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We have discussed previously that my goal during facial rejuvenation is to make a person look younger, to turn the clock back so to speak but the leave the patient looking as natural as possible. In order to rejuvenate the appearance of someone with a droopy neck it is frequently necessary to address weathered and wrinkly skin, aging eyes, droopy brows, frown lines between the brows and forehead, weak chins, thin and wrinkly lips and fat loss within the face, all items that normally occur with aging. Without doing so at the same time as the facelift is performed will result in a lack of harmony and incomplete facial rejuvenation.

Performing a facelift does not change the texture of your skin. There isn’t much point in having a nice, tight neck if your skin tone is aged and sun damaged. Each and every facial rejuvenation procedure for us begins and ends with good skin care! Check out our skin care line at and have the staff come up with a customized skin care program for you. This skin care program suffices for the majority of patients but occasionally, we see patients with severely sun damaged and wrinkled skin that surpasses skin care product capabilities to improve. In such patients we discuss the possibility of performing a skin resurfacing procedure with a laser during the same operation as the facelift. Not removing such a person’s wrinkles will result in tightened neck skin but insignificant overall improvement if the skin remains wrinkled like a prune! The following is an example of performing ancillary procedures at the time of a facelift to enhance the final results.

The above example shows a 79 year old female before surgery, and two years following a facelift, actual patient of Dr. Bunkis. In addition, she had a brow lift to raise the brows and remove the lines between her brows and forehead, excess skin removed from her upper and lower eyelids, and her face resurfaced with a CO2 laser, all in one four hour operation!

Another area that we frequently address at the time of facial rejuvenation surgery is the chin. In patients with a weak chin, it is virtually impossible to obtain a pleasing neck contour without adding to the length of the lower jaw by adding a small chin implant. This is done through the same incision under the chin that all facelift patients get to allow us access to the neck fat and lax muscle bands – no additional cuts are necessary to add a chin implant and this adds but a few minutes to a facelift procedure.

Above example shows a 53 year old lady before and after a facelift procedure, actual patient of Dr. Bunkis, along with a brow lift, upper and lower eyelid surgery to remove excess skin and lower lid fat, and a small chin implant to improve the appearance of her profile.

Finally, as we age, all except the obese, experience a loss of facial fat, a thinning of the cheeks above the jowl, a thinning of the lips, and sagging of tissues in the midface region. In such patients I address the midface sagging with a midface lift, and add fat to the lips and cheeks to restore youthful fullness to the face.

This is an intraoperative view of a fat injection into the mid-cheek grooves and cheeks to restore youthful roundness during a facial rejuvenation procedure, which also included a facelift, brow lift and upper eyelid blepharoplasties.

This is the before and after of a 60 year old female, actual patient of Dr. Bunkis, whose rejuvenation included the perioral area, the area around the mouth. During normal aging, lips sag, thin and begin to develop vertical lines. Fullness was restored with microfat grafting and the surface wrinkles improved with a CO2 laser resurfacing. Such fine touches help balance the final results so that the lips match the neck, the neck matches the eyes, the eyes match the brows, and the patient is left with a natural, balanced and rejuvenated appearance.

If you have any specific questions about cosmetic procedures, your best bet would be to see a qualified plastic surgeon to review your options. Pease feel free to contact our office at 949-888-9700 to set up an appointment with Dr. Bunkis; check out our web site at to see further examples of similar patients.

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