I have operated on patients in their late 30’s who were good candidates for a facelift, but those instances have been few and far between, and usually with extenuating circumstances such as severely stretched skin from obesity and subsequent weight loss. You are correct in feeling that younger patients with early signs of aging usually are not candidates for a full face lift. Such patients can frequently be helped quite considerably with one of the newer minimal incision techniques including neck liposculpting, tightening the neck muscles through small incisions just beneath the chin and perhaps the ear, endoscopic forehead lifts, or some of the modern midface lifts that are performed through hidden incision inside the mouth and behind the hairline.

Perhaps a series of one of the nonablative laser treatments or intense pulse light (“IPL”) treatments will remove surface blemishes and tighten the skin sufficiently to buy you some time. A lot of the decision making depends on your expectations as well and the degree of laxity you have. But to tell you the truth, as I stated earlier, I could not begin to tell you what your best option would be without evaluating you in person. Please call us at (949) 888-9700 and ask the staff to arrange a complimentary consultation for you and I will be happy to give you my best opinion as to your options. I see patients at the Waves Beyond Skin Care Spa in San Clemente on a regular basis and could see you there if it’s more convenient for you. But first, I will show you examples of three younger patients who received minor procedures that bought them some time before they were ready for a full facelift.

42 year old female with early signs of cheek hollowing and deepening of nasolabial folds (the fold between the lips and cheeks), before and after injections with Sculptra Aesthetic®, a long lasting filler.   By the time this filler wears off and her neck droops more, she will be ready for a full face lift.

Actual patient of Dr. Bunkis – 35 year old female with some upper eyelid hooding, a minor neck adiposity, and early facial laxity, before and after a one hour procedure in which I did her upper eyelids and liposuctioned her neck and jaw line.

Actual patient of Dr. Bunkis – 44 year old female with more than average sun damage, before and after a full-face phenol peel.

Dr. Bunkis answers your questions in this column weekly but to give the best answer to the question below, Dr. Bunkis asked his skin care team,  our nurse Tracey Prescott, R.N. and our medical aesthetician, Anne Floerchinger, to provide the following response:

A: Great question!!! You will know when you are saggy enough to warrant surgery, but in the meantime, there are many non-surgical treatments that can improve the quality of your skin.

Most of us do not appreciate fine facial wrinkles, hyperpigmentation and tactile roughness. Now you can have smoother, less pigmented skin with the newest FDA approved Tretinoin cream, Refissa®.   It is emollient based and does not dry out your skin. This product has become the gold standard medical treatment for photo-damaged skin. It works by stimulating cell turn over and causing the sun damaged outer layers to slough off. Refissa® is the first important step to healthier skin. Always remember sun protection year round!

The next step, now that your skin is healthier, may be one of the many peels we offer. Here at Orange County Plastic Surgery we have many peels to choose from. For the purposes of this article we will focus on the Microlaser peel.  Microlaser peel, the “week-end” skin peel, treats skin conditions more aggressively than the Refissa® is capable of doing. The Microlaser peel is performed with Sciton’s Erbium laser which uses a computer guided scanner to ensure maximum precision treatment uniformly. You will see improvements in just a few days!

What exactly does the Microlaser peel treat?

It is a minimal to full epidermis laser peel that precisely removes the outer most layers of the skin. The procedure is individually tailored to the nature of the problem to be corrected: wrinkles, scars, keratoses, pigmentation problems, overall sun damage.

How often does a Microlaser peel need to be done?

As mentioned above, year round sun protection is a key to healthy skin.  The results of any treatment, not just the Microlaser peel, will last longer and be more efficacious if you avoid future sun damage.    One Microlaser peel procedure will usually be sufficient for a few months but subsequent treatments may be required. As mentioned earlier treatments are customized to each person. During your consultation we can determine what will be best for you.

What can I expect from the treatment?

Smoother, healthier, more vibrant skin. A blended complexion with a lessening of fine lines.

Is the treatment painful?

When you come in to the office, a topical triple anesthetic cream will be applied. This application will make the procedure quite tolerable.    Afterwards you will have a surface Oxygen treatment (Oxymist®) created especially for our patients at Orange County Plastic Surgery.

What is my aftercare? Do I need to wear any bandages or dressings?

No.  Microlaser peel is not like a CO2 laser and requires nothing more than a protective ointment like Aquafor or vaseline. This is used as a barrier while you grow new epithelium (baby cells, new skin). You will also come back in to our office for oxygen treatments for the next two days.

Mention this article when calling our office and receive a complimentary consultation and 25% off your Microlaser peel or 20% off your Refissa®!

As you can see, there are options to a scalpel and needle when making your skin look better! You are in good hands at OCPS and we look forward to seeing you so we can customize a skin care program for you!

-Trace Prescott, R.N. and Anne Floerchinger

Orange County Plastic Surgery Skin Team

JB
Dana Point

Well, that’s a timely question! Just last week, we received information about a new filler, Hydrelle™. This is also a hyaluronic acid but is a little more densely cross-linked, and thus thicker, than other similar products. We have just started using it but the manufacturer claims that it lasts longer than other HA’s. It is thicker, and thus not meant for lips, but is excellent for nasolabial folds, Marionette lines and tear troughs (cheek indentations). This product is the only HA on the market that is mixed with a local anesthetic so injections hurt less! Here is some information from the manufacturer – along with a web link to a $200 rebate coupon!

By the way, Tina and I are off to Italy for a well deserved vacation next week…but don’t forget that our staff is presenting a special skin care brunch on September 19th. Our aesthetician, Anne, and our nurse, Tracey, will both be speaking, giving demonstrations and distributing many prizes. Please call 949-888-9700 if you’d like to reserve a spot – space is limited so please call now.

Introducing Hydrelle^™
The First FDA-Approved Hyaluronic Acid Dermal Filler with Lidocaine.

Appearing on “The Doctors” television show – September 7th, 2009

Hydrelle HA Dermal Filler….

• Contains 0.3% Lidocaine for greater patient comfort … no mixing or diluting of product necessary
• Highest concentration of hyaluronic acid available in the U.S. today  28 mg/mL
• Approximately 50% less volume needed compared to leading HA’s … cost-effective because patients may require fewer syringes
• Provides long-lasting wrinkle correction with an easy, “patient comfortable” injection procedure… can last up to 12-months*
• FDA-approved for the correction of moderate to severe facial wrinkles and folds, such as Nasolabial Folds

Visit www.hydrelle.us/coupon for more details AND A $200 REBATE FROM COAPT!

*In a European study 80% of the patients had a noticeable correction at 9 months and 51% of patients had noticeable correction at 12 months.

Summer’s almost over and it’s time to get our skin in tip-top condition for the holiday season. We offer top of the line laser treatments, including Microlaser peel, IPL and high end chemical peels. They are relatively painless procedures with little or no down time. We also offer the best in skin care products, including Obagi, Jan Marini and Neocutis. Have you every wanted longer or fuller eyelashes? Latisse™ has arrived! It is the only FDA approved way to longer, thicker lashes. Amazing results!

In addition, we offer cutting edge fillers, including Juvederm™, Restylane®, and Prevelle Silk™. We are also offering two new fillers, Hydrelle™, which recently received positive feedback on The Doctors TV show, and Sculptra Cosmetic®, which is new to the cosmetic world. Botox® is also a very popular procedure at our office. We are very excited about all we have to offer our clients.

While Dr. Bunkis is vacationing in Italy, please join the skin care team for a special event at our beautiful office in Rancho Santa Margarita, on Saturday, September 19th at 10am for a “Breakfast/Champagne Brunch and explore your options for facial rejuvenation. Please call (949) 888-9700 to RSVP as seating is limited. We also invite you to take a look at our web site prior to the event at www.ocps.com .

If you’ve been thinking about a surgical procedure our office is offering a “Pay Half Now” Program. With this program our patients can pay only half of Dr. Bunkis’ fee upfront and the remainder will be financed at zero percent interested by Orange County Plastic surgery, with a manageable monthly payment worked out between us. How good is that!

PS – Special giveaways to start your skin in the right direction for fall.