Bolitho MD

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


18Apr, 2015

A Quick Guide Into Breast Implants

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Doctor With Rx Prescription

While breast augmentation surgeries continue to be a sought after procedure for women of varying ages, it is important to glean a better understanding regarding breast implants. The size of the implants will invariably influence how a woman appears as well as what their daily lifestyle is, including sports and activities.

First and foremost, it is highly important that a woman does her due diligence in terms of researching the right plastic surgeon. They must be board certified in plastic surgery and specialize in surgeries of the breast.

As mentioned earlier, women seek this surgery at different ages and timeframes of their lives. For example, a woman in her twenties may want to increase the volume in her breasts, while others who have had children and breastfed, decide to have a breast lift and augmentation with implants.

It’s important to note here that a breast lift may not always need an implant. This decision is made between the doctor and their patient.

Despite the original aesthetic goals, this surgery will increase breast volume and projection. The goal for a plastic surgeon is to make certain that the augmentation improves a woman’s silhouette; in other words, balance her proportionately.

Breast implants are measured by cubic centimeters. The larger the implants, the greater the cubic centimeter numbers. Implants are filled with either silicone or saline, and its shell is almost always made of silicone.

So how many cubic centimeters does it take to go up a bra size? This popular question is answered with 150 to 200 cubic centimeters. When looking at breast implants, it’s difficult for a patient to determine by mere sight alone what size would be best. However, when she explains during a consultation she would like to increase her cup size by one or two, this can help a surgeon hone in on her aesthetic wishes.

Nevertheless, before deciding on what cubic centimeters is best, a doctor and patient must be mindful of the following:

  • The implants match breast width
  • Implant size matches a woman’s lifestyle in terms of exercising and sports
  • The implants are proportionate with a woman’s frame and do not make her heavier in size

For some women, their reaction into getting an augmentation is to have larger, fuller breasts. But the best plastic surgeon will explain any risks which may be involved in going “too large.” A handful of these risks may include:

  • Atrophy caused by the weight of the implants
  • Muscles and tissues start to thin out
  • Stretch marks caused by the implant weight
  • Large implants may cause rippling appearance
  • Bottoming out from the implant weight

And more…

There are instances where a woman decided to undergo a drastic augmentation with very large implants, and within a year, decided to replace them with a lower cubic centimeter number. If a patient waits too long to replace them and the skin is stretched, a breast lift may need to be implemented with the new augmentation procedure.

Plastic surgery is a personal decision, especially that of a breast augmentation. Much thought and consideration needs to be made and working with a skilled plastic surgeon is essential during the process.


21Mar, 2015

The History of Breast Augmentation

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Think that the first breast augmentation surgery was in the 1980s? Try earlier, and flip a couple numbers to read the 1890s. While breast augmentation is one of the most highly performed cosmetic surgeries both nationally and internationally, doctors have been testing ways to enhance volume for decades.

And, yes, it has come a long way.

Back in the 1890s, paraffin was injected into the bust for enhancement, but this treatment stopped rather quickly after it was discovered that the ingredient was seeping into other areas of the body.

Years later, more specifically in the 1920s and 1930s, doctors tried an “early version” of a fat transfer. They actually extracted fat from parts of the patient’s body and injected it into the breasts. This treatment didn’t have a very long shelf life.

In the 1950s, the introduction of the insertion of sponges, cartilage, polyurethane and even glass balls were utilized to examine what method was best. Out of all of these, the sponges worked well, but the results were not long lasting. The sponges would shrink and become stiff after a period of time.

In 1962, a shift in breast augmentation occurred. Timmie Jean Lindsey, hailing from Houston, Texas, agreed to undergo the surgery using silicone implants. What she originally went into surgery for was to remove tattoos on her breasts and what she got in return was an enhancement from a B to C cup and a gratis otoplasty which she wanted for aesthetic improvement.

In the operating room were Drs. Frank Gerow and Thomas Cronin performing this historical surgery.

Little did anyone know that this two hour procedure would change the way breast augmentation would be done in the future.

For Cronin, the concept really became a reality when he gave his presentation at the 1963 International Society of Plastic Surgeons convention in Washington DC. Those in attendance thought it was remarkable.

And as many say, the rest is history.

Known as medical devices, breast implants have solid silicone shell. Inside them, doctors and patients have a choice whether they prefer a silicone or saline filled implant. Each kind is approved by the FDA.

And since the 1960s, these implants have improved and changed dramatically including these following nuances and features:

  • The shell texture of an implant
  • The projection and profile of an implant
  • The anatomic shape of an implant
  • Diameter of an implant


It’s also important to note that while the U.S. Food and Drug Administration conclude that the silicone-gel implants to be “generally safe,” it is advisable that patients who undergo an enhancement using these medical devices communicate with their surgeons on a frequent basis. Routine postoperative appointments are part of this protocol, and sometimes an MRI may be recommended every few years.

When a woman decides to undergo a surgery such as this, it should never be done in haste. It’s always recommended to have a thorough consultation with a board certified plastic surgeon, discuss the benefits of the procedure, choose the right size of an implant which is proportionate to the body, and touch upon any risks factors.


13Feb, 2015

Recovery Time for a Mommy Makeover Varies

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Mother and two kids silhouettes on beach at sunset

When a woman completes her family and has given birth to her last child, she may begin to think of a rejuvenation surgery for her body. For many females, undergoing pregnancy can take a bodily toll on her abdomen and breasts.

While the numbers may drop on the scale, the excess skin generally remains and cannot return to its natural position. It’s all part of pregnancy.

The great news is that a rejuvenation procedure called a mommy makeover can help restore a woman’s body back to her pre-pregnancy days. While the procedure undoubtedly provides wonderful results including a flatter abdomen, a slimmer waistline, and more youthful looking breasts, the recovery time is indeed something to be mindful about.

Some women try comparing the recovery time of a mommy makeover to a C-section, but this isn’t quite accurate in terms of a tummy tuck, also known as an abdominoplasty.

While each woman recovers at a different rate, at the end of the day, what dictates the recovery time is what type of tummy tuck a surgeon has chosen for their patient.

A breast lift, with or without an implant, will cause some discomfort, but the abdominoplasty along with muscle plication is really the determining factor.

Liposuction is generally utilized during a tummy tuck as it truly sculpts the abdomen, hips and waist. The three types of procedures to choose from are the following:

  • Liposuction only: For patients with limited excess skin and small amounts of fat deposits
  • Mini-abdominoplasty: For patients who require below the belly button abdominal improvements
  • Full abdominoplasty: For patients who require both below and above the belly button abdominal improvements

As mentioned before, the more muscle plication involved, the longer the recovery.

The good news, however, is over the last few years the advent of longer acting anesthetics lasting up to four to five days has modernized healing.

San Diego board certified surgeons are discovering that by utilizing this along with spinal anesthesia during the time of general anesthesia, is providing patients different modalities to enhance their recovery.

In turn, patients are in less discomfort after surgery.

The revolutionary idea that pain management starts in the operating room has broken the proverbial glass ceiling and is making huge strides in the world of not only cosmetic surgery, but all operations.

Some surgeons are calling this movement preempted pain relief so that prior to even starting the surgery, local anesthetic is injected into the surgical field. This very well has proved to minimize a patient’s anesthetic requirements so they awaken more clearly while blocking the pain for a longer period of time.

Patients following this surgical protocol, including mommy makeovers, do much better.

In terms of recovery, while patients may be walking the day of surgery or on the very next day, total recovery takes about four weeks. And if a woman’s profession is not physically laborious, she can return to work sooner.

For the first few days following surgery, assistance will be needed especially if a patient has younger children. In advance, she will need to designate a caregiver, be it a family member or friend. It’s also recommended to have a nurse stay with her the first night or two following surgery to monitor her progress.

Plastic surgery takes patience because it is a journey with amazing results. And mommy makeovers afford ladies a lovely transformation.