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.

13Jan, 2017

Breast reduction recovery expectations

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Breast reduction recovery expectations

When women decide to undergo a breast reduction, more times than not, they have done their due diligence about the procedure. Even prior to their consultation with a board-certified plastic surgeon that specializes in breast surgery, they have put a great deal of consideration and thought into the procedure.

While this surgical decision is a personal one, women who choose to embark on this procedure do so for a variety of reasons. However, the one goal most agree upon is decreasing the size and weight of their naturally large size so they can achieve the following:

  • More balanced proportions
  • Lessen discomfort such as neck, shoulder, and back pain
  • Improve symmetry
  • Achieve aesthetic goals

A breast reduction surgery involves the removal of redundant skin, excess tissue, and fat. Also patient dependent is the repositioning of the nipple-areola complex to a more youthful position.

Typically done under general anesthesia, a breast reduction procedure is performed as an outpatient surgery. While most patients return home the very same day of their surgery, in some instances, it may be recommended for others to stay overnight at the hospital for extensive reductions or a medical condition that may need monitoring following surgery.

While patients will be mobile the same day of their surgery, it’s highly advised that they have assistance for the first 24 to 48 hours following their procedure. They may also need someone on hand to help them dress or assist them in caring for younger children for a few days.

Patients who have a desk job can expect to return to work in about a week whereas someone with more laborious responsibilities such as nursing may require a couple of weeks.

A breast reduction surgery is considered a common procedure, and patients are generally quite happy with their surgical outcome. It renews a person’s comfort level be it aesthetically or even physically.

Another postoperative guideline is to avoid heavy lifting which includes not taking on more than 10 pounds within the first couple of weeks. Aside from walking, most patients are required to wait four to six weeks before returning back to their normal exercise regimen. Between this time-frame, patients can gradually increase their activity levels. At six weeks following a breast reduction surgery, patients generally return back to their full and normal activities.

It’s important to stop a specific movement if there is any discomfort and relay this to your plastic surgeon. Following postoperative guidelines and having clear communication with a patient’s plastic surgeon is extremely advantageous.

While swelling generally decreases a couple weeks following surgery, it completely recedes in about two to three months. This is when a patient is able to visibly notice the final results of their procedure.

21Dec, 2016

Plastic surgeons recommend cessation of e-cigs prior to surgery

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Plastic surgeons recommend cessation of e-cigs prior to surgery

In a recent December publication of United Press International, Health Day News reported how two plastic surgeons stated in the Plastic and Reconstructive Surgery December issue how stopping the use of e-cigarettes prior to surgery was highly advised. The doctors highlighted in the piece included Dr. Alan Matarasso of Albert Einstein College of Medicine and Dr. Peter Taub of Mount Sinai Medical Center.

According to Health Day News, the doctors stated, “Based on our current best knowledge, it seems reasonable to advise plastic surgery candidates to cease e-cigarette use,” they said. The doctors continued, “Refraining from [e-cigarette] use four weeks before surgery is a prudent course of action, despite the fact that it has yet to be determined if the effects are similar to traditional cigarettes.”

While the health impacts of “nicotine vapor” continue to be researched, it appears the reason for this medical recommendation underscores patient care. The doctors referred to a study which revealed how stopping traditional smoking three to four weeks prior to a procedure could significantly decrease the risk of postoperative complications.

Blood flow and blood supply is essential following plastic surgery procedures, such as breast surgeries and abdominoplasties. Tissue healing following surgery requires this blood flow.

Erring on the side of caution, it’s believed that e-cigarette users should follow the same protocol as those who use traditional tobacco products. The reason behind this cautionary advice stems from the fact that the side effect of nicotine is best described as a vasoconstrictor.

According to the American College of Surgeons, traditional cigarette smoking does increase complications both during and following surgery. It’s their estimation that following the “no smoking rule” a few weeks prior and after surgery lessens the risk of wound healing by nearly half.

Many plastic surgeons also encompass the cessation of nicotine patches and gum in this medical protocol.

In addition to nicotine, carbon monoxide is also another concern.

While carbon monoxide withdraws oxygen away from the tissue area, as mentioned earlier, nicotine constricts blood vessels which deliver oxygen and nutrients to tissues. Again, this blood flow is vital to the healing process.

If the percentages in oxygen and nutrients drop during the recovery process, there is a risk factor following surgery in areas such as infection, increased chance of scarring, and additional complications.

While some plastic surgeons follow a smoking cessation of four weeks prior and after surgery, others have a more conservative approach of six weeks. A large gap of time is highly recommended and encouraged.

During a patient’s consultation with their plastic surgeon, it’s imperative to be candid regarding any smoking history. And this includes vaping. A surgeon’s top priority is the care of his/her patients and making certain, as a doctor-patient team moving forward, all can be done for an outstanding surgical outcome.

26May, 2016

Considerations for revisionary breast surgery

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Considerations for revisionary breast surgery

Through many years of practice, revisionary breast surgery has evolved into a specialty.  Those who have undergone a breast enhancement procedure will sometimes want–or sometimes need–a revision surgery. Implants may be used in procedures such as a breast augmentation, breast lift, or breast reduction.

It’s important to note that not all patients who undergo a lift or reduction may require an implant – it’s a personal choice that can be discussed at a consultation with a board certified plastic surgeon.

While some patients may be displeased with the aesthetic outcome of their initial procedure, there may be other factors which lead them to seek a revision. These reasons, both personal and medical, may include the following:

  • Symmastia
  • Capsular contracture
  • Implant rupture
  • Bottoming out
  • Symmetry issues
  • Implant disappointment
  • Downsizing implants
  • Replacing implants

 

In some instances, women who are finished having their families may have chosen to have implants placed without undergoing a breast lift. While some patients are content with the results, others may be dissatisfied with the position and want to improve their appearance with a revision.

For mothers who had an enhancement prior to bearing children, undergoing a second augmentation after building their families is also another aesthetic scenario. The effects of bearing children, such as weight gain and breastfeeding, may alter the appearance of woman’s bust line. In some instances, a lift may be recommended to address skin redundancy

Another motive may be when a woman decides that the upper silhouette she wanted to achieve many years ago through implants is not a current aesthetic goal at this point in her life. In these instances, she may decide to downsize.

As one can imagine, revisionary breast surgeries are performed for a variety of reasons.

When electing to undergo a revision for aesthetic purposes, it’s generally advised to wait four to six months following the initial surgery to ensure all healing is complete–this includes any residual swelling. If a patient decides that she does not want to return to her original surgeon for a revision, it’s highly advised that she seeks a board certified plastic surgeon that specializes in breast revision surgery. Surgeons at this level have mastered their craft.

During a consultation with a new cosmetic surgeon, be candid with the doctor when it comes to the reason, or reasons, behind the revision. At this first appointment, clear communication is necessary. It’s important that the surgeon doing the revision surgery and the patient have an excellent rapport.

Following an exam, the doctor will convey their thoughts regarding a revision. The details of the surgery, the recovery process, and realistic expectations will also be discussed.

Before or during the consultation, make it a priority to review their patient gallery photos of women who have undergone a breast revision surgery. If possible, ask the doctor if they have any “before or after” images of patients who were in a similar circumstance(s). This will provide an excellent gauge as to whether or not the surgeon’s talents are aligned with a patient’s goals.

20Aug, 2015

Breast Reduction Surgery Brought Into The Spotlight

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Fashion Girl Relaxed With Her Legs Raised Up

Recently, Hollywood celebrity Ariel Winter of television sitcom Modern Family decided to publicly announce her reduction mammoplasty also referred to as breast reduction surgery. Winter was one of many women who suffer with the daily discomfort due to excess weight on their chests.

While most women undergo this surgery at 18 years of age and over, Winter, 17, had the surgery during the early part of summer. The surgery transformed her from a bra cup which was a size 32F to 34D.

She recently told a People magazine reporter, “I was 15 years old with [size] F [breasts]. How do you navigate that?”

Having a celebrity such as Winter convey what she did is helpful to so many women who experience the same troubles she did. They are able to relate to what she has encountered as well as empower themselves knowing that there is a solution and not to discount the benefits of breast reduction surgery.

Numerous women are affected with discomfort due to their breast size. In fact, it is estimated that more than one million American women are encountering this.

Moreover, most women do not impulsively decide on this surgery. They perform their due diligence by researching it, finding the best board certified plastic surgeons, perusing before and after galleries on surgeons’ websites, and visit helpful online resources where potential patients can ask doctors questions such as RealSelf.com.

Despite being fitted for the right bra and undergarments, there still remains a direct link to pain and discomfort due to the heaviness. As mentioned earlier, women seek this breast reduction surgery because of the excess weight on their chest which can cause the following issues:

*Back pain

*Neck pain

*Headaches

*Shoulder pain

*Shortness of breath

*Numbness and tingling in the arms

Headaches may be derived from the tightness in the shoulders and neck.

It is also important to point out that the more excess weight on the chest a woman carries, the more her shoulders tend to lean and roll forward. This may cause anatomical changes to her frame. Her posture may be compromised to compensate for the cumbersome pounds she must carry.

A group of doctors, including Bethannie Snodgrass, MD who authored, “When Less Is More: The Complete Guide for Women Considering Breast Reduction Surgery,” clearly points this out in her comprehensive book.

Snodgrass wanted her readers to know that this position could potentially cause a compression located in the thoracic spine. A culmination of pressure in the shoulder blades, ribs, nerves may theoretically cause this.

Another area of discomfort which cannot be overlooked is the shoulders. By the end of the day, bra straps are embedded so deeply into the shoulders of women leaving red and painful indentations.

Like all cosmetic and reconstructive surgical procedures, the decision to learn more about a breast reduction should be made thoughtfully. And teaming up with the right board certified plastic surgeon can help answer questions and navigate a patient in their decision making process.

25Mar, 2015

Common Reasons Why Women Undergo A Breast Lift

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Life achievement - happy woman arms up in success. Back view of

Prior to having cosmetic surgery, it’s important that one researches the procedure they are interested in as well as taking the time to thoughtfully consider the surgery as a whole. For women who consider having a breast lift, many really have done their research and have thought a great deal about it before visiting with a board certified plastic surgeon.

They’ve read content articles on the web and learned about surgery variations in regard to the extent of a lift they very well might need. Inevitably, this leads up to their first consultation.

With that said, there are various reasons why a woman decides to undergo a breast lift. It’s also important to note that there really is not a particular age range for this surgery because it can vary between the ages of thirties to sixties.

However, plastic surgeons will tell their potential patients to have their children first and then their breast lift procedure. It’s not advised to have the surgery if a woman wants to continue building her family.

Once she has had her last child, then that is the optimal time to have the surgery in where redundant skin can be removed and the breasts lifted. Some mothers choose not to have implants, while others may want more projection and volume and request them.

For the most part, however, mothers generally are happy with the lift alone since it does restore a level of volume.

The very next reason a woman may choose this surgery is following significant weight loss.

Weight gain can also occur in the bosom, and after the pounds drop on the scale, volume is lost and sagginess remains. A breast lift can restore this area to a more youthful appearance. The use of implants can also be discussed.

There is also a significant amount of women who have challenges with breast asymmetry in where one breast is larger than the other. For this type of condition, a surgeon will recommend if a lift, breast reduction or breast augmentation is in order. While every patient differs in their needs, sometimes two procedures are recommended such as a breast lift and augmentation to correct the aesthetic issue.

The last reason a woman may consider a breast lift is if she decides to downsize her augmentation. For those who had an augmentation in their earlier years, they may come to the realization that they prefer a smaller implant size which compliments their physique and personal comfort levels.

If a woman changes larger implants for smaller ones, a plastic surgeon will be able to assess whether or not there will be redundant skin following the exchange. If this is the case, then a surgeon will implement a breast lift with the procedure.

A consultation will provide great insight into this procedure regardless of why a woman decides to undergo it. While looking for a surgeon who specializes in this area, do peruse their patient gallery to assess whether or not their skill sets match one’s need for this surgery.