This past week has been both professionally enriching and personally delightful. Dr. Deborah Ekstrom and I were fortunate to spend time in Salzburg, Austria—home to Mozart, stunning mountains, and a wealth of history.

On the professional side, we were honored to work alongside one of Europe’s top facelift surgeons, Dr. Walther Jungwirth. In the operating room, Dr. Jungwirth demonstrated his renowned fan facelift technique, which we found both elegant and effective. In return, we shared our own approaches during grand rounds at the University Plastic Surgery Department—Dr. Ekstrom presenting her outstanding results with facial fat grafting, and I discussing my refinements in facelift surgery. It was inspiring to exchange ideas with colleagues who share the same passion for advancing aesthetic surgery.

Of course, it wasn’t all work! Dr. Jungwirth and his wife, Andrea, graciously introduced us to Salzburg’s beauty and traditions. We immersed ourselves in Mozart’s legacy by attending a live concert and touring the Mozart Museum in his birthplace. We also ventured into the famed salt mines—after all, Salzburg literally means “Salt Fortress.” For centuries, salt was considered “white gold” and built the city’s wealth. Today, the mines remain active, but their greater role is as a reminder of Salzburg’s central place in European history.

Our hosts also welcomed us to their mountain home in Dienten, where we travelled to a mountaintop chalet for a hearty Austrian meal. One of the highlights was joining in the annual festivities honoring St. Rupert, the patron saint of Salzburg. Known as the city’s founder and the first bishop, St. Rupert established the great Salzburg Cathedral and ensured the church’s central role in shaping the region’s history. Dressed in traditional lederhosen and dirndl, we celebrated alongside locals, experiencing the joyful blend of faith, culture, and community.

Yesterday was less glamorous—a 20-hour journey through airports (Frankfurt, not one of our favorites) and airplanes to return home. Yet, as we woke up this morning to the California sunshine and stepped back into surgery, we felt renewed by the experiences, friendships, and knowledge gained abroad.
We are grateful for the opportunity to learn, teach, and connect across cultures—and even more grateful to be back, ready to serve you with the very best that modern facial rejuvenation and plastic surgery in general has to offer.

Drs. Bunkis and Ekstrom lecturing at the University in Salzburg.

Salzburg is very close to the German border. The salt mine tour starts and ends in Austria, but at one point, the tour crosses into Germany.

Celebrating St. Rupert’s Day with our Austrian friends, Dr. Walther and Andrea Jungwirth.

Let’s continue this week’s article with a quiz:

QUIZ OF THE WEEK
When combined with a facelift, which procedure can restore youthful fullness and softness to the face?

A) Botox® injections
B) Microfat grafting
C) Thread lifts
D) Chemical peels
E) Laser resurfacing

(Answer at the end of this blog!)

At Orange County Plastic Surgery, many of our patients know us best for the teamwork we bring to the operating room. Dr. Juris Bunkis, in my view the best facelift surgeon in the Newport Beach area, and I frequently do longer and more complicated procedures together. This is certainly true with facial rejuvenation if significantly microfat grafting is anticipated. With over 40 years of experience each, we have found that some of the most natural, long-lasting results come from combining techniques—and often, combining our own talents as surgeons.

Dr. Bunkis focuses on his signature A to V Natural Facelift, restoring the natural contours of the face and neck with precision and artistry. At the same time, I work my magic with microfat grafting, a procedure that restores the volume and softness we all lose with age. Together, we frequently share additional procedures such as eyelid surgery, brow lifts, chin augmentations, or rhinoplasties.

Why add fat grafting to a facelift? While facelifts reposition sagging tissues, they do not replace the volume lost over time. Microfat grafting fills in hollow cheeks, temples, and brows, softening sharp lines and adding youthful fullness. We can even treat the back of the hands at the same sitting, giving patients a more complete rejuvenation.

Here’s how it works: while Dr. Bunkis begins the facelift, I harvest fat from a discreet donor site—most often the abdominal wall. The fat is carefully processed, purified, and then reinjected into the face (and perhaps also into the hands) in precise micro-droplets. A typical case may require up to 150 cc of fat, and I may spend as long as two hours refining the injections to achieve natural, balanced results.

This is where teamwork truly shines. Microfat grafting is a meticulous and time-consuming procedure—but when performed by myself alongside Dr. Bunkis’ facelift, the overall operating time is dramatically reduced. Patients benefit from less time under anesthesia and from having two specialists each focusing on what they do best: Dr. Bunkis delivering world-class facelifts, and Dr. Ekstrom providing unmatched expertise in fat grafting.

For our patients, that translates into safer surgery, shorter recovery, and results that are both youthful and natural.

Quiz Answer: B) Microfat grafting

Fun Fact: Did you know that once transferred, your own fat not only restores volume but also carries stem cells and growth factors that can actually improve skin quality—often giving patients a smoother, healthier glow in addition to added fullness?

This female in her early 70’s sought facial rejuvenation from Drs. Ekstrom and Bunkis and it was decided to offer the patient joint surgery by both surgeons. She is shown here before and after microfat grafting to the cheeks/temples/brows and lips as well as a transconjunctival lower lid blepharoplasty to remove her lower lid fat pockets, insertion of a small chin implant to improve her profile, and Dr. Bunkis’ A to V Natural facelift. (Actual patient of Dr. Deborah Ekstrom and Dr. Juris Bunkis.)

Orange County Plastic Surgery at CosmetiCare
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Corona del Mar, CA 92625

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