What's New with Dr. Carolyn Chang
Living in San Francisco and having this fantastic profession has exposed me to so many dynamic, innovative, and interesting people. It's during these interactions, while sharing stories and experiences that I'm often asked for advice or guidance, and vice versa. Inevitably, I learn about some great new innovation, or place, or product that I would love to share with the rest of the world. This is the inspiration for this column.

I invite you to join me in this new endeavor where I'll share with you my inside knowledge -- I'll talk about general health and beauty, and interesting and exciting lifestyle related discoveries. And of course, I'll talk about plastic surgery because, after all, we're all curious about  WHAT'S NEW, aren't we!

Enjoy,

Say Good Day to Grey

October 5th, 2009

Congratulations to Mia Caybut – my hair colorist extraordinaire of 10 years, who was just named San Francisco Magazine’s 2009 Best of the Bay and SF Gate’s Readers’ Choice!

Over the years Mia has taken my hair from dark to lighter and back again, but recently I have been getting increasingly worried about a new phenomenon, grey.  People with darker hair often notice those little grey hairs earlier in life.  I am certainly one of them, and although I’m not quite there yet, I wanted to know how Mia was going to help me with this fast approaching new hair dilemma.

In order to strategically hide those grey hairs and maintain a more youthful appearance longer, Mia has created an innovative technique she calls HALO. She applies a lighter tint around the face.  This matches the color of the fine hairs that frame the face.  She then applies a darker tint on the rest of the hair.  Mia says, “This works really well on people who have allowed dark tint to grow out and are ready to go lighter.”

When the time comes, then, I’ll let my roots come in, and then I’ll make an appointment with Mia for her rejuvenating HALO treatment!

Mia
For more information on Mia, visit www.colorbymia.com

Dr. Carolyn Chang, San Francisco Plastic Surgeon

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New You, New Look, and Free Lingerie

October 2nd, 2009

A fun new promotion from Mentor breast implants has just been brought to my attention.  For a limited time, between September 28, 2009 and December 31, 2009, patients who choose Mentor MemoryGel® silicone breast implants for their augmentation can receive a complimentary Lolita strapless bra from Le Mystère No.9 lingerie. This is Le Mystere’s #1 selling bra, regularly retailing for $76.00.

The Le Mystère No. 9 collection is the first collection of patented designer bras designed to address the unique changes in shape and size that occur after a breast augmentation.

To receive this limited-time promotion, you must download and complete this form after your surgery.  Then send the form via mail or fax to Le Mystère.  All forms must be postmarked or received by Le Mystère by December 31, 2009.

Read more about this exclusive offer on Mentor’s LoveYourLook.com, and enjoy your “free gift with purchase!”

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Dr. Carolyn Chang, San Francisco Plastic Surgeon

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The Mommy Makeover: Part 1 – An Interview with the Southern Marin Mothers’ Club

September 28th, 2009

I was recently interviewed by the medical writer for the Southern Marin Mothers’ Club about the “Mommy Makeover.” I’ve included an excerpt of the feature below. The article was featured in the organization’s September newsletter and is full of useful and practical information.  You’ll find link to Part 2 of this article at the bottom of the page.

Feeling Good and Looking Good: Part 1
Mommy Makeover Surgery:  A conversation with plastic surgeon, Dr. Carolyn Chang

Being pregnant and becoming a mom are among the greatest experiences in life –however for many mom’s, the toll pregnancy takes on their bodies is a badge that they don’t want to wear forever.  With the growing trend among mom’s to seek “mommy makeover” surgery, I spoke to San Francisco’s mommy makeover expert Dr. Carolyn Chang, a leading plastic surgeon and Vice Chair of Plastic Surgery at California Pacific Hospital, to understand more about why moms are having surgery, what they’re having done, and what considerations a mom should have before embarking on surgery.

What’s behind the recent trend of “mommy makeovers”?
Many women are waiting longer to have children, and their bodies are simply not able to snap back, particularly if they have had several pregnancies or multiples, which can really take a toll on the belly.  I also think that because of the increased exposure of plastic surgery in the popular media, more women are aware of it as a possibility to explore.

Who do you believe is the ideal candidate for mommy makeover surgery?
Any mother who is feeling self conscious about her body after pregnancy is a candidate, however surgery should only be reserved for those who have such profound changes that diet and exercise cannot reverse.  And she should never contemplate surgery unless she is at a stable, healthy, and sustainable weight.

What are the most common types of surgery that moms are getting?
A mommy makeover surgery usually combines some type of body contouring like a tummy tuck or liposuction with breast surgery to bring the body back to pre pregnancy shape.  As a result of pregnancy over stretching of the abdominal tissues can cause separation of the abdominal muscles that support the abdominal wall.  The result may make a woman look and feel like she is falling out” in the front.  Some patients tell me that people still ask them if they are pregnant years after they have delivered!

Many mom’s also notice that their breasts have changed after their pregnancies and breast feeding — most often that they have shrunk and sagged.  In other cases, they have stayed persistently too large and heavy.  Women who experience any of these symptoms in their breasts or abdomen are usually candidates for a mommy makeover.

(Click here for Part 2 of The Mommy Makeover article)

smmcLogo For more information on the Southern Marin Mothers’ Club visit: www.southernmarinmoms.com

Dr. Carolyn Chang, San Francisco Plastic Surgeon

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The Mommy Makeover: Part 2 – An Interview with the Southern Marin Mothers’ Club

September 28th, 2009

My Mommy Makeover conversation with the Southern Marin Mothers Club continues below.

(Click here to read Part 1 of the Mommy Makeover article)

Feeling Good and Looking Good: Part 2
Mommy Makeover Surgery:  A conversation with plastic surgeon, Dr. Carolyn Chang

Can you describe the procedures that most women are including in a mommy makeover?

  • Tummy Tuck (abdominoplasty)
    The tummy tuck, or abdominoplasty, is the mainstay of the mommy makeover.  This procedure is designed to tighten the abdominal wall by repairing and realigning the abdominal muscles and removing any excess skin and fat that may have persisted after pregnancy.  The scar that is created for this procedure most often extends hip to hip.  This scar can be customized in its position, so it can easily be hidden under most bikini bottoms.  Patients are often worried that this type of surgery is especially hard to recover from.  I find that using a temporary implantable pain pump really helps to minimize the discomfort after surgery.

What’s important about this procedure is my patients not only look better afterwards, but they often feel better as well, because the abdominal muscles are realigned, the back is stabilized and straightened, thereby relieving the lower back pain that a lot of mothers feel.

  • Liposuction
    The general rule of thumb is that the places where your body collected fat before you had children will be the places where it will continue to deposit afterwards — and often to an even larger degree.  A common request among moms is to reduce the love handles, also called the flanks, through liposuction in conjunction with a tummy tuck.  In this way, the entire torso area can be slimmed and sculpted.  Other common areas that respond well to liposuction include the outer and inner thighs and the upper arms.
  • Breast Augmentation
    During pregnancy, the breasts engorge due to hormonal changes in preparation for breast feeding.  Afterwards, as the milk production diminishes, many women actually notice that their breasts become even smaller than they were pre-pregnancy.  This is because the breast tissue actually shrinks.  Breast augmentation is a procedure that uses silicone or saline breast implants to enlarge the breast tissue again and restore that youthful fullness.
  • Breast Lift (mastopexy)
    For some women, the swelling of the breasts results in overstretching of the skin, and afterwards, sagging breasts.  Implants can help in some of these cases. But in the most severe, the nipple position is so low on the chest that an implant alone cannot fix the problem.  For these mothers a breast lift, or mastopexy, is the answer.  A mastopexy re-centers the nipple on the breast mound and ‘lifts” the entire breast so that it is rounder in shape again.  A mastopexy can be performed alone or with an augmentation.

There are many ways to perform a mastopexy, and unfortunately, all result in some external scarring.  To minimize this, my preferred technique is that of a shorter lollipop scar.

  • Breast Reduction
    For those mothers whose breast tissue actually got larger after pregnancy, a breast reduction is available to relieve the weight and reshape the breasts to a more youthful contour.  Like the mastopexy, my preferred method when possible is through the shorter lollipop type scar, as opposed to the old-fashioned anchor type scar.  Not only is the scar shorter with the lollipop technique, but the shape tends to be rounder and perkier.

Beyond questions specific to surgery, what are the most common questions that mothers ask you about a mommy makeover?

How much time will I need for recovery?
Depending upon the selected procedures, recovery generally takes about a week or two.  I insist that my mothers get reliable help for their children during this time period.  I want them to take the time to rest and recover.  Mothers can feel guilty about taking time away from their children, but they shouldn’t lose sight of the importance of doing something for themselves as well.

How do I explain this to my children?
Mothers with young children are afraid of frightening them, and mothers with older children, particularly girls, are afraid of encouraging unhealthy body image issues.  In general, I have found that reassurance without going into too much detail works well with the younger children, and a frank conversation works with the older children.  A mommy makeover is reconstructive in nature, so it is not difficult to explain the motivations to have it done to a teenager.

When is the right time to have surgery?
My response is always the same, “It’s when you’re ready.”  Which means you have worked as hard as you can to get your body back into shape naturally. It also means that you are mentally ready and 100 percent committed to having a procedure.  You should have planned this carefully with your family to insure that they are onboard.  And finally you should do your homework to seek referrals to plastic surgeons from your doctor and word of mouth referrals from family and friends, and select a board- certified plastic surgeon with whom you are confident.

A little trepidation is normal, however being prepared will insure that you will have a successful result and recovery, and a more satisfying overall experience.

smmcLogo

For more information on the Southern Marin Mothers’ Club visit: www.southernmarinmoms.com

Dr. Carolyn Chang, San Francisco Plastic Surgeon

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One Day You’re In, the Next You’re Out

September 25th, 2009

As Fashion Week draws to a close in New York, I thought it would be fun to take a peek at the must-have trends that are emerging on the catwalk. The consensus is that the look is more realistic, wearable, and conservative, and according to the New York Times, a clear reflection of our economic times.  Familiar silhouettes are reworked.  Leather jackets, power belts, and shoulder baring little black dresses are among the tops picks for the season.  Peruse the New York Times Magazine slideshow to see the other fashion dos for fall.  Check out even more fall trends at bargain prices, and read how you can get THE LOOK for Less .

leather jacket

Dr. Carolyn Chang, San Francisco Plastic Surgeon

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Another Anti-Aging Recipe From Chef Elizabeth Howes

September 15th, 2009

My friend and personal chef, Elizabeth Howes, has done it again! She has provided us with yet another delicious recipe full of wonderful antioxidants.

As we discussed in an earlier post, foods that contain antioxidants such as beta carotene, lutein, lycopene, selenium, and Vitamins A, C, and E can dramatically boost skin health and help ward off signs of aging from the inside out.

Take some time this week to indulge in the recipe below, and watch your skin glow… Enjoy!

Roasted Organic Beets and Carrots with Ras el Hanout Vinaigrette, Meyer Lemon Chickpea Purée and Grilled Whole Grain Naan

Beets

Yield: Makes 6-8 appetizer servings | active time: 30 minutes | total time: 1 hour, 15 minutes

Ingredients

  • 8 organic beets (red and golden), cleaned, trimmed
  • 6 medium organic carrots, cleaned, peeled and trimmed, and cut into wedges
  • 2-3 medium whole grain naan, grilled on a grill pan or outdoor grill until crisp
  • Handful Marcona or slivered almonds

Vinaigrette

  • 1 ½ tablespoons aged balsamic vinegar
  • 1 teaspoon ras el hanout*
  • Sea salt and freshly cracked black pepper, to taste
  • 3 tablespoons extra virgin olive oil

Meyer Lemon Chickpea Purée

  • 2 cans organic garbanzo beans (or 4 cups fresh)
  • Juice of two organic Meyer lemons, zest of one
  • 1 clove crushed garlic
  • Sea salt and freshly cracked black pepper, to taste
  • 3 tablespoons extra virgin olive oil
  • ½ cup filtered water, if needed

Preparation
Preheat the oven to 400 degrees.  Wrap red beets and golden beets in foil separately so the colors don’t run together.  Place on a baking sheet and roast for 35-45 minutes, or until fork tender.  Toss the carrots in olive oil, sea salt, and pepper, and roast in an uncovered glass baking dish for 15-20 minutes, tossing once, until fork tender.  Let all vegetables cool.

In a glass bowl, combine balsamic vinegar, ras el hanout, sea salt, and pepper.  Whisk in olive oil until vinaigrette is emulsified.

For purée, place all ingredients except olive oil and water in a food processor.  Pulse until mixture is well-combined.  With motor running, drizzle in olive oil slowly.  If mixture is too thick, add water slowly until smooth.

Toss vegetables with some of the vinaigrette in separate bowls and arrange on a large platter, topping with almonds.  Place purée in a glass bowl and garnish with lemon zest and a drizzle of extra virgin olive oil, if desired.  Cut grilled naan into wedges and place next to chickpea purée.

Antioxidant Profile
This fun dish covers so many antioxidant bases in one delicious bite.  The carrots and beets are high in vitamins A and C and beta-carotene.  The citrus also contains high levels of vitamin C.  In general, vitamin C is critical for collagen synthesis, and all anti-oxidants help to eliminate free radicals which can lead to wrinkles and skin damage.  Vitamin E is found in the chickpeas, almonds, and whole grain naan.  It is vital in protecting skin cells from UV light, pollution, and other elements that produce cell damaging free radicals.  If that’s not enough, it also helps reduce the appearance of fine lines and wrinkles.

In addition, many of the spices found in ras el hanout, including clove, cinnamon, and turmeric, contain powerful antioxidants that can protect against skin cell damage.

*Ras el hanout is a popular blend of herbs and spices that is used across the Middle East and North Africa. The name means “head of the shop” in Arabic, and refers to a mixture of the best spices a seller has to offer.  Generally, it consists of some combination of pepper, cardamom, mace, cayenne, fennel, ginger, nutmeg, allspice, cinnamon, cloves, turmeric, lavender, and dried rosebuds.  It can be found at specialty grocers or spice shops.

SL Logo

For more information about Elizabeth and Saffron Lane, please visit www.saffronlane.com.

Dr. Carolyn Chang, San Francisco Plastic Surgeon

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Antioxidants: A Recipe for Anti-Aging

September 3rd, 2009

These days it seems that anti-aging antioxidants are in everything from serums and night creams to shampoo and cellulite lotions. And that’s great. But how about preventing the signs of aging from the inside out? I recently sat down with my personal chef, The Next Food Network Star’s Elizabeth Howes, owner of Saffron Lane boutique catering, to put together a few anti-aging appetizers for summertime entertaining. 

The antioxidant substances in foods that contain beta carotene, lutein, lycopene, selenium, and Vitamins A, C, and E can dramatically boost skin health, providing that much sought after youthful glow naturally. 

Beta-carotene – protects the skin cell membranes and stimulates the growth of new skin cells.  Sources:  carrots, sweet potatoes, kale, spinach, and cantaloupe.

Lutein – increases skin hydration, elasticity, and skin lipid concentration.  Sources:  carrots, squash and other orange and yellow fruits and vegetables, and green leafy vegetables, such as spinach, arugula and watercress.

Lycopene – reduces skin wrinkling, redness, and inflammation.  Sources:  tomatoes, pink grapefruit, watermelon, persimmons, apricots.

Selenium – provides a natural glow to skin and has been linked to a 60% reduction in skin cancer.  Sources:  watercress, seafood, eggs, chicken.

Vitamin A - known to rejuvenate the skin and improve overall structure, tone, and quality.  Sources:  peaches, tomatoes, sweet potatoes, squash, apricots, broccoli.

Vitamin C – very important in collagen production and overall skin health.  Sources:  tomatoes, citrus fruits, strawberries, green peppers.

Vitamin E – vital in protecting skin cells from UV light, pollution, and other elements that produce cell damaging free radicals.  It also helps reduce the appearance of fine lines and wrinkles.  Sources:  whole grains, nuts, seeds, green leafy vegetables.

Here is one of Elizabeth’s low-calorie, but utterly delicious, appetizer recipes to kick off that alluring glow, while enjoying the last cherished days of summer with good friends. Stay tuned for more great anti-aging recipes!

Organic Peach, Cucumber & Golden Tomato Gazpacho
Peach Gazpacho

Yield:  Makes 8-10 appetizer servings | active time:  20 minutes | total time:  45 minutes

Ingredients

  • 2 cups pitted and chopped organic peaches
  • 2 cups chopped ripe organic tomatoes
  • 1 cup chopped organic English cucumber
  • 1 medium shallot, chopped
  • 4 tablespoons extra virgin olive oil
  • 4 tablespoons white wine or champagne vinegar
  • 1 handful organic basil, torn
  • 1 ½ teaspoons sea salt
  • ½ teaspoon black pepper
  • ½ cup filtered water

Preparation
In a food processor, place all ingredients except the water and pulse until mixture is coarsely chopped.  Add water and pulse a couple times again until the gazpacho is blended but still a little chunky.  Place in a glass bowl and cover with plastic wrap.  Let refrigerate for 20-25 minutes, or until well chilled.  Serve immediately in small glasses or bowls.  Garnish with diced peach and a cucumber round, if desired.

Antioxidant Profile
This is an antioxidant powerhouse loaded with vitamin A and C from tomatoes and peaches and a special bioflavonoid found in cucumbers.  It also contains a great deal of lycopene and allium compounds.  This is a true collagen producer (and also low in calories), so don’t be shy about seconds!

SL Logo 2008 copy

For more information about Elizabeth and Saffron Lane, please visit www.saffronlane.com.

Dr. Carolyn Chang, San Francisco Plastic Surgeon

 

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Mascara – A Thing of the Past?! Introducing Latisse.

August 31st, 2009
Latisse: Before and After

Latisse: Before and After

We’ve all seen the ads. Enter the beautiful Brooke Shields batting incredibly lush lashes below her perfectly defined signature brows.  She uses Latisse.  The buzz around this product is incredible, and I’m sure you have questions about what it is and why it works.

What:
Latisse was recently released by Allergan and contains the active ingredient, Bimatoprost (Lumigan). This drug was initially intended to treat glaucoma, an eye disease.   It was noted that patients who received this medication reported increased eyelash growth as a side effect, and a new application was born.

How:
Latisse goes on like eyeliner. You apply a drop to a disposable applicator and spread it across the base of the upper lashes. It must be used daily to see results.  The product gradually enhances the eyelashes by prolonging their growth cycle. The end result is thicker, longer lashes. There will be noticeable improvement within four weeks, with fullest benefit after 16 weeks. After the 16 weeks, the manufacturer recommends applying the product every couple of days in order to maintain length and fullness.

Rare potential side effects such as a darkening of eyelid skin and a possible increase in the brown pigmentation of the colored part of the eye may occur.  Other possible side effects include itching, redness, dryness, and irritation of the eye or surrounding eyelid skin where Latisse is applied.

Where:
Latisse is available at medical offices, including ours, and it is wise to consult with your physician as to whether you are a good candidate for it.  Run, don’t walk; it’s going fast, and you’ll have to fight my office girls for it!

Dr. Carolyn Chang, San Francisco Plastic Surgeon

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The Vogue 100

August 27th, 2009

vogue100B

I am excited to report that Vogue Magazine has asked me to be one of their Vogue 100. This is a group of 100 women around the country selected by Vogue to serve as editors, tastemakers, and ambassadors in the world of fashion and beauty. Stay tuned for the inside scoop – I’ll keep you posted!

Dr. Carolyn Chang, San Francisco Plastic Surgeon

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Star Gazing…

August 22nd, 2009

We can’t help but read the gossip magazines, or at least flip through them – our secret guilty pleasure.  And even the ones we don’t read, we sneak a peek at when leaving the grocery checkout counter…

So what’s the latest gossip coming from the celebrity plastic surgery world?  Victoria Beckham’s breast reduction!  Rumor has it that she is so intent to be on the cover of Vogue magazine that she had her breasts downsized to increase her odds of landing the cover. Vogue’s editor, Anna Wintour, said she would consider putting Victoria on the cover, but told her she had to get her breasts looking better.  Beckham recently had her surgery in France to downgrade from a 34DD cup to a B cup.

Victoria Beckham prior to her capsulectomy

Victoria Beckham prior to her capsulectomy

So what’s the real scoop?
Victoria likely had a procedure called a capsulectomy, or a removal of the scar tissue surrounding the implants, with an implant exchanged to a smaller size.  Victoria’s breasts were not only larger before, but they were also encapsulated, or hardened.  This hardening occurs when the natural scar tissue that forms around any breast implant in the body thickens and contracts.  The result is that the breasts look high, round, and unnatural.  We’ve definitely seen plenty of evidence of this phenomenon in the pages of US Weekly.

Capsular contracture can occur in various degrees, from mild to severe.  Mild encapsulation may be evident only as a slight firmness in the feeling of the implants, with minimal cosmetic consequence.  More severe degrees can result in distortion of the breasts, and even pain in some cases.  Long term untreated severe encapsulation is associated with a higher rate of implant rupture, and mammography in these patients is less reliable.  For these health reasons, in addition to the undesirable cosmetic consequences, many patients may want to replace their encapsulated implants.

Luckily, most breast implants do not encapsulate to a severe degree, and there are various preventative measures that one can take, such as breast implant massage.  Your surgeon should provide you with instruction as to how to best prevent encapsulation.

In the meantime, Victoria looks great.  Her breasts are much more natural looking.  I think they complement her figure nicely.  Ms. Wintour should take note – only time will tell…

Dr. Carolyn Chang, San Francisco Plastic Surgeon

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