The Evolution of Cosmetic Surgery

Boosted by baby boomers doing all they can to maintain their youth, cosmetic surgery is growing in popularity at a rapid pace. Statistics report that over the past five years, cosmetic surgery procedures have grown by almost 300%.

Desired concepts of beauty are constantly changing, due in part to new technology and expert techniques. According to plastic surgeon, Juris Bunkis, M.D., F.A.C.S. of Orange County Plastic Surgery in Rancho Santa Margarita and Dublin, California, the tight, pulled “wind tunnel” look was the signature of a 1970s-era facelift. There was also the scooped nose with a pinched nasal tip, and unnaturally round, hard breasts after breast augmentation surgery.

Such obvious signs of surgery are no longer desirable by most people, and increasingly shunned by patients who wish to turn back the clock in a more natural way, without such tell-tale signs of surgery.

“Facial surgery is not about looking 30 at age 75! No amount of skin and muscle tightening can achieve such an unrealistic goal,” stated Dr. Bunkis. “It’s about looking the best you can, at any age.”

Other factors play a role in relaying a patient’s age such as the quality of the skin, sparkling eyes and the sound of a voice. The goal of facial rejuvenation today is to create as youthful a result as possible while maintaining a balanced and natural, un-operated look.

New Approaches To Facial Surgery

Dr. Bunkis explained that the newer approaches to facial surgery are primarily aimed at the mid facial region. The relatively new midface lift specifically addresses the central facial hollowness that naturally occurs as many people age. By suspending tissue back to its original place, the aging face can then be sculpted tension free to recreate the soft and graceful curves of youth.

“It is absolutely necessary to achieve this balance to arrive at a pleasing surgical result, explained Dr. Bunkis. “My techniques have changed over the last twenty years, and the concept of a pleasing result continues to evolve.”

Compared to the mid 1970’s, when Dr. Bunkis began doing surgery, techniques today utilize shorter and less visible facelift incisions and a greater emphasis has been placed on midface lifts and other techniques which elevate the fallen tissues in a more natural way. Today’s techniques do not raise the sideburn, distort the hairline behind the ears, or leave patients with a horizontal, pulled back look that was so common in years past.

Understanding the Aging Process

A key factor in plastic surgery advances has been a better understanding by plastic surgeons of the nature of the aging process, and the development of techniques that address aging skin tissue. Nevertheless, technical advances still cannot guarantee a perfect result. Patients must start by choosing the right surgeon—one who not only understands their concerns, but one who also has the ability to focus on what the surgery will achieve, as well as the artistic talent to achieve the desired result. With his years of experience and artistic touch, Dr Bunkis brings to his patients a knowledge and expertise in aesthetic surgery that makes him a leader in his field.

Dr. Bunkis’ main objective is to achieve a natural look for each patient, and to allow each patient to look as good as they can for their given age. He evaluates each patient’s concerns, decides how best he can help them, and offers a solution to their problems. This frequently requires a discussion of areas or procedures that the patient may not have previously considered.

“For example, if someone comes in with a complaint about a droopy neck, but does not mention their severely sun damaged skin, I feel it my duty to discuss laser skin resurfacing for completeness sake”, said Dr. Bunkis. He believes that a layperson may not realize that tightening droopy muscles and skin will not affect the skin’s quality. Such a person may wake up after a face lift with a gorgeous jaw line and face contours, but be disappointed because the skin is still blotchy and sun damaged. Not approaching the face as a whole may create an unnatural result and deprive the patient of full benefit of the doctor’s talents.

The ideal facial rejuvenation procedure leaves the patient with a jaw line that matches the rest of the face including eyes, forehead and skin texture. This process, Dr. Bunkis explains, begins with a through consultation.

Facial Rejuvenation Consultation

So what are the consultations like and what suggestions may be made? This depends on each patient’s concerns, desires, and present condition. Dr. Bunkis begins each facial consultation with an explanation of the aging process and discusses generalized skin care, as well as general anti-aging treatments, which may be applicable.

Normal facial aging is a two-prong process. The first prong is genetically determined, such as the formation of the jowls, drooping of the neck or brows, bagginess of the eyes, the degree of chin prominence, or the size of the nose. These features are not under the patient’s control and cannot be changed without surgery. The second prong of the aging process includes skin texture and the general health of our skin, as well as the amount of fat in our necks, and the impact of sun exposure, obesity, smoking and excessive use of alcohol. This latter group is obviously under a patient’s control. Dr. Bunkis attempts to help each patient develop a healthier lifestyle and, along with his aesthetician, discuss sun protection and long-term skin care options.

Different Facelift Approaches

Dr. Bunkis gave examples of different approaches that might be offered to patients of various ages with various degrees of aging: “For a patient in her thirties with a slight neck fullness, a lipo-sculpting procedure may be all that is required to give her a youthful jaw line, as the skin will usually have sufficient elasticity to snap into place. This same approach would not be appropriate for a patient in her forties, as skin and muscle laxity would be expected to persist if the issue is not addressed.

“For such a patient, however, a traditional facelift may not be required yet. Quite possibly an excellent result could be expected by combining the liposuction with a short incision under the chin to tighten the neck muscles. Or we may add to this a midface lift, which can be achieved with a small stab wound in the fold between the cheek and the upper lid and a short incision behind the sideburn—avoiding incisions around the ears. In an older patient, not only would a full facelift be indicated, but also brow lifts, lip enhancements, or skin resurfacing may be added to achieve the optimal result.”

Setting Expectations

Whatever approach is suggested, Dr. Bunkis explains the expected outcome to each patient thoroughly. “I can do this by placing the patient in front of a mirror and lifting their skin, or by using computer imaging. During the consultation, I always relay my philosophy and give each patient a realistic idea of what they can expect to achieve with surgery. This is an art form and the patient deserves to know my vision before we embark on the surgical voyage,” concludes Dr. Bunkis.

Dr. Bunkis practices in South Orange County and in the San Francisco East Bay. A Board Certified Plastic Surgeon specializing in cosmetic surgery of the face and body, Dr. Bunkis has years of unsurpassed surgical expertise. Below are examples of actual patients of Dr. Bunkis that illustrate the various options for facial rejuvenation.

A 35-year-old anesthesiologist patient with a full neck, before and after neck liposculpture, chin implant and rhinoplasty. This same neck contour and sagging could not be corrected as effectively with an isolated liposuction procedure in someone a decade or two older because of the loss of skin elasticity and muscle laxity.

A 48-year-old, weathered female patient who looked significantly older than her stated age, before and two years after (at age 50) following a full-face CO2 laser resurfacing, endoscopic brow lift, facelift, upper and lower eyelid procedures. The neck was liposuctioned as a part of the facelift, but a neck liposuction alone would only have left her with a thinner but saggier neck and not addressed the unusual laxity and sun damage she had.

Dr. Bunkis can be reached by calling (949) 888-9700 or you can write to him at bunkis@ocps.com.

I will show you an example of a 26 year old singer who, to most people looked quite good before surgery, but did not like the bulkiness of her nasal tip and wished to bring her small bump down. These results certainly are not very dramatic but left the patient with a result that pleased her a great deal. One of the best ways to envision how you would look following such procedures is through the use of computer imaging. If you would like to set up a complimentary computer imagine session, please feel free to contact Orange County Plastic Surgery at 949-888-9700.