated and fine lines are more apparent. While these signs may be normal, both women and men may very well want to take steps to facial rejuvenation.

There are various reasons as to why skin ages. For many, although they have been incredibly diligent with their sunscreen, over sun exposure may still have occurred triggering premature aging such as fine lines, wrinkles, and age spots.

While UV damage plays a role in aging skin, other factors contribute to it as well including a sluggish cellular turn over, loss of natural hydration, and repeated facial movements that cause dynamic wrinkles. For those unfamiliar with the term, “dynamic wrinkles,” this occurs from recurrent facial actions such as smiling which can develop wrinkles over time along the outer corners of the eyes and mouth.

While surgical facial rejuvenation such as a facelift or lower limited facelift can produce excellent results, some patients may decide to travel a nonsurgical pathway first. And on this road are the following aesthetic avenues.

Skin Care Regimen

One of the best investments an individual can make is to team up with a medical skin care professional. An example of this is an aesthetic nurse specialist who works alongside a board certified plastic surgeon. Partnering with such an expert will offer a springboard of skin care options such as being afforded medical grade skin care products which match a person’s needs.

While many plastic surgery offices offer specific skin care lines, one prescription product not to be overlooked is Retin-A. This topical appeared on the market nearly three decades ago and was intended for the use of patients with acne. Not long after it was on the market, users noticed another improvement in their skin: Rejuvenation.

Patients agreed that their skin appeared smoother, age spots had diminished, and fine lines and wrinkles were less noticeable.

A complete antiaging skin care regimen requires Retin-A.

In office visits with a medical specialist may also include chemical peels, dermaplaning, and micro-needling to enhance those skin care results.

Botox

As mentioned earlier, dynamic muscles occur due to the frequent use of facial muscles. One way to minimize their appearance is via Botox injections. A board certified plastic surgeon or their aesthetic nurse specialist can deliver this leading cosmetic injection. Finding a skilled injector who is adept in the facial anatomy is critical for one interested in receiving Botox. The results of Botox should be a refreshed and natural look.

It’s important to note that some individuals in their late twenties and/or early thirties utilize Botox to prevent these dynamic wrinkles from forming.

Fillers

The loss of hydration in one’s skin will have side effects. Some of these may include the following:

  • Less youthful fullness
  • Dull facial canvas
  • Fine lines and wrinkles
  • Skin sensitivity

While some topical and in-office treatments can help with hydration, a group of patients turn to hyaluronic fillers to help treat nasolabial folds and marionette lines. Conversely, fillers such as Juvederm can help augment the lips, while Voluma can augment the cheek area.

From skin care products and treatments to cosmetic injections, each one should be tailored to a patient’s aesthetic needs and desires.

29Sep, 2016

A Break Time Peel Review

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A Break Time Peel Review

Since offering a “Break Time Peel” to our menu of nonsurgical antiaging services, our office has received wonderful feedback regarding this treatment protocol. In under an hour, our aesthetic nurse specialist, Elizabeth Reed, champions this visit which leaves patients looking luminous.

Recently Reed had the opportunity to perform a Break Time Peel on one of our patients, Christina M., 50.

“Elizabeth is my nurse injector for Botox, and I see her every few months for a touch-up. On my last visit with her, she mentioned how I may benefit from a Break Time Peel. I have had dermaplaning before but never a chemical peel in conjunction with it,” she said. “I decided to give it a try since Elizabeth also has me on a great SkinMedica routine. I trust Elizabeth, and she is a perfectionist.”

Before the treatment, Reed analyzed Christina’s facial canvas. She then prepared her face for the dermaplaning.

“I was used to this portion of the treatment. Elizabeth gently glides this stainless steel tool over my face,” Christina said. “There is no discomfort whatsoever and is quite relaxing.”

The dermaplaning removes vellus hair, also known as peach fuzz, as well as the top layer of dead skin cells.

Next came the light chemical peel.

“Elizabeth gently applied a topical ingredient. A small fan was placed over my face to lessen any tingly or burning sensation,” Christina said. “And even that was minimal.”

Elizabeth made a couple more passes with the topical chemical peel. She ensured Christina was comfortable by having the small fan rotating overhead.

“Elizabeth is so conscientious making certain I was comfortable,” Christina said. “The Break Time Peel lasted under an hour and before I left, Elizabeth applied sunscreen on my face and reminded me to always wear it when outdoors.”

A few days later, Christina has noticed a youthful skin boost. While her skin is visibly smoother, her facial canvas is brighter. And skin peeling is minimal.

“I absolutely love the results of the Break Time Peel,” Christina said. “This is something I am definitely going to do regularly!”

24Sep, 2016

Nonsurgical facial contouring choices

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Nonsurgical facial contouring choices
As one reaches their forties and fifties, they may undoubtedly notice their facial contours have altered over time. For example, the fullness in the midportion of their face, particularly in their cheeks, may have lost their youthful volume. As someone looks closely at the lower portion of their face, they may also witness submental fullness, which is more often referred to as a double chin. At different angles, the submental fullness may appear more prominent.

Although these changes don’t occur overnight, many can attest to the fact that it almost appears as if it has. The truth of the matter is that these facial transformations creep up year after year. In addition to maturity, other reasons for these changes may be heredity, weight gain, or weight loss.

Cosmetic injections have made incredible strides in the world of aesthetics. Botox, for example, is one of the leading injections used to diminish lines and wrinkles along the forehead, between the brows, and crow’s feet. While Botox is in the lead, other cosmetic injections have been pioneers in their own aesthetic right. And these injections are top choices for nonsurgical facial contouring.

To address the loss of fullness in the cheek area, a product by the name of Voluma has been considered one which has offered patients with an outstanding outcome. While patient dependent, the effects of Voluma may last up to two years.

During a consultation with a plastic surgeon or their aesthetic nurse specialist, they will determine if a person is a good candidate for Voluma. If it is determined so, photos may be taken prior to the injection so before-and-after pictures will be available.

Prior to the injection, a topical lidocaine cream will be applied to help ensure more comfort for the patient. Methodically, the medical professional will deliver the Voluma slowly. Towards the end of the injection series, a mirror will be on hand so the patient can see the aesthetic transformation. And the results are immediate. There is no downtime with Voluma; however, there may be a bit of bruising which can be easily camouflaged by makeup.

A quickly rising star for addressing submental fullness is another cosmetic injection called Kybella. While the former injection only requires one visit, Kybella is considered more of a treatment plan which may range from two to five series. Kybella’s main ingredient of deoxycholic acid breaks down and destroys fat deposits to help eradicate the appearance of a double chin. Once a person is determined to be a candidate for Kybella, the medical professional will map out the injection area on the underside portion of the chin and numb the region prior to delivering the treatment.

Treatment sessions are generally recommended to be spaced about six weeks apart. Icing is important after treatment to help alleviate any bruising or swelling following the injections.

While these treatments are considered nonsurgical, it’s incredibly important to have them executed by a medical professional who is adept in the facial anatomy.

9Sep, 2016

A great skin care routine makes a difference

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A great skin care routine makes a difference

While individuals are incorporating a healthy lifestyle through diet and exercise, their desire to keep their skin looking youthful is also important to them. Many are beginning to realize that incorporating a great skin care routine compliments those health and wellness efforts.

As one ages, skin changes naturally occur such as the following:

  • Fine lines and wrinkles
  • Age spots
  • Lack of skin hydration
  • Loss of volume
  • Loss of elasticity

While the aging process impacts the above facial characteristics, it is also important to point out how the environment takes a toll on one’s skin.  For example, free radicals, pollution, and unprotected sun exposure can also accelerate premature skin aging.

Despite these daily challenges, one should not curtail their skin care energies but instead implement a regular regime for both morning and night.

Partner with a skin care professional

With a mountain of skin care products to choose from, the task of choosing the right skin care routine can be downright daunting. Teaming up with a skin care professional, particularly an aesthetic nurse specialist, is an exceptional choice.

A person of this magnitude and skill can perform a skin care evaluation and help map out the right morning and evening routines. They can also afford patients medical grade skin care products which truly offer users driven results.

Skin care plans are tailored specifically for one’s skin type and examples may include the following:

  • Cleanse – To prepare skin for topical treatments
  • Treat – To target specific challenges such as fine lines and wrinkles or hydration
  • Repair – To reverse skin damage such as the use of a retinol product
  • Moisturize – To add hydration to the facial canvas including the eye area
  • Protect – To implement a solar defense to help ward off future skin damage

Skin care treatments to reverse skin damage

The advantage of partnering with an aesthetic nurse also means that they are adept in particular skin care treatments that can help diminish the signs of aging. Even in cases where one has undergone surgical facial rejuvenation, such as a lower limited facelift, skin care texture still needs to be addressed.

Most skin care treatments can be performed on a monthly basis, but again, it’s all patient dependent. And some treatments can be done with less frequency. These procedures require minimal to no downtime and produce radiant results:

  • Dermaplaning: To remove the top layer of dead skin cells and vellus hair (peach fuzz)
  • Chemical Peels: To help rejuvenate the skin by diminishing the signs of fine lines, even out skin tone, and lessen the appearance of age spots
  • Micro-Needling: To help stimulate collagen and to deliver medical grade products into the skin for more luminosity.

In addition to these treatments, patients may also decide that they want to pursue cosmetic injections which may consist of Botox, Kybella, Juvederm, or Voluma to maintain their youthful skin care goals.

Solar protection bears repeating

While one is implementing a healthy lifestyle and skin care routine, a SPF sunscreen defense is of the utmost importance. When an individual turns a broad spectrum sunscreen application into a daily habit, they will invariably reap the rewards because of it.

 

 

17Aug, 2016

Changing the face of science

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Changing the face of science

Science continues to redefine itself in the area of facial rejuvenation. With an eye to the future, a recent article published in JAMA Facial Plastic Surgery has paved the way to new ideas and possibilities. And in the world of science, it’s all about new concepts.

While facial surgery such as facelifts, cosmetic injections, and even fat grafting have filled a vital niche for many patients opting for rejuvenation, researchers are testing to see if the human body can somehow perhaps be encouraged to stimulate facial tissue regrowth.

This area of science is called regenerative medicine.

In Vocativ, reporter Alexandra Ossola covers this recent article which was authored by Matthew Q. Miller, MD. Miller is a surgeon specializing in the head and neck regions from the University of Virginia Health System.

Ossola writes, “Though scientists’ interest in regenerative medicine has grown steadily since the early 2000s, interest in facial surgeries in particular isn’t reflected in the literature until 2010. Miller believes there are two reasons for this. Generally, facial surgeries have good outcomes—they heal quickly and have a low rate of infection, so there’s no need for dramatic improvement.”

Miller also shared that there is not “margin for error” in operative facial surgery.

“Even small imperfections can really stand out, as people’s eyes always focus on the faces of others in day-to-day interactions. Because of this, new techniques are a little slower to gain widespread acceptance among surgeons,” Miller said.

Also interviewed in the article was Richard D’ Amico who serves as the chair of the Regenerative Medicine Task Force which is a branch of the American Society of Plastic Surgeons.

D’Amico notes how hyaluronic acid fillers support facial structures. Fillers such as these are noted to add a more youthful appearance when volume or elasticity has dissipated due to age or premature aging. While injections of this type such as Juvederm offer a great outcome, the results are temporary lasting up to a couple of years.

While patient dependent, fat grafting is generally utilized during a facial surgery to add volume. Following liposuction of a small area such as the thighs, abdomen, or hips, the fat is then filtered via a centrifuge before the injections occur in the rejuvenation procedure

In the article, D’Amico described this process as labor intensive thus requiring it to be more expensive for the patient.

“If regenerative medicine works the way researchers think it could, patients could just get a quick injection, plus some localized anesthesia, to repair their facial tissues,” Miller writes. “And while it might not be able to repair tissues in a “Star Trek-like fashion” (that is, with a device that can heal wounds almost instantly), Miller and his co-authors write, these regenerative techniques could usher in a new age of plastic surgery for the face.”

The three levels scientists are currently focused on include the following:

  • Stem Cells
  • Platelet Rich Plasma (PRP)
  • Protein Matrix

While more research is underway and these above scientific avenues still require more answers, it’s interesting to know how science continues to play a role in facial rejuvenation in one form or another.

5Aug, 2016

A Break Time Peel Awaits You

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For the entire month of August, please join us for our “End of Summer” Break Time Peel Special.

 

 

3Aug, 2016

End of Summer Special!

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End of Summer Special

For the entire month of August, let Elizabeth Reed, Dr. Bolitho’s aesthetic nurse, unleash a more youthful you with a “Break Time Peel.” In less than an hour, Elizabeth will provide a tailored facial rejuvenation treatment with gorgeous results.

A “Break Time Peel” includes the following:

STEP 1: Dermaplaning – Gentle exfoliation to remove dead layer of skin cells and peach fuzz

STEP 2: Light Chemical Peel – To treat superficial fine lines, sun spots, and even out skin tone

STEP 3: Luminous and renewed skin with no downtime

Regularly priced at $350, this “Break Time Peel” special is being offered at $250.

And during this tailored session with Elizabeth, she will perform a skin evaluation and provide helpful anti-aging tips.

Call 858-458-5100 or email info@bolithomd.com to book this incredible appointment today.

“End of Summer Special” expires on August 31, 2016.

 

27Jul, 2016

The Anti-Aging Skin Defense

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The Anti-Aging Skin Defense

For those who want to defy premature skin aging, there is an arsenal of tools which can help make that possible. From those twenty-something years and beyond, there is a youthful pathway for every age group.

Regardless of how ever old one is, there is a tried and true daily routine which consists of sunscreen. Apply a broad spectrum sunscreen of SPF 35 or more every single day and reapply throughout the day if spending time outdoors. Don’t neglect the neck and décolletage area.

And yes, take part in this daily routine even on overcast days.

For those in their late twenties and early thirties, aside from the above solar protection, many are seeking the help of a registered aesthetic nurse who can assist premature skin-aging prevention. While this includes finding the right skin care line, these skilled skin care professionals are also delivering Botox to future areas which could be prone to wrinkles. This type of strategy helps from having these wrinkles develop.

For those in their late thirties to early forties, additional skin changes may occur such as the following:

  • Decrease in elasticity
  • Wrinkles and fine lines
  • Uneven skin tone
  • Age spots
  • Uneven skin texture

While every person is different regarding their skin care type, an aesthetic registered nurse can help remedy these challenges in a variety of ways. As Botox helps smooth out fine lines and wrinkles along the forehead and around the eyes to treat crow’s feet, fillers such as Juvederm can help plump and diminish those marionette lines around the mouth.

When one reaches their mid to late forties and early fifties, they may begin to notice that there is a loss of volume in the cheek area which occurs with the natural aging process. Voluma is an injectable which affords patients with a wonderful option in restoring this volume.

Some nurses will recommend delivering Voluma prior to the Juvederm. The reason behind this is on occasion the Voluma can help remedy or lessen marionette lines by adding more volume and lift to the medial facial region. Again, this is all patient dependent.

While cosmetic injections continue to serve as a great anti-aging defense, there are other treatments that do an extraordinary job such as the following:

  • Dermaplaning as a way to exfoliate and remove vellus facial hair.
  • Chemical peels as a way to diminish fine lines, age spots, and even out skin tone.
  • Micro-Needling as a way to promote collagen and more youthful looking skin.

As one reaches their late forties and early fifties, they may implement the procedures just mentioned as well as a cosmetic injection named Kybella to help submental challenges otherwise known as a “double chin.” Kybella may take two to four sessions to complete, but the treatment destroys fat cells on the underside of the chin.

It’s important to note that while these nonsurgical treatments help a number of individuals, some patients prefer to have plastic surgery procedures such as a neck lift, lower limited facelift, or eyelid surgery for their aesthetic goals.

Despite whatever rejuvenation road one is on, there are a multitude of options to achieve youthful results.