Balance & Beauty

The concept of beauty is constantly changing. This in turn affects the way cosmetic Surgery is approached. Orange County plastic surgeon, Juris Bunkis, MD, explains to Michelle Dickson, how a natural, more youthful look can be achieved using plastic surgery.

While, enhancing one’s appearance has been documented for literally thousands of years, modern plastic surgery is a relatively new art form. Boosted by baby boomers doing all they can to hang on to their youth, cosmetic surgery is growing in popularity at a rapid pace. Technology, techniques and the desired concept of beauty are constantly changing. Choosing a qualified surgeon then, has never been more important; this precisely is to ensure that the patient achieves the desired result from his aesthetic surgery.

The “tight -pulled look” was the 70’s signature of a facelift, as was the scooped nose with a pinched and uplifted nasal tip, or the unnaturally round hard breasts following an augmentation. These “obvious” signs of surgery are no longer considered desirable in most circles, and are increasingly shunned by patients who wish to strip away the years in a fashion that leaves a more natural appearance, without the tell – tale signs of surgery.

Facial surgery is not about looking a mere thirty at the age of seventy-five. No amount of skin and muscle tightening can achieve such an idealistic goal. Other factors such as the quality of the skin, the sparkle in the eyes, the sound of one’s voice, stature and the environment do play a significant role in relaying a patient’s age. The goal of facial rejuvenation today is to create as youthful a result as possible while maintaining a balanced, natural and “unoperated” look.

According to Orange County plastic surgeon Dr. Juris Bunkis, it is absolutely necessary to achieve this balance if one is to arrive at a pleasing surgical result. “My techniques have changed over the last twenty years, and the concept of a pleasing result continues to evolve. Compared to the mid 1970s when I 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 vector. Today’s techniques do not raise the sideburn, distort the hairline behind the ears, or leave patients with the horizontal, pulled back look that was so common in years past.”

A key reason for these advances has been a better understanding by plastic surgeons of the nature of the “aging process”, and the development of techniques that address these aging tissues. Nevertheless, technical advances still do not guarantee a perfect result. Patients have to choose the right surgeon, who not only understands their concerns, but one who also has the ability to focus on what the surgery will achieve. The surgeon, besides, should have an artistic talent as well 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.

“My main objective is to achieve a natural look for each patient, and to allow them to look as good as they can for their given age. My goal is to evaluate each patient’s concern, decide how I can best help them, and offer 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, my duty includes a discussion regarding laser skin resurfacing. A layperson may not realize that tightening drooping muscles and skin will not affect skin quality. Such a person may wake up after a facelift with a gorgeous jaw line and facial contours but be disappointed because the skin is still blotchy and sun damaged. Not approaching the face as a whole may also create an unnatural result and deprive the patient of the full benefit of our talents. The ideal facial rejuvenation procedure leaves the patient with a jaw line that matches the eyes, forehead and skin texture.” This process, Dr. Bunkis explains, begins with a thorough 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.

Facial aging is a two prong process. The first process 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 a nose. These features are not under a patient’s control and cannot be changed without surgery. The second 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 the excessive use of alcohol. This latter group is obviously under a patient’s control. Dr. Bunkis will assist a patient to develop a healthier lifestyle and, along with his esthetician, discuss sun protection and long-term skin care options.

Dr. Bunkis gives examples of different approaches that might be needed for patients of various ages. With a patient in her thirties having slight neck fullness, a liposculpting 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 could be expected to persist if this issue is not addressed. For such a patient, however, a traditional face-lift may not be required. However, 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 also, which can be achieved with an incision inside the mouth and behind the temporal hairline, avoiding incisions around the ears. In an older patient, not only would a full-face lift usually be indicated, but also brow lifts, lip enhancements, or skin resurfacing may be added to achieve the optimal result.

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.
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