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Filling Up at Lunchtime Isn't Just for Your Appetite
by: Dr. Bunkis
Fine lines are fixed with simple filler procedures.
Fine lines are fixed with simple filler procedures.

Q: I’m 49 years old, am starting to droop a little and would like to look better. I saw a cosmetic surgeon who recommended a face lift, but I have two issues: 1) I am a little scared of having surgery, and 2) in this bad economy, I don’t think I can afford the cost of down time or the cost of the procedure. Do you have any other recommendations for me?

-Jill H., Huntington Beach

A: It is very difficult to give you a specific answer without seeing you in person but I can address a few generalities. Rest assured that there are alternatives to traditional procedures but in general, these “Quick and Easy Fixes,” as we call them, do not produce results as dramatic as traditional procedures nor results that last as long. These “lunch-hour procedures” frequently do not require anesthetics and can be performed during a brief office visit. For many patients on a tight budget or with a limited ability to take time off to heal, these new procedures are a panacea!

I’ll first address aging in general and then go over a few things we can do to counter these natural phenomenon. As we age, the skin itself looses elasticity and collagen fibers. A number of structures under the skin loosen as well and droop downward, pulling the overlying skin with them. These effects are most commonly seen as brow drooping, lid laxity, a descent of the middle part of the face with jowl formation, and neck laxity. These deeper effects are all hereditary in nature and cannot be significantly altered by things we do non-surgically. The traditional way to address these areas is with lifting the drooping muscles and underlying tissues back to where they used to be when we were younger.

But utilizing newer techniques such as mid-face lifts and some of the so called thread lifts, we can reposition these tissues to a more pleasing position in a brief procedure, under minimal anesthesia, and with minimal down time – what the patient has to understand is that the results will not be as dramatic nor last as long compared to a standard lift. Totally nonsurgical ways to improve these deeper structures include injections of Botox® to weaken underlying muscles which are causing wrinkles, particularly for the vertical lines between the brows and around the eyes to address crow’s feet, and the injection of various fillers to fill lines, the hollows under the lower eyelid bags, to fill indentations along the top of the nose (the so called non surgical rhinoplasty) or to enhance lips. The number of fillers available to us is vast, ranging from the gold standard, the hyaluronic acids like Juvederm, Restylane, Pearlane and Hydrelle, the longer lasting but more costly Artefill or Sculptra Aesthetic, or your own fat in the form on micro-fat grafts. The micro-fat grafts can also be utilized to plump up the tops of the hands to replace subcutaneous tissue that is lost in the normal aging process. Each has its pros and cons and these will all be reviewed with you when you come in for a consultation.

The more superficial signs of aging, such as the sun damage that occurs from excessive exposure, can be improved by topical treatments ranging from the variety of peels, creams and facials provided by our aestheticians to the micro-peel laser, IPL and dermabrasion procedures performed by our laser nurse, to the deeper peels and laser treatments that I do as a surgeon to address the more severe lines and surface sun damage. These procedures all improve your surface texture (removing brown spots and superficial wrinkles), and the deeper procedures I do will also tighten the skin and remove even the deeper wrinkles, but the deeper the treatment, the longer the healing process will be! It is very helpful to have a consultation with one of our medical aestheticians and to draw up a custom game plan for your skin – a long term skin care program will improve the quality of your skin and slow down the aging process! Of course, the best thing you can do for your skin is to avoid excessive sun damage and to use sun block regularly – and we certainly have some very good sun blocks to offer you.

(Actual patient of Dr. Bunkis, your results may vary)

47 year old female, before and six months after, a 10 minute microfat grafting procedure in which fat was transferred from the abdominal wall to reinflate the lips, cheeks, nasolabial folds and Marionette lines.

In summary, we have a plethora of “Quick and Easy Fix” procedures and products to offer our patients, and each is recommended after a thorough consultation which includes an evaluation of your skin and a determination of your expectations. We at Orange County Plastic Surgery would be glad to see you for an evaluation of your skin and would like to help you come up with an appropriate plan to minimize your signs of aging! Sometimes a very pleasing change over can be achieved with a relatively simple and minimally invasive procedure! 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 consultation with Dr. Bunkis, our nurse, Tracey Prescott, or one of our medical aestheticians, Anne Floerchinger or Janet St. Pierre, please feel free to contact Orange County Plastic Surgery at 949.888.9700.

949.888.970 | 30212 Tomas Ste. 275, Rancho Santa Margarita, CA 92688 | 


As Medical Director of Orange County Plastic Surgery, Juris Bunkis, M.D., F. A.C.S. brings 30 years of surgical expertise to our communities. Dr. Bunkis is a Harvard trained, Board Certified Plastic Surgeon and Member of numerous prestigious organizations including the American Society of Aesthetic Plastic Surgeons, The International Society of Aesthetic Plastic Surgery, the American Society of Plastic Surgeons and the California Society of Plastic Surgeons. Dr. Bunkis, a former faculty member at the University of California, San Francisco, has published more than 40 scientific publications, abstracts and book reviews, and 17 book chapters in plastic surgery text books. For questions or advice, please contact Dr. Bunkis directly at

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