
The Zen of Fishing: A Surgeon’s Prescription for Relaxation
By Drs. Deborah Ekstrom and Juris Bunkis
Last week, we took a well-deserved break from the operating room and office to spend a day fishing out of Huntington Harbor. As plastic surgeons, we spend our days focusing on the fine details of facial rejuvenation and body contouring, but on the water, everything slows down, and we get to appreciate the beauty of nature and the simple joys of life.
Fishing is our version of meditation—our own Zen practice. There’s something inherently peaceful about being out on the open water, feeling the gentle rise and fall of the boat, and watching the horizon stretch endlessly. It’s a moment to unplug, breathe deeply, and let go of the stresses of daily life. If there’s a better natural remedy for high blood pressure, we haven’t found it!
Captain Woody guided us to some prime fishing spots between the oil rigs off the Long Beach coast. The technology they use today is fascinating—sonar systems help explore the ocean floor, identifying natural reefs, shipwrecks, and other underwater structures that serve as thriving habitats for fish. These hidden ecosystems are essential for sustaining marine life, and they make for some excellent fishing.
Of course, there’s the thrill of the catch—the tug on the line, the battle to reel in a fish, and the satisfaction of a successful hook-up. But just as rewarding is the quiet rhythm of the day: the sound of water lapping against the boat, the occasional call of a seabird, and the camaraderie of good company. Whether we bring home a fresh catch or not, we always return to shore feeling refreshed and recharged.
For those interested in fishing off the Southern California coast, there are plenty of options. Deep-sea fishing charters target yellowtail, tuna, and dorado further offshore. Coastal and inshore fishing offer calico bass, halibut, and rockfish around reefs and wrecks. Popular fishing spots include the waters around Catalina Island, San Clemente Island, and the deep trenches off Newport Beach. Even local piers and jetties can yield exciting catches for those who prefer to stay on land.
For us, fishing is more than just a hobby—it’s a way to restore balance in our busy lives. Whether you’re an experienced angler or a first-timer, we highly recommend a day on the water. It might just be the best prescription for stress relief you’ll ever get!
Boys do not Want to Look Like Girls: Understanding Gynecomastia
By Drs. Deborah Ekstrom and Juris Bunkis
Gynecomastia surgery is one of the more frequently performed procedures at Orange County Plastic Surgery. Gynecomastia, the enlargement of male breast tissue, can be a distressing condition for boys and men of all ages. While not life-threatening, it can significantly impact self-esteem, confidence, and overall quality of life. Understanding the causes, prevalence, different presentations, and treatment options is crucial for patients considering surgical correction.
Etiology
Gynecomastia results from an imbalance between estrogen (which promotes breast tissue growth) and androgens (which suppress it). Common causes include:
• Puberty: Hormonal fluctuations in adolescence often cause temporary gynecomastia.
• Obesity: Pseudogynecomastia, or fat accumulation in the chest, can mimic true gynecomastia.
• Medications: Drugs such as anabolic steroids, anti-androgens, and certain antidepressants can contribute to breast enlargement.
• Medical Conditions: Liver disease, hyperthyroidism, and certain tumors can trigger hormonal imbalances leading to gynecomastia.
• Aging: Natural declines in testosterone can lead to late-onset gynecomastia.
Incidence & Presentations
Gynecomastia is common, affecting up to 70% of adolescent boys, though most cases resolve within a few years. In adults, the prevalence ranges from 30-40% and tends to persist unless treated.
Patients may present with:
• Mild cases: Small, localized glandular tissue beneath the nipple.
• Moderate cases: Noticeable breast enlargement with some skin redundancy.
• Severe cases: Significant breast development with excess skin, often requiring skin excision.
Treatment Options
Non-Surgical Treatments
• Observation: Most adolescent cases resolve on their own. For this reason, we never operate on younger patients who have had the breast growth for less than two or three years.
• Medication: In select cases, anti-estrogen drugs (like tamoxifen) can help, though they are rarely the first-line treatment.
• Weight Loss: Beneficial in pseudogynecomastia but not at all effective for true glandular gynecomastia.
Surgical Procedures
For persistent or severe gynecomastia, surgery offers the most effective solution. Techniques include:
• Liposuction: Best for fatty gynecomastia, using small incisions to remove excess fat.
• Excision of Glandular Tissue: Direct removal of firm, fibrous breast tissue through an incision around the areola.
• Combination of Liposuction and Excision: Ideal for most cases, achieving a contoured, masculine chest.
• Skin Excision: Required in extreme cases with significant excess skin, often after massive weight loss.
The skin excision will leave a scar along the inframammary fold and the nipple areolar complexes are replaced as free grafts.
Conclusion
Gynecomastia is a common yet often embarrassing condition that can be effectively treated. A personalized surgical approach ensures optimal results, restoring a firm, masculine chest and boosting confidence. If you or a loved one is struggling with gynecomastia, consulting an experienced plastic surgeon is the first step toward a lasting solution.
If you want to see if you can have any part of your body improved, contact us for a consultation:
For CA, please call 949-888-9700 or visit www.orangecountyplasticsurgery.com
Or for MA location, call 508-755-4825 or visit www.salisburyps.com