Bolitho MD

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


29Mar, 2016

Chemical Peels for Skin Rejuvenation

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Chemical Peels for Skin Rejuvenation

Implementing a skin care routine is imperative if one wants to maintain and promote healthy skin. While sunscreen is at the very top of the list, the application of Retinol is also on the aesthetic checklist. It should be noted that Retinol should be prescription strength based on percentages and issued by a healthcare professional. Based on one’s skin care needs, a professional will choose the right percentage for the patient.

With a skin care regimen in place, another treatment for consideration is a chemical peel. Once again, this treatment should be done in a medical facility performed by an aesthetic nurse.

Nicole Dowler, who is an aesthetic nurse who works with plastic surgeon Dr. Glynn Bolitho in La Jolla, is a major proponent of chemical peels.

“It’s really important to have cellular turnover with your skin,” she said, adding how a chemical peel can promote this.

Dowler also went on to say that if one is not exfoliating or doing peels on a regular basis, dead skin cells build up on the facial canvas and naturally slough off at a slower pace.

A routine exfoliation helps encourage cellular turnover and recommended at least twice a year.

However, each individual is unique with their skin care goals so an individual plan needs to be mapped out. If one is doing light chemical peels then they may be able to have a few or more per year. Again, it all depends on the patient.

According to Dowler, chemical peels can help with the following:

  • Diminish the appearance of wrinkles
  • Balance skin tone
  • Lessen the appearance of brown spots
  • Lessen the appearance of sun damage

“Each person is going to have an individualized treatment plan, and that’s the beauty of all these different options,” she said. “If somebody is not ready for cosmetic injections, they may opt to do a couple chemical peels.”

When Dowler consults with a new patient for the very first time, she assesses their skin for the most optimal peel. For example, if an individual has never had a chemical peel or has used Retinol, she will start the regimen with a really light peel.

For a more seasoned patient who has undergone previous peels and a daily use of Retinol, then pursuing a more potent chemical peel may be a consideration.

Dowler mentioned that some patients who may want to want a chemical peel the day of their consultation do need to be advised to stop their Retinol regimen 72 hours in advance especially if the percentage of Retinol being used is a higher percentage, such as 2 percent.

Dowler also noted how patients do need to be prepared for chemical peel aftercare in terms of what to expect.

“Right after a peel, your skin looks really great for about two to three days, and then it starts to peel. Peeling is a side effect and it may not affect everybody,” she said. “If someone doesn’t peel, it doesn’t mean that the peel’s not working – it’s just individualized.”

However, if one does experience peeling it will begin a few days after the peel and ends about a week later.

Dowler said on a personal level, it takes her up to two weeks for all the flakiness to disappear.

“If someone is doing a peel before a big event like a wedding, I recommend the treatment at least four to six weeks before,” she said.

22Mar, 2016

Americans increase the price tag of plastic surgery

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Americans increase the price tag of plastic surgery

Over the years, plastic surgery has been fueled by several factors, but the leading demand stems from individuals who want to look as good as they feel. With that being said, the American Society for Aesthetic Plastic Surgery (ASAPS) recently released some data indicating the amount of money that Americans spent on plastic surgery procedures in 2015 reached an unparalleled all-inclusive price tag: $13 million.

Since ASAPS released this information, a handful of articles have followed highlighting different portions of the study. The data was incredibly concise, revealing the top-tier body and facial rejuvenation procedures that both men and women seek; however, women comprised 90 percent of the procedures underwent in 2015.

In 2015, a total of female Americans had 11.5 million plastic surgery procedures. And men tallied 1.5 million procedures.

Plastic surgery has become an important part of American culture, not to mention around the globe. But here in the states, many have suspected that Corporate America has fueled the desire to seek facial rejuvenation. For many individuals who have worked so hard to achieve their career status, a number of them want to retain their position and not retire. A group in this category view plastic surgery as an asset toward their extended career investment.

In the Washington Times, Jennifer Harper wrote a follow-up piece to the ASAPS data. In her article was a statement by president of ASAPS, Dr. James C. Grotting.

“I personally believe the motivating factors for that are varied, but remaining competitive in the workforce is certainly a common factor. Youth is a commodity, and people are investing in themselves to maintain a younger, healthier appearance,” Dr. Grotting said.

While different age ranges were assessed, 40 percent of patients between the ages of 30 to 50 took part in cosmetic procedures. For women, the top procedure in 2015 was liposuction. Following close behind was breast augmentation, tummy tuck, breast lift and eyelid surgery.

The procedures men sought differed; however, their number one procedure was also liposuction. Next was nose reshaping surgery, eyelid surgery, male breast reduction and facelift.

Although not in the top five for women, buttock augmentation and buttock lifts increased quite quickly in numbers, as well. And the demand is increasing.

Harper wrote, “The surgeons note that fat transfer to the face – a new category – ‘instantly’ landed in the top-10 list, as did nonsurgical skin tightening, a procedure particularly popular among men.”

Fat transfer in the face can be considered by many as being done in lieu of fillers. As one ages, they begin to lose volume in their face, particularly around the nasolabial folds and cheek area. While fillers can last up to a year or more, some patients are welcoming a fat transfer. Fat is extracted from a person’s body and then utilized to add youthful fullness to facial features.

In the non-operative sector, Botox led the way at 4.2 million procedures last year. Fillers trailed close behind as did other minimally invasive procedures such as chemical peels.

Be it operative or non-operative procedures, plastic surgery is filling an aesthetic niche for people of all ages.

17Mar, 2016

Breast Revisionary Surgery Transforms and Corrects

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Breast Revisionary Surgery Transforms and Corrects

Breast surgery is a personal decision which should be made mindfully and thoughtfully. While moving forward with the best of intentions, sometimes a patient’s surgical outcome is not to her satisfaction. Be it a breast reduction, breast augmentation, or breast lift with augmentation, a situation may arise which triggers a patient to consider a revision.

There is an array of issues which may occur following the primary operation.

“There is one issue that we call symmastia in where the skin in between the breasts actually lifts off the sternum and can be challenging to correct,” said patient concierge Karen Martindale, who works alongside renowned plastic surgeon Dr. D. Glynn Bolitho. “And another issue a patient may experience is capsular contracture.”

Other matters patients experience may include symmetry challenges, downsizing or replacing breast implants, and more. Martindale explained that some patients after their childbearing years may have had implants to improve volume without a lift. Patients who want a revision in this case are generally not content with the descension.

Martindale explained that when a woman comes in for a consultation, it is most optimal if they have on hand their previous operative notes and what type of implants they currently have so the doctor can review the material.

“Following this, Dr. Bolitho will perform an examination and will be able to show patients a before-and-after gallery of those who underwent the same type of procedures with outstanding results.”

Martindale attributes Dr. Bolitho’s expertise from years of experience in performing breast reconstruction surgeries for women who had lost one or both breasts to cancer.

And each person is different in terms of how long they will wait until they seek a revision. In addition, they may undergo more than one revision.

“Some patients will travel long distances to find the right surgeon to help them with their issue. We’ve had patients in our practice who find Dr. Bolitho after undergoing several revisions,” she said.

According to Martindale, Dr. Bolitho has helped women achieve the aesthetic symmetry they desired, avoid another capsular contracture, and reverse a host of other issues.

“Many women we see in consultations are so close to taking out their implants completely due to the frustration levels,” she said. “I personally have a friend who had eight procedures before she came here to see Dr. Bolitho.”

Martindale shared how her friend was told by one surgeon that she had to have her implants removed because she was prone to capsular contracture. She would encapsulate weeks after surgery, and her implants would be hard again.

And then she went to Dr. Bolitho for a revision.

“My friend is so happy and there has been no evidence of a repeat capsular contracture,” she said.

Martindale’s friend is one of many patients who has sought Dr. Bolitho for help. Breast revisionary surgery can truly transform a woman’s desired aesthetics.

7Mar, 2016

ASPS Unveils Data

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ASPS Unveils Data

The American Society of Plastic Surgeons (ASPS) is an authority when it comes to collecting information from its elite circle of plastic surgeons so it can generate statistical data. Every year both medical professionals and laypeople are quite interested in the results for their own personal reasons.

For plastic surgeons, they can gauge trends as well as the changes in their own practice. And for non-medical individuals, they have the opportunity to see what is deemed “popular and trendy” in the world of plastic surgery.

According to the press release issued by ASPS, procedures have switched gears in relation to cosmetic procedures since the start of the millennium. And these procedures fall into the categories of operative and other treatments described as minimally-invasive.

The survey revealed a robust total of 15.9 million procedures in both categories. From the data collected in 2015, there was a 2 percent procedure spike in the United States.

In the press release, ASPS president David H. Song, MD, MBA, FACS provided his viewpoint.

“While more traditional facial procedures and breast augmentations are still among the most popular, we’re seeing much more diversity in the areas of the body patients are choosing to address,” he said. Dr. Song added, “Patients have more options than ever, and working closely with their surgeon, they’re able to focus on specific target areas of the body to achieve the look they desire.”

While the press release was indeed filled with statistics, on the other hand, it provided an educational outlet. Interestingly the organization pointed out how in the past “plastic surgery” used to be tantamount facelift procedures. Yes, while facial rejuvenation is still a sought after procedure among certain demographics, other aesthetic procedures have made their own significant mark included the following:

  • Brachioplasty (arm lift)
  • Mastopexy (breast lift)
  • Gluteal Augmentation (buttock lift)
  • Lower Body Lift

According to ASPS, they compared patient stats from 2000. The numbers of arm lifts increased 4,959 percent with 17,099 procedures performed in 2015. Breast lifts increased 89 percent with 99,614 procedures performed in 2015, buttock lifts increased 252 percent with 4,767 procedures performed in 2015, and lower body lifts increased 3,973 percent with 8,431 procedures performed in 2015.

In 2015, the top surgical procedures in the lead were breast augmentation, liposuction, rhinoplasty, eyelid surgery and tummy tucks.

In the minimally-invasive category, it’s not surprising to discover that Botox was at the top of the list with 6.7 million treatments performed in 2015. The other procedures that followed were fillers, chemical peels, laser hair removal, and microdermabrasion.

Dr. Song made another critical statement regarding minimally-invasive procedures.

“The number of available providers, lower costs and the less-invasive nature of these procedures obviously appeal to a much broader range of patients,” said Dr. Song. “However, we urge anyone who is considering a minimally-invasive procedure to consult with a board-certified, ASPS-member surgeon.”

While these procedures are not deemed surgical, they are still considered medical procedures and should be carried out in a medical setting.

Like all ASPS members, Dr. Song encouraged patients to seek only the most “qualified and highly trained” medical professionals for these procedures. And of course, this holds true for all plastic surgeries.

As many begin to digest the newest data from ASPS, it will be interesting to see what 2016 brings.

3Mar, 2016

Spring Into Beautiful Skin

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Spring Into Beautiful Skin

Let our aesthetic nurses, Nicole and Elizabeth, put the “Spring back in your skin,” for the entire month of March. Celebrate a flawless springtime facial canvas at our new aesthetic department nestled inside our consultation suite.

Leading the way toward spring fresh skin is our SkinMedica Chemical Peels. Receive a series package of 3 peels for only $285 which is regularly prices at $585. It’s our special gift to you.

During your tailored 30-45 minute session with Nicole or Elizabeth, they will evaluate your skin and select the right chemical peel for your specific needs. A leader in skin care, SkinMedica peels rejuvenates premature skin aging in the following ways:

  • Minimizes the appearance of fine lines
  • Helps restore uneven skin texture
  • Diminishes the appearance of age spots
  • Renews acne-prone skin

And more….

And to keep the springtime momentum moving forward, there’s another special bonus gift. The first 25 patients who book their appointment will receive $50 off their next Botox treatment (offer expires on March 31, 2016).

We look forward to helping you get your skin “springtime ready.”

Call (858) 458-5100 or email us at to book your special aesthetic appointment.

27Feb, 2016

New Consulting Suite Increases Service

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New Consulting Suite Increases Service

The Clifton Room offers patient care in a warm setting.

Recently Dr. D. Glynn Bolitho opened his new consulting suite adjacent to his operating suite. The new addition truly exceeds the expectations of his patients in an effort to ensure that each individual receives genuine care and comfort. This has always been the cornerstone of this compassionate practice.

Tucked away in the new consulting suite is the Clifton Room. The finest of patient care begins here in a warm setting, punctuated with a memorable ambience. The room exudes comfort allowing a patient the time they need to chat with their patient concierge, Karen Martindale, and ultimately their plastic surgeon, Dr. Bolitho.

Before visiting with this dynamic duo, patients can enjoy the privacy of this sitting room while being afforded the opportunity to view the “before and after” photo gallery on a flat screen television.

In many respects, the Clifton Room satisfies the unexpressed personalized desires of their patients, and the move into a larger suite made the Clifton Room possible.

The visionary behind the Clifton Room was Karen Martindale.

“Having been in the field of plastic surgery for the past 30 years, it was my dream to do something special like this for our patients,” she said. “While working at different practices over the decades, I have met with thousands of patients. Firsthand, I noticed the anticipation one feels when they are about to meet with a plastic surgeon.”

Martindale added how disrobing for a potential body contouring procedure may sometimes elevate this anticipation. And at many plastic surgery centers, patients are automatically escorted into an examining room which can be stressful.

“We wanted to take that anxious feeling away and instead create an atmosphere where the patient has the opportunity to get to know us before going into the examining room. We wanted to create a living room environment where one could sit down, relax, and be greeted in a proper fashion,” Martindale said.

And in this setting, one can unveil their aesthetic desires in the most comfortable way possible.

In many respects, the Clifton Room allows patients the ample time they need to spend with Dr. Bolitho and his medical team. Even with a demanding practice, Dr. Bolitho welcomed this new opportunity making certain his patients were indeed receiving the attention they deserved.

“Dr. Bolitho is not the type of doctor that only spends 15 minutes with a new patient,” Martindale said. “Dr. Bolitho’s different in that he really likes to visit with his patients. It’s something that he enjoys.”

Martindale also shared that since the Clifton Room was created, the patient flow at the practice is notably smoother. Following their visit, Martindale then escorts them to the consultation exam room.

However, the most wonderful part of the Clifton Room has been the client feedback. Many patients agree that they have never experienced a room such as this before in a doctor’s office.

“I’ve been personally told by patients how quickly they are put at ease and don’t feel as anxious as they once thought they would be,” she said.

And that was the mission all along: enhanced patient care, memorable comfort, and a polished ambience.

23Feb, 2016

Cosmetic Injections Myths Debunked

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Cosmetic Injections Myths Debunked

A new era of aesthetics can be found by way of cosmetic injections be it Botox or fillers, such as Juvederm. This medical treatment can temporarily reverse signs of aging by smoothing out fine lines and adding volume which dissipates as one matures.

Like any treatment, there are myths about cosmetic injections. And thanks to medical professionals, they can reveal the truth about them.

For many who want to embark on the cosmetic injection pathway, plastic surgeons and aesthetic nurses often hear concerns from patients that they don’t want their face to look unnatural and frozen.

Nicole Dowler, RN, who is certified in the delivery of cosmetic injections, indicates that outcomes such as this where one has difficulty moving their face has undergone too much of everything. For Dowler, her motto is “less is more.”

And this approach is best.

“People don’t want to look like they have had something done. So the best response to that is to try a little bit and then come back for another visit a couple weeks later,” she said.

According to Dowler, if one has undergone Botox and/or filler by a medical professional who knows facial anatomy then nobody is supposed to notice.

“People will know you look good, but they won’t be able to figure out what was done if it was properly delivered with the right amount,” she said.

Another item Dowler pointed out is that people can sometimes be uneasy with the fact that Botox is derived from botulism. Potential patients want to be assured that these injections are safe to do.

Botox is used in high unit amounts in cases such as migraine treatments, spasms, cerebral palsy, and more. The usage for cosmetics is a great deal less. And patients were using Botox to treat a myriad of health issues years before it hit the cosmetic scene.

“The amount of units that we’re using for cosmetic reasons is so small,” said Dowler, noting how she has never personally witnessed a negative outcome. “It’s such a small amount that we’re using to help soften those lines that people usually feel pretty good about it once I explain it that way.”

Highly regarded fillers such as Juvederm and Voluma are made of hyaluronic acid. According to Dowler, hyaluronic acid naturally occurs in the human body so there is nothing foreign about it.

Like Botox, potential patients have heard myths about how fillers have the potential to look obvious or overdone. Medical professionals know that delivery should be slow and methodical.

“It’s very easy to add a little at a time,” she said.

If for any reason a patient is unhappy with the outcome, Dowler said there is a substance that can be injected into the area of where the filler was which can reverse the enhanced appearance.

“Basically, it dissolves the filler,” she said. “People are pretty happy about that.”

However, although there is a substance to reverse a filler, the approach is still to add a little at a time to achieve the most natural and youthful appearance possible.

16Feb, 2016

How Botox Addresses All Generations

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How Botox Addresses All Generations

The advent of Botox has afforded numerous possibilities for patients worldwide. Its uses have been phenomenal and have ranged from treating migraines, cervical dystonia, hyperhidrosis, muscle stiffness in the upper and lower limb regions, eyelid spasms, and more.

And Botox has made aesthetic headlines in temporarily smoothing out facial wrinkles for up to three months or more.

Nicole Dowler, a registered nurse who specializes in aesthetics and cosmetic injections, shared how cosmetic injections such as Botox serve people of all ages. It’s just not isolated to one core age group as many may have thought.

It’s far more reaching than that.

According to Dowler, one can start Botox in their late twenties for preventive measures. Using Botox prior to getting wrinkles in common areas can actually help ward off the deep wrinkles that people typically get as they age.

“In your thirties and forties, Botox can help someone maintain a younger look with these injections before having operative facial rejuvenation procedures such as a facelift,” she said. Dowler continued, “So it starts off as preventive and then turns into prolonging any type of facial surgery.”

And for those who have undergone a facelift, Botox can help maintain those youthful results. In other words, when someone undergoes operative facial rejuvenation, they can turn to Botox at some point for continued benefits.

“A facelift is actually removing skin and tightening facial features,” she said. Dowler continued, “Patients typically seek Botox for those fine lines around the eyes and along the forehead.”

Dowler went on to say that those who have had a facelift will also want to incorporate fillers into their aesthetic roster to really maintain the results from the facelift.

Each age range has a specific need for Botox. The right dosage amount assists in preventive care, promotes a youthful appearance, and maintains optimal results following an operative rejuvenation procedure.

Dowler also pointed out the need for patients to do their due diligence when they do decide to embark on cosmetic injections. It’s highly important that individuals delivering Botox and fillers are medically trained and certified.

“Someone who is medically trained will know the anatomy of the face and will also be aware, especially with Botox, how much to inject,” she said.

Injecting too much may cause a “heavy feeling” in the forehead region. While this sensation will disappear, it’s an uncomfortable feeling.

“You really want somebody with experience,” she said.

Dowler also wants people to be on guard in being “oversold” with treatments. The goal is to have natural, youthful beauty and not to appear “overdone” in the cosmetic injection outcome.

Results like this simply mean that the person delivering the injections puts too much in an individual’s face. Dowler cannot stress enough finding a medical professional who is an expert in the anatomy of the face.

In addition to the anatomy, Dowler mentioned medical professionals will know the areas to avoid when injecting Botox. Conversely, these professionals will know which veins and arteries to avoid with injection fillers.

“It’s important to do your research before you get injections,” she said, noting to also avoid Botox coupon deals.

Cosmetic injections are a medical procedure and must be performed by certified medical professionals for the best aesthetic outcome.

10Feb, 2016

The Botox Balance

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The Botox Balance

Recently an article lit up the cyberspace headlines highlighting how millennials are making appointments with their plastic surgeons. Born between the early 1980s to early 2000s, many millennials are incorporating cosmetic procedures into their daily culture.

While the story covers the demand for Botox and fillers, it gives one pause as to better understand the growing need for this generation to find an aesthetic balance.

Once the article broke out in the New York Daily News entitled “Record number plastic surgeons working on millennials,” its author, Jacqueline Cutler, raised exceptional awareness.

The article cited a fairly recent survey championed by The American Academy of Facial Plastic and Reconstructive Surgery. The most glaring information was how plastic surgeons tallied their own office numbers indicating that 64 percent of their patients were below the age of thirty.

So what’s causing this ripple effect? The answer seems to be the ongoing craze of selfies and it’s not expected to end anytime soon.

Another clear cut reason many might have already suspected are celebrity triggers. High profile people have the type of clout to sway their followers either with their own selfies or photos in online and/or print publications. In the survey, it was estimated that 82 percent of plastic surgeons agreed that celebrities impact cosmetic surgery trends.

With that said, the article pinpointed how millennials are seeking fuller lips and line-free foreheads to ensure picture perfect selfies.

Cutler interviewed Dr. Edwin Williams III who told her, “Younger patients should be advised to be careful not to go overboard too soon with injections. In fact, some procedures like overly plumped lips and a frozen forehead can actually age you beyond your years.”

Nicole Dowler RN, an aesthetic nurse who specializes in cosmetic injections and works with San Diego plastic surgeon, Dr. D. Glynn Bolitho, offered her viewpoints on cosmetic injections among millennials.

It’s Dowler’s belief that beginning Botox in one’s late twenties is a good idea because these injections are considered preventative measures.

“It is easier to maintain a line-free face than it is to try and correct deep lines that are already there,” she said. Dowler continued, “So if you start doing Botox prior to getting wrinkles then you won’t get the deep wrinkles that no one wants.”

While Dowler is a proponent of Botox is this age range, she is also pragmatic in her approach. According to Dowler, her philosophy regarding injections is the “less is more” theory.

“Being conservative is key and a proper consultation with a trained medical professional is always important before deciding where to use Botox and fillers, including how often it should be used,” she said, noting her concern that individuals are overdoing cosmetic injections these days.

Dowler’s recommendation is simple. Abide by the manufacturer’s recommendation for the amount and frequency of treatment. Discussing these issues with a nurse or doctor will help ensure an individualized treatment plan.

At the end of the day, it’s critical for those in the medical profession to educate their millennial patients about aesthetic treatments ranging from cosmetic injections, to chemical peels, to a skin care regimen. A conservative approach is always the best pathway to take.

3Feb, 2016

A Beauty Soiree Invitation

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Elizabeth Reed and Nicole Dowler are considered top-tier talent for cosmetic injections.

Elizabeth Reed and Nicole Dowler are considered top-tier talent for cosmetic injections.

Your pathway to beauty awaits you on February 16 during our “Beauty Soiree.” Our newest team members, Elizabeth Reed and Nicole Dowler, are both highly talented registered nurses whose delivery in cosmetic injections is considered exceptional.

Please join Dr. Bolitho’s team members for a memorable day filled with special prices, opportunity drawings, and light refreshments at our new consulting suite.

Space is limited with Elizabeth and Nicole so be sure to reserve your spot today by calling 858-458-5100 or emailing us at


Friendship Bonus!

Bring a friend and both of you will receive an additional 10% off all services performed by Nicole and Elizabeth during the Beauty Soiree!


Special Services With Elizabeth and Nicole

BOTOX: On this special day Botox is priced at $12 per unit (regularly priced at $14 per unit). Our first 25 patients will receive an additional $50 instant rebate!

VOLUMA AND JUVEDERM ULTRA: Our guests will receive $100 off the regular price.


A Skincare Special 

Receive 10% off skincare products and complimentary computer skin imaging analysis and evaluation.


Special Beauty Bonus

Spend $500 or more and receive a SkinMedica gift product.