Bolitho MD

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


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.

5May, 2016

Anti-Aging education promotes youthful beauty

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Anti-Aging education promotes youthful beauty

In a time where various anti-aging techniques are making headway, the importance of partnering with an aesthetic nurse is incredibly important to meet those personal skin care goals. While mainstays such as Botox and fillers are part of this equation, continuing education and refining one’s skills in this “beauty arena” raises the bar in relation to the level of care for facial rejuvenation.

Recently, aesthetic registered nurse Elizabeth Reed attended a Las Vegas conference for the Society for Plastic Surgical Skin Care Specialist. Additionally, Reed works alongside the highly regarded Dr. D. Glynn Bolitho, chief of plastic surgery at SCRIPPS Memorial Hospital, La Jolla.

In tandem, Dr. Bolitho was in attendance at the annual convention for The American Society for Aesthetic Plastic Surgery (ASAPS).

Reed enjoyed the educational ambience which immersed her in lectures about the novel technologies emerging in the near future as well as keeping medical professionals up to date on new products.

“It’s such a great learning experience for me by ensuring that I’m on top of the newest things that are going on in facial rejuvenation,” Reed said.

Reed admits that her favorite part of the conference was taking part in an “injectables” course to further polish her technique. In essence, the hands-on training was an exceptional way to refresh her knowledge on the facial anatomy so patients can receive optimal results for various fillers such as Voluma and Juvederm.

“Voluma is an ideal selection used mostly for facial volume restoration while Juvederm acts as a great filler for the lips and nasolabial folds to smooth out smile lines around the mouth,” she said. “It was really a useful course for me.”

Top tier individuals who perform cosmetic injections have an in-depth background and education in the anatomy of the face.

“You really have to know the facial anatomy because it’s the key to safety, outcome and the end result for a patient’s aesthetic satisfaction,” she said.

As a whole, the conference afforded Reed an opportunity for valuable educational knowledge which in turn would benefit patients at the practice. And it’s knowledge such as this which patients seek.

Reed pointed out that when a medical team from a plastic surgery practice attends these types of conferences that it speaks volumes to their dedication. A quest for education also means fulfilling and exceeding the needs of their patients.

“It is all about creating an outstanding outcome for patients both surgically and non-surgically,” Reed said. She added, “And that also includes maintaining a youthful appearance to one’s skin even after surgery so they can continue to age gracefully.”


21Apr, 2016

How to get beautiful eyes

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How to get beautiful eyes

Even in the Old Hollywood era, beautiful eyes were an asset for the silver screen. Decades later, gorgeous eyes are still a sought after commodity. While many beauty experts have touted their own secrets, the truth of the matter is that there is a three-step protocol to rejuvenate the eye area. The burning question, “How to get beautiful eyes?” can be answered with these simple and valuable steps.


Fabulous Lashes with Latisse

According to Elizabeth Reed, an aesthetic nurse who works with board certified plastic surgeon Dr. D. Glynn Bolitho in San Diego, lashes are the first ingredient to beautiful eyes.

“Latisse can help lengthen, strengthen, and achieve darker eyelashes. Long, healthy lashes frame the eye area better and attract attention to the eyes,” she said. “I use Latisse, and a lot of the ladies here in the office use it, too. We just love the results.”

According to Reed, users will start to see lash improvement within the first month. However, the incredible results will start to grow in within two to three months.

Applied on the upper lashes every evening, Latisse is incorporated into a nighttime skin care regimen.


The Wonders of Botox

Over time and with repeated muscle movements, fine lines begin to emerge around the outer corners of the eyes. Some call these lines crow’s feet while others describe them as squint lines. But one thing that can be agreed upon is that most women would prefer them to disappear.

And that aesthetic wish can be achieved with Botox.

Reed delivers small amounts of Botox into these facial crevices to help smooth out those lines. She was also quick to point out that Botox for this very reason is not meant to change the shape of the eye nor should it. The goal is to minimize the appearance of fine lines around the eyes.

“I believe less is more and I am definitely a more conservative injector because I really don’t want someone to know that you’ve had Botox,” she said. Reed continued, “I want patients to look refreshed.”

Reed wants people to know that the amount of Botox used is dependent upon a person’s muscle movement. In other words, there is not a standard amount for everyone – instead it’s an incredibly tailored procedure.


SkinMedica TNS Eye Repair

While Latisse can help create gorgeous lashes and Botox can erase squint lines around the eyes, a daily topical skin care treatment can help rejuvenate this fragile skin area with complete hydration. The goal is to locate a topical which can gently help erase imperfections while improving the quality of one’s skin.

Reed describes SkinMedica TNS Eye Repair as an amazing product offering an anti-aging component to achieve the three-step process to attain beautiful eyes.

“This product is really great in minimizing those fine lines and wrinkles around the eyes,” Reed said. She added, “It has a high concentration of Vitamin C and E and hyaluronic acid to increase the hydration.”

A results-driven formula used on a daily basis can offer maximum benefits which help create and maintain healthy and beautiful looking eyes.


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.

16Jun, 2015

Changing the Face of Facial Rejuvenation

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The world of cosmetic surgery is growing more popular, and with it, new technology to help promote a more youthful appearance continues to emerge. Many companies are pioneering technology to help reduce fine lines and wrinkles.

While new technology continues to appear on the horizon, it’s critical that consumers do their due diligence while leaning on a plastic surgeon for their honest point of view regarding a novel noninvasive treatment.

The advent of these new treatments is highly popular to patients because in essence they require no downtime. The idea of reversing facial aging with the aid of ultrasound or radiofrequency is incredibly attractive. The thought of lifting and tightening the brow, chin and neck area can naturally spark a great deal of interest. Yet, one must not forget to do their homework.

Following research, one is encouraged to team up with their plastic surgeon in looking at the new technologies that have come along while judging them against what the industry already has. Quite frankly, the field of facial rejuvenation already has a significant arsenal of techniques and modalities to treat different patients in various areas.

As new technology comes forth, in tandem with being FDA approved, it’s important to note that it may not necessarily be better than what is currently being used. And this is where research comes in.

It’s the responsibility of a board certified plastic surgeon to be cautious with new technology and use it appropriately, only when there is sufficient data.

For example, statistical data for newer technology needs to be balanced with the reality of sound research versus what is being driven by the industry. At the end of the day, it’s the responsibility of a doctor to make a truly objective assessment.

The one thing a plastic surgeon does not want on their menu of services is to offer a patient a modality or technique that they do not have the greatest confidence in – even if it is being touted as the next “big” thing.

Conversely, many of these treatments are costly and may require more than one session to receive the full benefit. While these noninvasive treatments may offer a youthful change, one needs to address if they provide more than just a subtle transformation.

Also, some treatments may not be as benign as one thought. Once again, lean on a plastic surgeon for guidance as well as seeking a second opinion. Inquire about any side effects in terms of the underlying tissue.

Some plastic surgeons who perform facial surgery are noticing a variance in the tissue where some of this new technology has been utilized. While it won’t affect the outcome of a facial rejuvenation surgery, there may be changes to the tissue.

For those patients wanting more than an understated aesthetic enhancement, they may very well consider that investing in a limited operative facial rejuvenation procedure to be ideal. When calculating costs and final results, this would provide an immediate and a longstanding outcome.

Cosmetic treatments are a personal decision. When one is ready to embark on a particular modality, please peruse the research data, independent patient reviews and team up with a board certified plastic surgeon for guidance.