Bolitho MD

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

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19Jan, 2017

Plastic Surgery Consultation: Plan Ahead

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Plastic Surgery Consultation: Plan Ahead

For some individuals, a new year means new possibilities. One pathway of possibilities may be aesthetics by way of plastic surgery. When one has located a board-certified plastic surgeon, the next step is scheduling a plastic surgery consultation.

It’s completely normal for a patient to feel a blend of excitement and nervousness at this appointment. Nevertheless, there are some things that a patient can do ahead of time to make the most of their consultation.

Karen Martindale is a patient concierge for San Diego plastic surgeon Dr. D. Glynn Bolitho. Dedicating more than 25 years in the cosmetic surgery industry, Ms. Martindale brings a wealth of knowledge to patients preparing for a consultation.

Ms. Martindale’s sage advice is to plan ahead.

Top plastic surgeons like Dr. Bolitho are going to be booked about four to six weeks in advance. So most of the time, a patient will not be able to walk in and request surgery the very next week,” Ms. Martindale said. “With that said, it’s never too soon to come in for a consultation.”

According to Ms. Martindale, some patients who want to learn more about liposuction or tummy tuck may think that they need to be at their ideal weight before their consultation. Ms. Martindale shared that potential patients do not need to wait.

“It’s always a great idea to come in for your consultation three or four months ahead of time so future plans can be made. Even though you may not be at your ideal weight, coming in and having your consultation is a great start,” Ms. Martindale said. “Many patients have also explained how the consultation served as a great incentive to help them achieve their weight loss goal.”

In other instances, achieving a certain weight loss for a particular procedure may not be necessary. Ms. Martindale shared an example such as for those wanting a neck lift or surgical facial rejuvenation procedure.

“If you’re within 10 to 15 pounds of your ideal weight, having a facelift may not make that much difference,” Ms. Martindale said.

Planning ahead is also needed if one is smoking traditional cigarettes or inhaling e-liquid nicotine while vaping.  Ms. Martindale wants potential patients to know that they need to stop smoking four weeks before and after surgery. And on a side note, Ms. Martindale happily reported how many of their patients never returned to their cigarette use.

Writing down questions ahead of time was also mentioned by Ms. Martindale.

“These questions can vary, but generally they range from recovery, when they can resume their exercise routines, and when they can fly,” she said.

For marathon runners readying for a future event, planning ahead on the opportune timeframe for surgery is important to address.

“Busy moms also need to coordinate their surgery time with their children’s schedules and possible childcare assistance,” Ms. Martindale said. “Another thing a patient will want to inquire is if their plastic surgeon will be out of town during the time they are interested in having surgery.”

In many respects, a plastic surgery consultation can help turn a possibility into a reality.

9Sep, 2016

A great skin care routine makes a difference

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A great skin care routine makes a difference

While individuals are incorporating a healthy lifestyle through diet and exercise, their desire to keep their skin looking youthful is also important to them. Many are beginning to realize that incorporating a great skin care routine compliments those health and wellness efforts.

As one ages, skin changes naturally occur such as the following:

  • Fine lines and wrinkles
  • Age spots
  • Lack of skin hydration
  • Loss of volume
  • Loss of elasticity

While the aging process impacts the above facial characteristics, it is also important to point out how the environment takes a toll on one’s skin.  For example, free radicals, pollution, and unprotected sun exposure can also accelerate premature skin aging.

Despite these daily challenges, one should not curtail their skin care energies but instead implement a regular regime for both morning and night.

Partner with a skin care professional

With a mountain of skin care products to choose from, the task of choosing the right skin care routine can be downright daunting. Teaming up with a skin care professional, particularly an aesthetic nurse specialist, is an exceptional choice.

A person of this magnitude and skill can perform a skin care evaluation and help map out the right morning and evening routines. They can also afford patients medical grade skin care products which truly offer users driven results.

Skin care plans are tailored specifically for one’s skin type and examples may include the following:

  • Cleanse – To prepare skin for topical treatments
  • Treat – To target specific challenges such as fine lines and wrinkles or hydration
  • Repair – To reverse skin damage such as the use of a retinol product
  • Moisturize – To add hydration to the facial canvas including the eye area
  • Protect – To implement a solar defense to help ward off future skin damage

Skin care treatments to reverse skin damage

The advantage of partnering with an aesthetic nurse also means that they are adept in particular skin care treatments that can help diminish the signs of aging. Even in cases where one has undergone surgical facial rejuvenation, such as a lower limited facelift, skin care texture still needs to be addressed.

Most skin care treatments can be performed on a monthly basis, but again, it’s all patient dependent. And some treatments can be done with less frequency. These procedures require minimal to no downtime and produce radiant results:

  • Dermaplaning: To remove the top layer of dead skin cells and vellus hair (peach fuzz)
  • Chemical Peels: To help rejuvenate the skin by diminishing the signs of fine lines, even out skin tone, and lessen the appearance of age spots
  • Micro-Needling: To help stimulate collagen and to deliver medical grade products into the skin for more luminosity.

In addition to these treatments, patients may also decide that they want to pursue cosmetic injections which may consist of Botox, Kybella, Juvederm, or Voluma to maintain their youthful skin care goals.

Solar protection bears repeating

While one is implementing a healthy lifestyle and skin care routine, a SPF sunscreen defense is of the utmost importance. When an individual turns a broad spectrum sunscreen application into a daily habit, they will invariably reap the rewards because of it.

 

 

27Jul, 2016

The Anti-Aging Skin Defense

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The Anti-Aging Skin Defense

For those who want to defy premature skin aging, there is an arsenal of tools which can help make that possible. From those twenty-something years and beyond, there is a youthful pathway for every age group.

Regardless of how ever old one is, there is a tried and true daily routine which consists of sunscreen. Apply a broad spectrum sunscreen of SPF 35 or more every single day and reapply throughout the day if spending time outdoors. Don’t neglect the neck and décolletage area.

And yes, take part in this daily routine even on overcast days.

For those in their late twenties and early thirties, aside from the above solar protection, many are seeking the help of a registered aesthetic nurse who can assist premature skin-aging prevention. While this includes finding the right skin care line, these skilled skin care professionals are also delivering Botox to future areas which could be prone to wrinkles. This type of strategy helps from having these wrinkles develop.

For those in their late thirties to early forties, additional skin changes may occur such as the following:

  • Decrease in elasticity
  • Wrinkles and fine lines
  • Uneven skin tone
  • Age spots
  • Uneven skin texture

While every person is different regarding their skin care type, an aesthetic registered nurse can help remedy these challenges in a variety of ways. As Botox helps smooth out fine lines and wrinkles along the forehead and around the eyes to treat crow’s feet, fillers such as Juvederm can help plump and diminish those marionette lines around the mouth.

When one reaches their mid to late forties and early fifties, they may begin to notice that there is a loss of volume in the cheek area which occurs with the natural aging process. Voluma is an injectable which affords patients with a wonderful option in restoring this volume.

Some nurses will recommend delivering Voluma prior to the Juvederm. The reason behind this is on occasion the Voluma can help remedy or lessen marionette lines by adding more volume and lift to the medial facial region. Again, this is all patient dependent.

While cosmetic injections continue to serve as a great anti-aging defense, there are other treatments that do an extraordinary job such as the following:

  • Dermaplaning as a way to exfoliate and remove vellus facial hair.
  • Chemical peels as a way to diminish fine lines, age spots, and even out skin tone.
  • Micro-Needling as a way to promote collagen and more youthful looking skin.

As one reaches their late forties and early fifties, they may implement the procedures just mentioned as well as a cosmetic injection named Kybella to help submental challenges otherwise known as a “double chin.” Kybella may take two to four sessions to complete, but the treatment destroys fat cells on the underside of the chin.

It’s important to note that while these nonsurgical treatments help a number of individuals, some patients prefer to have plastic surgery procedures such as a neck lift, lower limited facelift, or eyelid surgery for their aesthetic goals.

Despite whatever rejuvenation road one is on, there are a multitude of options to achieve youthful results.

11May, 2016

Skin care treatments following a facelift

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Skin care treatments following a facelift

Over the years, operative facial rejuvenation procedures have become incredibly refined. Be it a facelift or lower limited facelift, a board certified plastic surgeon can adeptly create both youthful and natural looking results. Operative facial rejuvenation is a blend of sheer artistry and skill. It requires years of dedication for a plastic surgeon to reach this level of perfection.

When a patient embarks on the operative facial rejuvenation journey, they will be delighted with their refreshed appearance. However, skin care treatment is an important part in maintaining those youthful results since a facelift does not alter the skin per se.

Different ways to enhance those facial features may include the following:

  • Chemical Peels
  • Dermaplaning
  • Botox

As mentioned, one way to rejuvenate the skin is by way of a chemical peel.

According to Elizabeth Reed, a registered aesthetic nurse who works for San Diego plastic surgeon Dr. D. Glynn Bolitho, a chemical peel can also help prepare the skin prior to surgery.

And following surgery, it can be an excellent protocol in controlling fine lines, wrinkles and brown spots.

“A chemical peel can give patients a nice healthy and youthful glow to their skin,” Reed said.

This type of luminosity is a skin care goal. According to Reed, following an operative facial procedure, she typically recommends a series of three chemical peels.

“You can space those about a month apart, and then the maintenance can be once every three months,” she said.

Another popular procedure that Reed likes to employ for patients is dermaplaning. Gently, she utilizes a stainless steel tool and delicately glides it along the face to remove both dead skin cells and vellus hair.

There is no downtime to dermaplaning and it can be performed on a monthly basis. With the right type of skin care navigation, an aesthetic nurse can map out the right anti-aging regimen. A few times a year, it may be suggested to combine both a dermaplaning and chemical peel. Performing a dermaplaning prior to a chemical peel will allow for better product penetration and optimal results.

“Following a dermaplaning, your skin is super soft,” she said. “So when you’re washing your face or you are putting on your makeup, you are noticing a wonderful smoothness to your skin.”

Another pathway for maintaining facial rejuvenation following a facelift or lower limited facelift is by implementing a regimen of cosmetic injections. Botox is highly sought after since it helps diminish the appearance of fine lines.

Every patient is unique and their skin care should be just as distinct. Prior to starting skin care treatments, an aesthetic nurse should thoroughly examine a patient’s face while listening to their patients’ skin care goals.

For Reed, this begins with makeup removal and then utilizing a bright magnifying light to afford a better skin care analysis. And then a suggested customized treatment plan can begin.

“It’s based on what the patient is looking for, and then I tailor the treatment for you,” she said. Reed added, “And it’s not always the same for everyone.”

Partnering with an aesthetic nurse can help achieve and maintain a youthful facial canvas.

27Jan, 2016

Comparing U.S. Cosmetic Surgery to Great Britain

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Comparing U.S. Cosmetic Surgery to Great Britain

It’s always incredibly interesting to see how cosmetic surgery trends in the United States compare to other parts of the world. Recently, the Telegraph in the United Kingdom wrote an intriguing article about cosmetic enhancements.

And quite frankly, the title of the article says it all: “Why are the over 55s turning to cosmetic surgery?”

Reporter, Saffron Alexander, begins the article by reviewing data from The Independent Pensions Advisory Service in Britain, otherwise known as TPAS. According to statistics, residents are enjoying their fifty-something years with purchases such as musical instruments, RVs, and telescopes to view the constellations.

However, another interesting find was cosmetic surgery spending.

Alexander turned to the United States, citing numbers from the American Society for Plastic Surgeons (ASPS). In 2014, the data collected revealed that Americans 55+ accounted for 24 percent of cosmetic procedures while those between the ages of 40 to 54 accounted for 34 percent.

Comparing the above information to The British Association of Aesthetic Plastic Surgeons (BAAPS) was informative. It appeared that plastic surgery percentages since 2013 have dropped 9 percent. The new mantra is “tweaked not tucked.”

In the article, the following BAAPS statement was included: “The demand for subtle, understated anti-aging procedures such as eyelid surgery, facelifts, and fat transfer remain largely unchanged, while more ‘conspicuous’ treatments such as tummy tucks and nose jobs are dropping dramatically.”

Alexander interviewed plastic surgeon and member of BAAPS, Naveen Cavale, who shared that this trend is more obvious for those over the age of 55.

“There has been a slight rise in the number of people aged 55 or older who are opting for cosmetic surgery. This could partly be because of the new financial freedoms they’re enjoying, but also the fact cosmetic surgery is no longer a taboo in society,” she said. Cavale continued, “It’s also much more affordable and accessible for the average person. The procedures we’re seeing most among the over 55s are things that contribute to facial rejuvenation. We’re seeing them opt for non-surgical procedures like fillers or Botox and other procedures such as facelifts or eyelid correction.”

Here in the United States, facial rejuvenation by way of lower limited facelifts, temporal brow lifts, eyelid surgery and cosmetic injections such as Juvederm and Botox are in the lead.

Most plastic surgeons will agree with Cavale that those who choose facial rejuvenation procedures are in a different demographic as compared to patients in their twenties and thirties.

The most telling information in this published article is that those over 55 who seek a cosmetic surgery procedure do so not to alter their facial features to turn back the clock decades, but rather the yearning to look “less tired” and refreshed is key.

While Cavale succinctly conveyed that patients want to “look better, not younger,” many would agree with this while also adding that any facial rejuvenation being performed affords natural looking results for the most optimal patient satisfaction.

 

5Jan, 2016

Cosmetic surgery and treatments in 2016

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Cosmetic surgery and treatments in 2016
With a new year, many individuals may consider this as an opportunity to improve their aesthetics through diet, exercise and cosmetic procedures. Recently, the New York Daily News covered an industrywide survey from an online website named RealSelf. This website is considered a portal which offers patients the opportunity to learn more about plastic surgery and nonsurgical options. With the assistance of plastic surgeons, potential candidates can have their questions answered as well as those who are patients in the midst of a procedure recovery.

A regarded site, RealSelf generated a survey to those working in the field in hopes it could glean a better understanding on where the plastic surgery trends were directed in 2016. According to the responses, five items stood out among the rest which included the following:

• Buttock augmentation
• Decrease bustline
Lip enhancement
Neck rejuvenation
Chin enhancement

Looking into 2016, these procedures appeared to be paving the way to a new year.

Body Contouring Procedures

When diet and exercise are unable to correct areas of the body where lax skin or stubborn fat deposits remain, many turn to body contouring procedures as an option. There are many procedures which fall into this category which may include the following:

• Breast lift
• Upper arm surgery
• Body lift
• Liposuction
• Tummy tuck
• Buttock augmentation

And more….

Buttock Augmentation

Board certified plastic surgeons are noticing that the desire for a more voluptuous chest size is now being shifted toward buttock augmentation. Implants are utilized for this surgery to enhance the size and curvature of the posterior region. According to the RealSelf survey, women prefer a smaller bustline and want to increase the shapely curves in their hind end.

Lip Augmentation

On the nonsurgical front, lip augmentation with the use of fillers is gaining attention, and according to the survey will attract new patients.

As reported by Jacqueline Cutler of the New York Daily News, “Thirty percent of dermatologists and 43% of plastic surgeons report they received more requests about lips in 2015 than 2014, another trend expected to continue.”

Neck and Chin Surgeries For Selfies

During 2015, there were an array of articles discussing how selfies were indeed an impetus for so many individuals wanting to undergo a facial and neck rejuvenation. Selfies have redefined how people see themselves, and most importantly, how they want to improve themselves.

While some patients may be tolerant with their facial aging for a period of time, the improvements they currently seek are surgically geared toward a more youthful neck and redefinition of the chin.

“And 68% of the doctors say they expect to have patients requesting neck and chin work in 2016,” Cutler wrote.

Plastic Surgery Consultations

While surveys can give insight as to where plastic surgery trends are headed, it’s highly urged and recommended that potential patients have a consultation with a board certified plastic surgeon to discuss the procedure(s) they are interested in. While learning more about the procedure, they can understand the recovery process.

Plastic surgery is a personal decision and one that should be made with thoughtful consideration.

18Dec, 2015

Rejuvenation: A Temporal Brow Lift

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 Rejuvenation: A Temporal Brow Lift

A forehead lift is a common operative facial rejuvenation procedure, but another surgery which is doing an excellent job in providing a youthful appearance above and around the eyes is a temporal brow lift. This procedure, growing more in demand, helps restore a well-rested appearance which affords patients with a more renewed and younger look.

With the hand of an experienced board certified plastic surgeon that specializes in facial surgery, redundant skin is removed and muscles which are repositioned does smooth out and redefine facial contours along the upper portion of the face.

It’s also common for one undergoing a temporal brow lift to also have an upper eyelid surgery since they do complement each other. However, each patient has their own unique aesthetic needs, and this may not hold true for everyone. A consultation with a board certified plastic surgeon will help determine this.

Different from a forehead lift, the temporal brow lift only addresses the outer portion of the brows. Majority of brow lifts, also referred to as forehead lifts, elevate this area completely. However, a temporal lift does not. Instead, it only elevates about half of the lateral portion.

The surgical incision on each side, which is up to one inch in length, is discretely placed behind the hairline so scars are camouflaged. And as the name of the surgery suggests, the incision location is directly above the temple.

The goal of this cosmetic surgery is to provide patients with a more natural and open appearance of their eyes. Many describe the surgical outcome as a more relaxed and refreshed presence.

A consultation appointment with a plastic surgeon will help determine if a temporal brow lift versus a complete brow lift is the right procedure. During this time, the surgeon will assess the natural position of a patient’s brows by their height in comparison to one’s shape and orbital rim.

The plastic surgeon will gently perform this manually and may also take measurements.

Additionally, the surgeon will determine if the central brows are not in need of any operative elevation. If the central portion is in a good position but the lateral portion reveals a descent, then a temporal brow lift will be suggested to reshape the eyebrows and eye contours.

Many patients who decide to have this surgery often express concern at their consultation appointment about how their facial expressions appear to others. This may include the following:

·       Worried
·       Tired
·       Upset

The above characteristics are not what people want to portray to the workplace, family, friends, and new people they meet. Even more so, when they are well-rested, they are often asked if they are tired because they appear that way. Of course, these surgical candidates prefer a more positive looking appearance.

While patients are thrilled with their surgical outcome, they are also delighted with the fact that the surgery is considered less invasive which also affords them with less risks and complications. Again, in order to assess whether a person is the right candidate for this surgery, please consult with a board certified plastic surgeon that has extensive experience in operative facial rejuvenation.

6Aug, 2015

Cosmetic surgery leads the way for Baby Boomers and Gen X

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FreeDigitalPhotos.net by Stock Images

FreeDigitalPhotos.net by Stock Images

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.

16Jun, 2015

Changing the Face of Facial Rejuvenation

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FreeDigitalPhotos.net by “ by stockimages

FreeDigitalPhotos.net by “ by stockimages

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.