My New Cowboy Hat

This winter has been exceptionable for rain and snow.  They have had record snowfall across the northeast.  This global warming is hard to figure out.  Where is Al Gore to explain it to all of us?  I had the pleasure of spending some of this winter in northwest Montana where our family has a home near Glacier National Park.  We have three young grandchildren who had not spent time in the snow and it was great.  They really liked the horse drawn sleigh.  The highlight for me was a new felt cowboy hat that was perfect in the cold.  Coming back to southern California is always nice.  We need all this rain  but it doesn’t match a good snowfall.

Cheers, Dr. Kemsley

1:         BOTOX INJECTIONS,  this works well and works by paralyzing the sweat glands.  The            Botox is a gentle injection that works within 3 days and lasts up to 6 months, and then needs to be repeated.

2:         EXCISION OF THE SWEAT GLANDS,  This is a simple procedure that can often be done     with local anesthetic.  There is a short incision that runs across the hair bearing area from the front to the back.

 3:         VASER ULTRASOUND, this also is a simple procedure where an ultrasound instrument is used under the skin to damage the sweat glands.  This can also be done under local anesthetic and the incision is tiny.

 I had this problem and 20 years ago had the excision done.  The results have been great.  If I was doing it again I would probably do the Vaser Ultrasound.

 Dr. Kemsley

Dr. Graham Kemsley

GYNECOMASTIA is enlargement of the male breast.  We see it in 10% of men.  Men are often very embarrassed by this and will not take their shirts off at the pool or beach.  Gynecomastia can be due to glandular enlargement or fat accumulation.  We see 2 different times this develops.  One is at puberty and this is mostly glandular enlargement from high hormone levels at this age.  The glandular enlargement is similar but not identical to a woman’s breast.  The second time we see gynecomastia is as men mature (sometimes called “man boobs” or “moobs”)and this is mostly fat with possibly some gland.  It can look worse as the skin loosens with age.  If it is mostly glandular we usually need to excise the tissue with a small incision below the nipple.  With mostly fat we can treat it by liposuction which has tiny incisions.  If there is a lot of skin looseness we may tighten the skin which requires more incisions.  Men that have this surgery are usually very grateful and find it changes their life.

Today I was asked by a patient if silicone breast implants are really safe.  This, of course, came from restrictions of silicone implants by the FDA  starting in 1990 that lasted for 15 years.  There was concern at that time that silicone might cause autoimmune diseases (like rheumatoid arthritis, scleroderma, and lupus) or increase breast cancer.  At the time I felt fairly comfortable that silicone implants were fine but we had to wait for the FDA to do it’s research.  Silicone implants became the most studied medical device in the history of the FDA.  The best reports came from large studies comparing women without implants and women who had silicone implants for many years.  They found that there was no difference in the two groups.  The only area where there was some difference is  some studies showed breast cancer was actually less in the patients with the implants!!!  The only explanation for this is that women who get implants usually have less breast tissue. 

I do use both silicone and saline implants (saline implants are filled with medical salt water) but I do prefer the silicone.  They have a more natural feel and the chance of breakage (usually from trauma like a car accident) is less(1% a year for saline vs. 0.3% for silicone.  Unfortunately the silicone implants are a little more expensive.

Dr. Kemsley

Dr. Graham Kemsley

I just finished a ZERONA series on a slightly heavy middle aged lady. I was not getting a lot of feedback from this patient during her treatments and had been anxious that she would be disappointed. before we started her 6th treatment she stood up and pulled her pants about 4″ away from her hips and said “look at this, I couldn’t pull these up 3 weeks ago”. She had the biggest smile on her face (I had a bigger smile on mine). She asked how soon she could start a second series!! I wish I had before and after pictures of her in those pants!!! I’ll be taking pictures of patients in tight pants before they start the ZERONA treatments from now on.

Lynn (nurse Ratched – from “one flew over the cuckoo’s nest”)

We know that smokers have increased heart disease, lung disease, lung cancer, stomach cancer, mouth cancer, and other trivial problems.

But what about just having surgery which is only for a few hours?  Is that ok?  Well, if you smoke before surgery you still have nicotine and possibly carbon monoxide in your system.  It doubles the chance of complications.  There is increased risk of infection, blood clots, scarring, healing problems, tissue death, and pneumonia. 

In plastic surgery the biggest concern is that the nicotine in your system interferes with circulation to  your skin and this can result in possible skin death with severe disfigurement.  This is worse in face lifts, tummy tucks, breast reductions and breast lifts.  Most plastic surgeons will not do these type of procedures unless the patient is nicotine free for at least 10 days.  Nicotine free means no cigarettes, no chewless tobacco, no nicotine patch, and no nicotine gum!!!

 Be safe and be honest with your surgeon.  Many operations have minimal risk for smokers but others are risky.

The best thing is to be nicotine free for at least 10 days.

Dr. Graham Kemsley

One Doctor said she took the machine to try it, expecting it not to work, and thinking she would get them to come and take it back.  After treating 18 of her family and friends (including her husband who had previous liposuction with okay results but *now *has a six pack) she was very enthusiastic about the future of fat reduction

*without* surgery.  I was happy and excited that we have the ZERONA and we are now seeing great results.  *Dr. Kemsley* does not have a six pack but his waist is *3″ smaller*!!!

Lynn (nurse HAPPY)

Latisse, *when applied to the base of your lashes,* *makes them grow *longer and thicker*!!!  Usually women see an improvement within a month and the lashes reach their desirable size within 3 months.  Latisse was originally used for Glaucoma (pressure inside the eye) where it was used as eye drops.  Women started to notice their lashes getting longer and thicker.  *They loved it!!!  You can too!!!