Everyone likes something different.  Buttocks are “no” different.  Some people like a full perky buttock and others like a small slender shape.

If the buttocks are too full we usually do liposuction or occasionally a buttock lift.  Buttock lifts usually require a significant incision.

Buttocks that are too small can be filled out by fat transfer or buttock implants.  Fat transfer requires getting fat from somewhere else on the body by a type of liposuction.  The harvested fat is prepared and then injected into the buttocks in multiple tunnels.  Buttock implants come in different shapes and sizes and are put through an incision between the buttocks.  The implants are usually placed between the gluteal muscle layers.

Dr. Kemsley

I could write a book just on facelifts. I’ll try and give a brief outline. There are many different types and levels of facelifts. If patients have some laxity in the face or jowls they can have a minifacelift (sometimes called a lifestyle lift or short scar facelift). If there is more looseness in the face and neck often with fat accumulation in the face and neck they will need a full face/neck lift.

Saline vs. Silicone Breast Revision Irvine

People often wonder what difference is there between saline and silicone breast implants. We do like silicone implants more than saline.  Silicone absolutely feels more natural.  In patients who have very little natural breast tissue a saline implant has more chance of getting folds or ripples that can be felt and actually show through the skin.  The only benefit to saline is they are less expensive.

I recently had a patient with saline implants that had ripples showing through the skin.  The implants were also sitting too  low adding to the unnatural look.  Our plan is to replace the implants with silicone and reposition them so they have a more natural feel and appearance.

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