Bolitho MD

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


6Aug, 2015

Cosmetic surgery leads the way for Baby Boomers and Gen X

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Plastic surgery has presented youthful opportunities to numerous generations. Currently, generations which are benefiting from it are the Baby Boomers and those leading the pack for Generation X.

These two groups are looking to board certified plastic surgeons to regain a more youthful appearance. Considering that people are working longer in corporate America, it’s reasonable that they want to look as good as they feel.

Additionally, social media and all its nuances, including online dating, have triggered consultation appointments with plastic surgeons.

A solid source for reliability comes from the American Society of Aesthetic Plastic Surgery, also referred to as ASAPS. Annually, they compile data to glean a better understanding of age groups seeking plastic surgery and correlating that information with types of plastic surgery treatments most chosen.

Here is precisely what ASAPS collected for the Baby Boomer generation for 2014:

  • Ten million patients underwent both surgical and nonsurgical cosmetic procedures
  • Those between 51 to 64 years of age were part of this calculation
  • Twenty-four percent had cosmetic surgery
  • Thirty-two percent underwent minimally invasive procedures
  • Those 65 years of age and above accounted for 5 percent of surgical rejuvenation


For those in their 30s to late 40s, Generation X has begun to rely on minimally invasive procedures such as cosmetic injections like Botox and Juvederm for facial rejuvenation; however, one would be remiss if they did not pinpoint the leap in Mommy Makeovers. This is a highly popular procedure that helps mothers restore their post baby figure with a breast lift and/or breast augmentation, tummy tuck and liposuction.

Now, back to the Baby Boomers and what types of procedures they did undergo in 2014:

Patient expectations for these procedures should be natural appearing rejuvenation.

Mature patients in the Baby Boomer generation can be afforded an array of rejuvenation procedures. Operatively, microsurgical skills are unmatched and board certified plastic surgeons are incredibly adept.

And on the anesthesia front, pain management begins in the operating room which ultimately means that patients require less anesthesia during the course of the surgery, awaken less lethargic, and experience lower discomfort levels postoperatively.

While such impressive surgical achievements have been made, a consultation with a board certified surgeon will determine the best procedures for those aesthetic wishes. It’s also important to note that a plastic surgeon will take a comprehensive look at a patient’s medical history.

They will assess any high risk factors such as:

  • Smoking
  • Diabetes
  • Blood thinner medications
  • Heart disease history

If any risk factors are determined, then a plastic surgeon will proceed accordingly.

Consultations are an opportune time to discuss a patient’s aesthetic wishes, learn about the surgery they are interested in, while discovering if they have a genuine rapport with their potential surgeon.

If all goes well during the surgery, the next step in planning the surgery can be done. However, if there is any ambivalence, do take time to think it over and perhaps even meet with the doctor once again. Cosmetic surgery is an important decision, and one should always be mindful during such considerations.

29Jul, 2015

Plastic Surgeons Redefine Hand Rejuvenation

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FreeDigitalPhotos by Marin

FreeDigitalPhotos by Marin

There is an array of minimally noninvasive procedures which do a tremendous job in restoring a more youthful appearance. On this aesthetic roster are liquid facelifts, commonly referred to as cosmetic injections.

While Botox® smooths out fine lines along the forehead area and lines around the eyes, fillers such as Juvederm®, can help erase nasolabial folds. And one would be remiss if they did not mention Voluma® which is an outstanding filler created by the makers of Juvederm® which adds volume to the cheek area.

Over the years, one area where women have wanted to revitalize is their hands. Environmental factors, such as ultraviolet rays, impact the hands which can spur premature aging. Signs of this may include one or more of the following:

  • Slack skin and wrinkles
  • A crepe-like appearance and texture
  • Dull skin tone
  • Dehydrated skin

Due to this natural aging process, tendons and veins on the tops of hands are more visible. Many women who undergo facial rejuvenation and live a healthy lifestyle also yearn to have younger looking hands.

While lotions can hydrate, it cannot add fullness.

Meeting the needs of these patients, many board certified plastic surgeons are now offering a minimally invasive procedure which lasts under 20 minutes called the “hand lift.”

The goal of the procedure is to rejuvenate the hands by adding volume. Doctors utilize the precise same fillers as they do for liquid facelifts.

Radiesse® was recently approved by the FDA for this procedure. It’s also important to note that this manufacturer is the first of its kind which is approved for this treatment.

Facial fat grafting, a procedure where a plastic surgeon harvests fat via liposuction from a patient’s body to add volume to the face, has also been used for hand augmentation. However, some doctors noticed once the fat was delivered, there was sometimes a bumpy appearance.

Radiesse® was decided among doctors to be an optimal choice since its compound ingredients are from calcium. Conversely, Juvederm ®has been a consideration, but it appeared that its hyaluronic acid components did not last longer than Radiesse®.

Plastic surgeons estimate that a hand augmentation with Radiesse® lasts up to a year. Some patients contend the newfound appearance lasts 24 months.

It seems that “hand lifts” are not only geared toward more mature women. Even younger women are undergoing the procedure so their hands have an additional boost of youth when uploading photos of their hands on social media sites. For example, women donning a new engagement ring or piece of jewelry want to share this with their friends but are unhappy with the way their hands appear.

New reports indicate that mature brides, mother of the brides, and mother of the grooms are also booking their hand augmentations. They want youthful appearing hands for those posterity photos.

While the side effects of this procedure are minimal, it’s still highly recommended to speak with a board certified surgeon about any potential risks or complications.

Hand lifts are indeed a growing trend and those in the cosmetic industry expect to see a higher demand for this procedure within the next few years.

6Jul, 2015

How Fat Grafting Enhances Facelift Surgery

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Woman Silhouette Watching Sun In A Sunset

Plastic surgeons have discovered the benefits of incorporating fat grafting methods as part of the protocol for operative facial rejuvenation surgery. In a recent issue of Plastic and Reconstructive Surgery, a medical journal published by the American Society of Plastic Surgeons (ASPS), they revealed some interesting data in how this technique is enhancing the world of facelift surgery.

In fact, it has swiftly become a common component to the surgery be it a limited incision facelift or a more comprehensive procedure.

The study which unveiled this information was championed by Dr. Sammy Sinno, a board certified plastic surgeon at New York University, along with the assistance of his colleagues.

Wolters Kluwer of Medical Xpress cited, “The researchers surveyed a random sample of ASPS members regarding their use of fat grafting for facelift procedures. In this technique, the surgeon performs liposuction to obtain fat cells from another part of the body—such as the abdomen or thighs—and carefully injects them to provide additional volume in selected areas of the face.”

More than 300 ASPS member surgeons took part in the survey.

Leaning on ASPS member surgeons provides an accurate base point. Those who are part of this organization are highly regarded for their education and expertise in their field of medicine.

The response from the study revealed that 85 percent of the respondents stated that they indeed utilize fat grafting during operative facial rejuvenation procedures, otherwise known as facelifts. It was suggested that the increase of this particular technique occurred within the last decade.

While operative facial rejuvenation addresses wrinkles, facial fat grafting is an excellent modality in addressing the loss of facial volume such as in the cheek area. This modality can be of great benefit to reverse this.

Leading up to fat grafting, the following occurs:

  • The collection of fat via gentle hand-harvesting (i.e., liposuction tool)
  • Process of purification
  • Delivery and transfer techniques

The study indicated that the common site where fat was harvested was the abdominal area. The amount of fat transferred into the facial area varied. The survey revealed that this small amount gathered ranged from 11 to 25 cubic centimeters, also known as cc’s.

While a degree of some fat from the transfer does have the potential to reabsorb, ASPS member surgeons agreed that the majority of the transfer was still visibly present one year postoperatively.

The common areas of fat grafting include the following:

  • Cheeks
  • Lower eyelids
  • Nasolabial Folds

In some instances, the study pointed out that fat grafting follow-up treatments were sometimes performed again four to six months after surgery to redefine specific areas. Nonetheless, both patients and their doctors were pleased with the aesthetic outcome.

Toward the end of the study, Dr. Sinno surmised, “The results of our survey demonstrate most surgeons currently believe that facial fat repositioning in combination with volume addition increases the ability to utilize these two complementary techniques to restore the volumetric highlights noted in youth, thereby enhancing facial shape.”

Frankly, volume restoration by way of fat grafting has added another level to facial rejuvenation and has invariably improved a youthful appearance for many patients. This additional phase has transformed into a more prominent role in facial rejuvenation surgery.