A study on aesthetic injectable procedures

Aug 22 2014
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Google Images

Google Images

Recently, there was a study on cosmetic injections. And it wasn’t about what injection was better than the other.

The title of the study says it all. Published in the journal of ISAPS Aesthetic Plastic Surgery, the report is entitled, Plastic surgeons or nurses: Who are the better injectors?

The report reads, “In recent years, minimally invasive aesthetic injectable procedures have grown in popularity as more and more men and women are seeking age-defying treatments. As Botulinum toxin — generally known as BOTOX® — use has increased, a growing number of non-aesthetic health professionals have emerged to perform procedures utilizing this and other injectables. According to a survey, plastic surgeons consider themselves the most capable injectors.”

Championing the study was Kevin Small, MD and Henry M. Spinelli, MD from the Division of Plastic Surgery Presbyterian Hospital in New York and Kathleen M. Kelly, MD from Columbia University in New York.

They and their teams performed the assessment and capabilities of those doing the injections.

The report went on to say, “Since studies have shown that patients identify training as the most important factor when considering these procedures, this study seeks to summarize the perspective of plastic surgeons regarding these paradigm shifts.”

Part of the study included an online survey. In 2013, during the summer months, more than 26,000 cosmetic surgeons received the survey.

A total of six questions helped determine the capabilities of those in the health and wellness field to administer fillers, Botox® and vaccines.

These healthcare practitioners included:

  • Plastic surgeons
  • Dermatologists
  • Dentists
  • Gynecologists
  • Nurses in the field of plastic surgery or dermatology
  • And nurses in fields outside of plastic surgery or dermatology

The report concluded, “Based on responses from over 880 plastic surgeons from around the world, plastic surgeons consider themselves and dermatologists the most capable injectors. However, they still believe nurses in other fields to be the most capable of administering vaccines.”

One of the head investigators of the study, Dr. Henry Spinelli shared his own thoughts on the findings. He added, “Since most of the growth in the field of cosmetic injectables is being driven by providers other than plastic surgeons and dermatologists, it appears that further clarification of training requirements and practice guidelines is necessary to ensure a consistent, reproducible, and safe experience for the patient.”

Researchers and administrators also hoped their findings would generate more discussion and investigation into injectable providers and perhaps reevaluate those standards.


Filed under : Botox, Juvederm | No Comments »

What to expect from breast implant removal

Aug 18 2014
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FDP by Adamr

FDP by Adamr

Just like breast augmentation surgery is a personal decision every woman makes for herself, so is having her implants removed if she changes her mind even years after the surgery.

When performed by a San Diego board certified plastic surgeon, the removal of breast implants is generally safe and effective.

Women have given so much thought to this procedure before undergoing it.

Because of this, they are invariably quite happy with the results and the benefits they had hoped for.

Those who decide to get their implants removed do so for a variety of reasons.

They may include:

  • Weight gain
  • Discomfort
  • No longer wanted or desired

The most common question women ask when considering implant explantation is how they will look afterward. Many women are concerned with excess skin which may follow postoperatively.

There a variety of factors for this answer.

Ultimately, it’s relative based on the volume contribution of the implant to the breast.

More simply put, any extent of sagging is dependent on how much breast tissue a woman has. One contributing factor of excess skin includes the size of the implant. The larger the implant, the more likely the breast tissue has stretched.

Other redundant skin issues may be the result of significant weight loss and childbirth.

During a consultation with a board certified plastic surgeon, they will be able to determine whether or not a breast lift, to remove the excess skin, will be recommended following removal of the implants.

Here are two patient examples.

Let’s say three months ago a woman had breast augmentation surgery, changing her bra size from a C to a D cup, and now wants the implants removed. More than likely she would not need a breast lift to remove excess skin.

However, a breast lift surgery, medically known as a mastopexy, may very well be needed in this next scenario.

Thirteen years ago, a patient underwent breast augmentation going from a B to D cup. Since that time, she gave birth to two children, breast fed them, and her weight has naturally fluctuated over the years.

Implant removal from this patient would more than likely result in a breast lift in order to rejuvenate her appearance.

As mentioned earlier, a board certified surgeon will help guide a patient in her wishes for implant removal, which may also include a breast lift procedure for the most optimal aesthetic outcome.

It’s also recommended to see a surgeon’s photo gallery of implant removal procedures they have performed to give women a better visual picture.

Patient Testimonials

Aug 16 2014
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vivid_flowers-wideWe are so thankful for the time our patients give us testimonials.

It’s thanks enough they entrusted us to care for them and even more special when they put it into words for us.

And most of all, thank you for allowing us to share your comments.

“Excellent care from the very first appointment.  Dr. Bolitho listened to me, talked to me, and never rushed me.  Dr. Bolitho and his team were professional and caring. Thank you!” – Shelly, breast lift with implant

“I was very nervous about having surgery.  Dr. Bolitho explained everything in detail and he followed-up with a call after surgery. Kandie was fantastic to get my surgery done quickly.  Everyone was very caring and helpful.  A good experience and love the outcome.” – Holly, cosmetic ear surgery

“If I had known what a positive experience this would be to remove my implants, I would have removed them years ago.” – Laura, removal of implants with breast lift

“After 30 years of continual problems with breast implants and multiple surgeries with multiple surgeons, I finally have breasts that I love.  Thank you so much!” – Barbara, breast revision

“Everything about my experience was excellent.  Dr. Bolitho and his staff are professional, caring and attentive.  I will recommend you all wholeheartedly!  Thank you!” Cheryl, breast augmentation

“After having a breast reduction, I was self-conscious about the scars and size.  Dr. Bolitho fixed them beautifully and now I feel amazing!” – Kris, breast augmentation with scar revision





The Dangers Of Plastic Surgery Tourism:

Aug 12 2014
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Here is some top information provided by the American Society of Plastic Surgeons (ASPS). “Plastic Surgery Tourism” has an attractive, low price tag but there may be risks to consider.

Lower facial rejuvenation offers major benefits

Aug 11 2014
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woman middle age

A person may have followed a rigorous skin care regime their entire life, still when they reach their 40s and  50s, they may begin to see a few sags and wrinkles.

While their skin still looks great, the signs of aging on their chin and neck may keep them from looking as youthful as they hoped for.

For many, the natural instinct is looking at ways to renew those areas by researching different San Diego facial rejuvenation techniques. In fact, there are ways a person can regain a younger appearance.

One is the non-evasive procedure called Ultherapy, an ultrasound lift. For some, it helps lift the jawline and chin area with absolutely no down time. The changes are subtle and the cost is around $3,000. The ultrasonic treatment which helps boost collagen offers improvement in skin tone and texture. Benefits of the treatment may continue to trigger skin improvement for up to six months.

And yes, there are other procedures which may cost less but once again offer a subtle change.

The decision for many, however, is usually a lower and limited neck lift. It’s a less invasive surgical procedure, which tightens up sagging skin around the jaw and neck.

Those who have slack skin around the jaw and neck may encounter it for a variety of reasons. Some are because of age, a genetic predisposition, or may even have extra fat under the chin.

When a surgeon removes the redundant skin from the neck and jaw, they can also remove additional fat from under the chin. This portion of a procedure offers excellent results.

This type of lift is a good solution for people wanting to concentrate on these areas to redefine the jaw line and neck which results in a more youthful look. A San Diego board certified plastic surgeon who specializes in operative facial and neck rejuvenation procedures has the skill to make a patient appear younger, naturally. Some patients share how those they see who don’t know about their surgery comment if they have lost weight because their jaw and neck are lifted.

Once a person has decided on this type of surgery the doctor will explain that it is done on the lower part of the face only. It addresses the jawline and directly below it. The upper facial area is not included in this type of procedure.

For that reason, many patients may decide to include a neck lift with a full operative facial lift.

Since both of these are elective surgeries, a person should take the time to pick and interview a board certified plastic surgeon which whom they are comfortable.

Great summer tips for oily skin

Aug 08 2014
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FreeDigitalPhotos.net by Marin

FreeDigitalPhotos.net by Marin

If you’ve got oily skin or may be prone to acne, perspiration can clog pores which may jumpstart breakouts.

Towards the end of summer when the temperatures rise, those with oily skin need some extra guidance to reduce acne and shine.

Dr. Bolitho, a board certified plastic surgeon in La Jolla, can help.  He offers an elite inventory skin care line at his practice which can help with these skin care issues. A part of his line is MyBody Skin Care which affords many skin care benefits, particularly one called, ERASE IT™.

This four-step medical acne treatment really clarifies while offering anti-aging properties.

The formula helps address breakouts while warding off future ones. Its system offers a cleansing gel, refining gel, oil-free moisturizer and tinted sunscreen SPF 30.

And let’s not forget the most important tips to keep in mind for those with oily skin and to reduce shine during the summer months. They include the following:

  • Non-soap cleanser for oily skin
  • Oil-free broad spectrum sunscreen
  • Wear less makeup and use mineral based cosmetics
  • Use blotting papers throughout the day, if needed
  • Scale back on nighttime moisturizers and serums

Here’s to a shine-free and acne-free rest of the summer!

Filed under : Acne, Skin Care | No Comments »

What to expect after breast augmentation surgery

Aug 05 2014
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FreeDigitalPhotos by Marin

FreeDigitalPhotos by Marin

For any woman who considers breast augmentation surgery, it should be a personal decision. A woman should be mindful about it and not rush into it.

With that said, for those who decide to undergo this procedure following an in-depth consultation, many wonder how long it will take to recover and what they can expect along the way.

As a San Diego plastic surgeon will tell her, every woman is different when it comes to recovering after the procedure. The best thing for the patient to do is to follow her doctor’s orders.

Most women are up and about within a few days, but she might feel tired and sore a bit longer.

Her doctor will ask that she wear a surgical bra after surgery for extra support.

In most cases a woman wants to shower as soon as possible after the surgery, so a waterproof dressing is applied to repel water.

Another thing a woman should consider is getting help caring for her children.

Although she will be up and around shortly after the procedure, her doctor will want her to rest so she can fully recover. Her doctor will also advise her on when it is safe for her to pick up small children again.

And she should take a break from housework and wait until her doctor tells her she can resume those chores.

There will also be a timeline on when she can return to work. If her job is low impact, she could probably be released to work fairly quickly.

However, if it’s more physical, she will be asked to take a longer break.

The same goes for resuming an exercise regimen. A check with the doctor will let a patient know when it is advisable to exercise the lower half of the body such as walking or using a treadmill.

Those activities usually can be revisited in about two weeks, but it could take several weeks before one could return to more vigorous exercise.

All of these recommendations by a doctor will help with the healing process and a woman will be proud of the new silhouette she wanted.

Keeping Lips Sun Safe

Jul 30 2014
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Kayak-sport01Keeping lips sun safe is equally as important as any other part of the body where sunscreen is necessary.

Lips are extremely susceptible to sun damage because of its thin layer of skin. Without any SPF lip balm protection, this area is a target for extreme sun damage.

So while out there enjoying those sports on water or land, a solar defense is needed.

Likewise, lips don’t have melanin like other parts of the body. What this means is that without a natural pigment, this part of the body will burn from sun exposure.

As many already know, collagen keeps skin looking young and lips have this biological ingredient. We are also aware that collagen can be destroyed from UV light. When lips are damaged from the sun, a breakdown in collagen occurs, causing wrinkles.

Other triggers for sun damaged lips are the following:

  • Cold sores
  • Sun blisters
  • Actinic cheilitis
  • Skin cancer

Actinic cheilitis is a lesion condition caused by the sun. When one is diagnosed with it, their lips become inflamed and the lower lip area becomes dehydrated and cracks. The skin also becomes very thick. Some patients also have a white and/or pale discoloration and there is excessive wrinkling. Some of these lesions are also considered pre-cancerous.

According to recent numbers, annually, there more than 3,000 new cases of lip skin cancers reported. And majority of them are diagnosed as squamous cell carcinoma.

It’s always important to visit a San Diego plastic surgeon or dermatologist for any suspicious skin blemish activity.

In the summer months, while at the pool or the beach, the reflection from the water and sand brings the UV exposure to a higher level.

For women, wearing traditional lipstick will not protect lips. In fact, wearing a non SPF lip gloss can actually cause more UV damage due to the moisture content and shine.

Here are some tips for lips for the whole family:

  • Purchase a SPF lip balm
  • Apply at least 30 minutes prior to going outdoors
  • The higher the SPF protection, the better
  • Reapply often

It’s important to remember that lips need to be protected not only during the summertime, but all year long.

New study: The effects of diabetes with weight-loss surgery

Jul 26 2014
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FreeDigitalPhotos.net by Photostock

FreeDigitalPhotos.net by Photostock

Weight loss surgery is extremely transforming for every patient. At the end of their weight loss and when they have achieved a stable weight, many opt for a post-bariatric body contouring surgery. This procedure removes any excess skin.

Being that our San Diego plastic surgery office performs this procedure to help patients complete their weight loss journey, we generally keep track of new studies in weight-loss surgery.

A recent one was just revealed from Manchester University and was highlighted this month in the Science Daily but published in the Endocrinology journal. It’s entitled, “Why weight-loss surgery cures diabetes: New clues.”

In essence, researchers are getting a better grasp as to why a significant group of gastric bypass surgery cures Type 2 diabetes.

The article reads, “Our research centered on enteroendocrine cells that ‘taste’ what we eat and in response release a cocktail of hormones that communicate with the pancreas, to control insulin release to the brain, to convey the sense of being full and to optimize and maximize digestion and absorption of nutrients,” said the study’s team leader.

It went on to say that the “Type 2 diabetes cure” may very well be linked to the “actions of specialized cells” within the intestine which emit a boost of hormones, also referred to as a special cocktail in the research report, when people eat.

Originally, researchers thought there was only one gut hormone cell. Now, there are found to be six of them; and, one is the hormone which controls hunger called ghrelin.

“Our research centered on enteroendocrine cells that ‘taste’ what we eat and in response release a cocktail of hormones that communicate with the pancreas, to control insulin release to the brain, to convey the sense of being full and to optimize and maximize digestion and absorption of nutrients,” said study team leader, Dr Craig Smith, a Senior Lecturer in Molecular Cell Physiology. He went on to say in the research report, “Under normal circumstances these are all important factors in keeping us healthy and nourished. But these cells may malfunction and result in under or over eating.”

In the research study, it’s reported that 75% of obese patients with diabetes are cured following a gastric bypass surgery. The research team is analyzing and understanding why this is the case by finding out more tangible answers.

“This is where things start to get really interesting because the most common type of gastric bypass actually also bypasses a proportion of the gut hormone cells. It is thought that this causes the gut hormone cells to change and be reprogrammed. For us, understanding how these cells change in response to surgery is likely to hold the key to a cure for diabetes,” said Smith in the research report, also noting how one day drugs may cure obesity and Type 2 diabetes rather than weight loss surgery.


Quick Tips To Prevent Summer Acne

Jul 22 2014
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It’s the middle of summer right now which means temperatures are rising higher.

Those prone to acne may be battling it a bit more at this time, whereas, those who normally don’t get acne may be seeing pimples.

It’s normal.

This is a common occurrence during the summer months.

The warmer weather actually jumpstarts oil production. In turn, our pores may become more at risk with getting clogged with debris, makeup and dirt.

Here are some quick tips to help battle current and future breakouts:


  • Team up with a skin care professional, such as a board certified plastic surgeon or dermatologist. They will have an inventory of result-driven skin care products.


  • Utilize a morning and evening skin care routine which includes a gentle, non-soap facial cleanser and oil-free moisturizer.


  • Don’t shy away from sunscreen. Instead, wear an oil-free broad spectrum sunscreen. Again, a doctor’s office will have the right selection or point you in the right direction.


  • Applying a daily moisturizer is important but this time of year, you’ll need to scale back to avoid more pimples. And remember, an oil-free moisturizer.


  • Leave the foundation for evening time. Instead consider a tinted sunscreen or even a CC cream for coverage during the day.


  • Wash your face both morning and night with a non-soap cleanser. However, if you find yourself sweating, be sure to wash your face as soon as possible.


  • For makeup, try using a mineral based makeup.

While summer time is a great time of year, our skin care does need to change with the seasons.