Bolitho MD

{name}{address}{city}{zipcode}{state}{country}{phone}
9834 Genesee Ave Ste 311 La Jolla San Diego, California
Phone: (858) 458-5100

BLOG

21Dec, 2016

Plastic surgeons recommend cessation of e-cigs prior to surgery

By: | Tags: , , , , , , , ,

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.

29Nov, 2016

Facial rejuvenation for the holiday season

By: | Tags: , , , , , , , , ,

Facial rejuvenation for the holiday season

As 2016 comes to an end, an array of festivities will be in full swing. In the weeks ahead, holiday parties, family gatherings, and other celebrations will fill the calendar. With these social engagements some may wonder what facial rejuvenation treatments are doable during this time-frame — meaning, facial rejuvenation with little to no downtime. This is important because this is the hustle and bustle time of the year.

The good news is there is a roster of treatments which fit into this category.

Cosmetic Injections

While cosmetic injections are minimally invasive, treatments should be performed in a medical setting by a healthcare professional adept in facial anatomy such as a plastic surgeon or their aesthetic nurse specialist. Depending on the treatment chosen, results can be immediate such as a filler or appear days after the injection series such as Botox.

As one ages, they tend to lose volume around certain areas of their facial canvas such as their cheekbones. Created by Allergan, JUVÉDERM® Voluma™ is a cosmetic injectable gel which can help restore this volume in a subtle and natural-looking way. An injection series in the deep subcutaneous and/or supraperiosteal region provides cheek augmentation to the mid-portion of the face and Voluma patients note that their results can last up to two years.

Also by Allergan is JUVÉDERM®, another hyaluronic acid cosmetic injectable gel, which is a leading choice to lessen the appearance of nasolabial folds and marionette lines.

Quite new to the aesthetic world of cosmetic injections is JUVÉDERM VOLBELLA® XC. This injection series specifically targets lip rejuvenation by adding subtle volume and lessens the appearance of vertical lines that occurs with age due to repeated muscle movement and solar exposure. Volbella which promotes both a youthful and subtle fullness offers results for up to a year.

One of the most popular cosmetic injections is Allergan’s Botox — another excellent choice for facial rejuvenation by minimizing the signs of aging in the following areas:

  • Horizontal forehead lines and wrinkles
  • Frown lines and wrinkles
  • Squint lines such as crow’s feet

As previously mentioned, it’s highly recommended to see a medical professional for these injections series. During a consultation, they will give their own recommendation after hearing the aesthetic wishes of their patients. The goal of all these injections is to have patients look refreshed with natural-looking results.

Skin Resurfacing

Chemical peels do a fine job in resurfacing the skin in terms of minimizing lines, diminishing age spots, and evening out skin tone. A chemical peel is a good choice if one is not attending an event for about 10 days. However, if this is not the case, another option is to schedule a Break Time Peel.

A Break Time Peel is a combination of dermplaning and a light chemical peel. Dermaplaning removes vellus hair and dead skin cells via a stainless steel tool and prepares the skin for the upcoming peel. Results from a Break Time Peel include the following:

  • Smoother skin texture
  • Improved skin tone
  • Produces and promotes collagen

In less than an hour, patients can return back to their day.

During this very busy time of the year, there is indeed an array of facial rejuvenation choices.