
Diplomacy, Friendship, and Forward Thinking: Our Trip to Washington, D.C.
By Dr. Juris Bunkis Medical Director, Orange County Plastic Surgery Honorary Consul of the Republic of Latvia
This past week, Dr. Deborah Ekstrom and I had the pleasure of traveling to Washington, D.C. to attend the annual meeting of the Latvian Honorary Consuls in America. It is always an important event on our calendar, but this year’s gathering felt especially meaningful given the rapidly changing international landscape and the increasingly important role Latvia plays on the world stage.
First, I must say how much we both love the unique atmosphere of Washington, D.C. There is an unmistakable energy in the city—government buildings filled with purpose, historic monuments standing as reminders of sacrifice and leadership, elegant embassies representing nations from around the world, and the wonderful mix of languages overheard in hotel lobbies and restaurants. There is an international sophistication that is palpable everywhere, and for those of us involved in diplomacy, it feels like being at the center of important conversations.
Before flying to Washington, I was asked to prepare a synopsis of the activities and accomplishments of our Southern California Latvian Consulate during 2025, along with our goals and plans for 2026. As many of you know, we have been extremely active, so my report was lengthy and detailed. I could not have accomplished all of this without Dr. Ekstrom’s tremendous help. Her support has been invaluable, and in recognition of that, she is welcomed into all of our consular meetings. I am always proud to have her there because she brings intelligence, insight, and thoughtful contributions to every discussion.
The morning sessions were devoted to updates from the Embassy and Consular Staff. We were welcomed by Her Excellency Ambassador Elita Kuzma, followed by briefings on Latvia’s foreign policy and national security priorities. Our liaison with the U.S. Congress presented valuable updates regarding congressional relations, while Martins Andersons, President of the American Latvian Association and a longtime colleague, shared important developments regarding the Latvian diaspora throughout the United States.
Perhaps the most practically useful presentation came from the Head of the Consular Division, who reviewed new forms, changing regulations, immigration matters, and day-to-day consular issues we regularly encounter. The Press and Public Diplomacy Counselor also updated us on communications strategies and public outreach.
The afternoon focused on trade and business relations between the United States and Latvia. We heard fascinating presentations from companies leading innovation in technology, particularly in drone development, where Latvia is becoming a surprisingly strong global leader.
The formal sessions concluded with a presentation by Latvia’s Minister of Finance, Arvils Ašeradens, who discussed the country’s economic outlook, the effects of instability in the Middle East, and projections for the coming years.
The evening reception at the Ambassador’s residence allowed us to continue these conversations, strengthen friendships, and build new professional relationships. We returned home energized, informed, and ready to continue serving. The next formal meetings will take place this July in Riga, Latvia—and we are already looking forward to it.
Arriving “to work” at the Latvian Embassy, on Dupont Circle, in Washington DC.
Minister of Finance, the Hon Arvils Ašeradens, and Her Excellency, Ambassador Elita Kuza, addressing us during our meetings.
Arriving at the Ambassador’s residence on Foxhall Crescent, a very elegant section of Washington that houses residences of many embassies.
Breast Implant Replacement: When Is It Time?
By Dr. Deborah Ekstrom
Orange County Plastic Surgery, Corona del Mar/Newport Beach
Quiz: How Long Should Breast Implants Last?
Which of the following is the best answer?
A. Breast implants last forever and never need replacement
B. Breast implants should automatically be replaced every 5 years
C. Most modern silicone breast implants are expected to last 15–20 years or longer
D. Implants only need replacement if they cause pain
E. Ruptured implants are always a medical emergency
The correct answer is C.
Most modern silicone breast implants—such as those made by Mentor and Allergan—are designed to be very durable and usually last 15 to 20 years or longer. However, they are not considered lifetime devices.
Recently, we have treated several patients whose implants had been in place for 30 or even 40 years. By that point, rupture is quite common, even if the patient feels perfectly fine. In many cases, the rupture is discovered only during routine imaging.
While modern implants are excellent, the shell naturally weakens over time. For this reason, we often recommend considering implant exchange somewhere in the 15-to-20-year range, even if there are no obvious symptoms. Preventive replacement can avoid complications and allows us to restore the breast pocket with the newest generation of implants.
One of the most common questions patients ask is: “What happens if my implant ruptures?”
Fortunately, with silicone implants, rupture is usually not dangerous. Most ruptures are what we call “silent ruptures,” meaning there is no pain and often no visible change in appearance. The silicone gel in today’s implants is cohesive—it tends to stay within the scar capsule that naturally forms around the implant rather than spreading throughout the body.
Diagnosis is often made with ultrasound, mammography, or MRI. Occasionally, patients notice subtle firmness, shape changes, or asymmetry, but most have no symptoms at all.
Even when rupture occurs, most patients do not suffer any harm. Treatment typically involves removing the old implant, performing a capsulectomy (removing the scar tissue pocket), and replacing it with a new modern implant. Once this is done, integrity is restored and patients usually recover beautifully.
We do occasionally see ruptures in implants less than 15 years old, but this is uncommon. More often, problems arise simply because implants have exceeded their natural lifespan.
The most important takeaway is this: breast implant replacement is not something to fear. With proper monitoring and timely exchange, patients can maintain both safety and excellent cosmetic results for decades.
Do you have or know someone who has twenty-year-old breast implants in place?
Come and see us to go over your options!
