Our last two articles came to you from Salzburg, Austria. While I enjoyed every moment of that European adventure, I am equally grateful to be back home and focusing on the most American of activities. This past Saturday, I had the privilege of attending the Miramar Airshow in San Diego County—an experience made all the more meaningful because I shared it with my son, Justin, and my grandson, Colton. Three generations together at one of the largest and most impressive aviation events in the world.

The Miramar Airshow is steeped in history and tradition. Held annually at Marine Corps Air Station Miramar (in San Diego County), it has grown into the largest military airshow in the United States, drawing hundreds of thousands of spectators each year. Its roots stretch back to the post-World War II era, and today it serves not only as thrilling entertainment but also as a tribute to the skill and dedication of our military aviators. The scope of the event is remarkable—static displays featuring everything from vintage warbirds to the latest fighter jets, coupled with high-energy aerial performances that make you look skyward in awe.

The highlight, as always, was the Blue Angels. Their precision, teamwork, and breathtaking maneuvers leave spectators with goosebumps and a deep sense of pride. Watching them streak across the sky reminded me of the countless times I had taken Justin to airshows when he was a child. Those memories came rushing back as I stood beside him and now watched his own son marvel at the spectacle. Life has a beautiful way of coming full circle.

Yet, as exhilarating as the flying and displays were, the real gift of the day was something quieter—simply being present with my son and grandson. We talked, we laughed, and I listened. I heard what mattered most in their lives right now, shared in their daydreams, and felt the joy that only comes from truly connecting with family. For me, this was one of the most pleasant and memorable days I’ve had in a long time.

I am already looking forward to the next family gathering—Colton’s upcoming birthday promises another special day together. In the end, whether soaring through the skies or simply sitting side by side, the moments spent with loved ones are the ones that lift us the highest.

My son, Justin, grandson, Colton, and the Blue Angeles streaking across the sky behind them.

Teaching Colton about the British Harrier Jet – the world’s first operational Vertical/Short Takeoff and Landing (V/STOL) ground attack aircraft, capable of taking off and landing vertically without a conventional runway by rotating its engine nozzles to direct thrust downward.

Always a good time for a snack!

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

Quiz Question:

Which of the following is the most important factor in how visible a facelift scar will be?
A) The type of sutures used
B) The surgeon’s choice of incision placement
C) The depth of SMAS tightening
D) The patient’s age
E) The amount of anesthesia used

(Correct Answer: B – incision placement)

When people think of facelifts, they usually imagine lifting and tightening the deeper layers of the face. And yes, under the skin, we are always working with the same foundational elements—the SMAS and platysma muscles. But what most patients (and their friends, family, and even hairdressers) notice after surgery isn’t the deeper work. It’s the scars. That is why facelift incisions are so critically important.

Dr. Bunkis: Traditional facelift incisions start in front of the ear, extending upward into the temple hairline. While this approach gives exposure, it often leaves patients with an unnatural upward shift of the sideburn—one of the biggest giveaways of facelift surgery. Behind the ear, traditional incisions sometimes cross into the hairline, leaving a visible “step-off” in the hair pattern. To us, these are telltale signs of a facelift that wasn’t done with enough attention to detail. I began my career in aesthetic surgery in the early 1980’s, using these same incisions – and this is how most plastic surgeons still make their incisions. But my technique evolved to the Natural A to V lift with invisible scars in the early 1990’s.

Dr. Ekstrom: That’s why our approach is different today. In front of the ear, we place our incisions discreetly behind the tragus and stop just behind the sideburn. This way, the scar is hidden and the sideburn maintains its natural position. Sometimes a small pucker of skin forms temporarily behind the sideburn, but it resolves within a month while preserving a natural look.

Dr. Bunkis: Behind the ear, we avoid crossing the hairline until well above the top third of the ear. This allows us to re-establish the hairline seamlessly, avoiding the unnatural “step-off” that is so difficult to hide. Again, there may be some initial puckering, but it smooths out quickly and prevents permanent scarring.

Dr. Ekstrom: Finally, we never pull the skin too tightly. Over-tightening not only distorts facial expression but also stretches scars wider over time. A gentle, well-balanced redraping leaves patients looking refreshed and natural—with scars that are almost invisible once healed.

Drs. Bunkis and Ekstrom: Attention to incision design is a subtle but essential art. Our patients want natural results, and thoughtful incision placement is what makes that possible.

Traditional incision placement. Note the incisions continuing straight up, in front of the ear, behind the temporal hairline. When these skin flaps are elevated and pulled backwards/upwards, there is no way that the sideburn and hairline behind the ear won’t be distorted. This is how the majority of plastic surgeons make their incisions today. This is a patient of Dr. Bunkis’ from the 1980’s, before he came up with the A to V Natural Facelift.

Proper incision placement for barely perceptible scars with Dr. Bunkis’ A to V Natural Facelift. This is a typical patient’s facelift lift incision markings and the same patient the day after surgery Not the minor skin puckering but the normal hairlines after surgery (Actual patient of Dr. Bunkis.)

Dr. Ekstrom’s facelift incisions, 3 ½ years after Dr. Bunkis performed his Natural A to V facelift on her. (Actual patient of Dr. Juris Bunkis.)

AVOID THIS!

These are patients, who presented to Orange County Plastic Surgery for unrelated issues after facelifts done elsewhere. These type of results are totally avoidable but these deformities are impossible to correct without hair transplants afterwards.

Orange County Plastic Surgery at CosmetiCare
1101 Bayside Drive, Suite 200
Corona del Mar, CA 92625

Take the elevator to the second floor (Suite 200) and check in with the front desk for your consultation or follow-up.
Free Parking Available.