This past weekend, we had the pleasure of attending a beautiful outdoor wedding outside of Austin, Texas. The event was charming—set under a warm Texas sky with thoughtful touches that made it truly memorable. In addition to celebrating with friends and relatives, we took time to explore the city and came away with impressions that left us reflecting on both Austin and our home in Orange County.

Austin is a city of contrasts. It is green and lush, with sprawling oaks and an undeniably vibrant energy. The city seems to be thriving, with cranes peppering the skyline and new construction everywhere. It is clear that Austin is growing fast, likely fueled by the well-documented migration of both people and companies from California—Tesla being a prime example.

We visited the Blanton Museum of Art, which we highly recommend. Its collection spans every major era of Western European and American art. While it doesn’t house the “big names” you’d find in L.A. or New York, its breadth and curatorial care made for a rich and satisfying experience.

Yet Austin isn’t without its challenges. We were struck by the number of unhoused individuals we encountered downtown—a poignant reminder that prosperity doesn’t touch everyone equally. Despite its economic boom and lower gas prices (under $3 a gallon), Texas also faces infrastructure and social hurdles that Californians will recognize all too well.

And then there’s the weather. At 86 degrees with 58% humidity, Austin felt surprisingly oppressive—especially compared to the dry warmth we enjoy in Orange County. Though the temperatures were similar, the humidity made a big difference. It is a reminder of just how lucky we are with our Mediterranean climate.

On the economic side, Texas offers lower personal income taxes and, for now, a generally lower cost of living. But after comparing our experiences, we’re not quite ready to trade our coastal breeze for southern barbecue full-time. Austin has a lot going for it, and we’re glad we visited. But when the weekend was over, we were just as glad to come home to Orange County—where we continue to do the work we love, in a place we love even more.

Dr. Ekstrom at the Blanton Museum, taking in George Romney’s “Lady Hamilton” from 1791

A classic Remington on display at the Blanton Museum of Art in Austin.

Two of Dr. Ekstrom’s grandchildren at the wedding, with their mom, Sydney.

When I began my plastic surgery career about 40 years ago, liposuction was just emerging as a new technique—and fat grafting was not even on the radar yet. Early attempts to use a patient’s own fat to restore volume were crude by today’s standards, typically involving large cannulas and inconsistent techniques that yielded unpredictable results. But as plastic surgery evolved, so did our tools, methods, and understanding of fat as a powerful regenerative tool.

One of the pioneers in this field, Dr. Sydney Coleman, helped bring fat grafting into the mainstream. I had the good fortune to visit Dr. Coleman and learn from him directly. Interestingly, during part of his residency at the University of California, San Francisco, Dr. Coleman worked under my longtime partner, Dr. Juris Bunkis. Dr. Coleman’s careful technique of fat harvesting, processing, and reinjection set a new standard in fat grafting and helped shift the procedure from experimental to essential.

Today, we have refined fat grafting into what we call microfat and nanofat grafting—techniques that allow us to treat delicate, high-definition areas with extraordinary precision. Using ultra-fine cannulas and carefully processed fat, we can restore volume, improve skin quality, and rejuvenate areas like the lower eyelid hollows, temples, lips, and the backs of the hands.

One of my favorite tools in this arena is the Tulip® system, which allows us to create nanofat—an ultra-filtered version of harvested fat that’s ideal for treating thin, delicate tissues. For example, nanografting the lower eyelids can dramatically reduce that tired, hollowed look with minimally invasive surgery. The same technique applied to the hands can erase years, softening tendons and veins while improving skin tone and texture. The caveat is that you have to have sufficient donor sites to make this procedure successful.

If you’ve found yourself avoiding rings or feeling self-conscious about your hands—or if your under-eye area doesn’t reflect the rested, vibrant person you are—microfat and nanofat grafting may be exactly what you’ve been looking for.

Fat grafting is one of my favorite procedures because it uses your body’s own natural tissue to restore youthfulness in a gentle, long-lasting way. If you are curious about what this could do for you, I invite you to call the office and book a consultation. Together, we will explore your best options for natural rejuvenation.

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