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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!


New Treatment for Stretch Marks

The Palomar Starlux laser has recently been cleared by the FDA for the treatment of stretch marks!  This laser represents the only procedural modality available that has been shown to improve stretch marks.  The initial clinical studies were all performed in Europe, and I am pleased to announce that Palomar has asked myself and Dr. Vic Narurkar to conduct confirmatory studies in the United States.  In addition, we will be refining treatment protocols and developing ways to better quantify results and predict treatment responses.  Please contact us if you would like to be evaluated for inclusion into the clinical trials.

You can view Palomar’s initial press release here.

The Starlux laser is a fractional non-ablative laser that works beneath the skin surface to increase collagen content in the skin. Small columns of micro beams emanate from the laser, penetrate the skin, and work in the dermal layers.  A stretch mark represents an area of the skin that has thinned due to excessive stretching, hormonal changes, or steroid use.  By increasing the amount of collagen in these damaged areas, the skin “plumps,” and the depth of the stretch mark is reduced.  Unlike the older ablative lasers, the skin surface itself is not damaged or abraded, and so many of the undesirable side effects that we saw before with lasers are avoided.  There is virtually no down time, and the major side effect profile involves the potential for hyperpigmentation, or darkening of the skin.  Fortunately, if this occurs, the pigmentary change gradually resolves in most patients.

Because skin types are variable, the response to the treatments are variable, and so results can vary widely, from only a mild improvement to a major improvement.  In general, however, one should see some improvement overall.  In order to achieve the best results, 2 or 3 total treatments may be necessary, and improvement can be noted even as far a year after initial treatment.

I am especially excited about this application for the Starlux laser.  It will allow my “mommy makeover” patients to achieve an even more complete abdominal rejuvenation.  The tummy tuck brings the abdominal area back to pre-pregnancy shape, and the Starlux laser will be able to improve the skin quality and texture.  For those who don’t wish to undergo surgery or don’t need it, this treatment will potentially provide a welcome relief to unsightly stretch marks!

Abdominal before treatment

abdominal stretch marks before treatment

Abdominal after treatment

abdominal stretch marks after treatment

For more information, Dr. Narurkar and I recently participated in an instructional webinar for Palomar Medical.  You can view this webinar at this link. And you can read the original research protocols and results here.

Dr. Carolyn Chang, San Francisco Plastic Surgeon

New Year, New You!

It’s 2010, and we are not only embarking on a New Year, but also a new decade!  So too come the traditional New Year’s resolutions. Maybe you have chosen to kick a bad habit, exercise more, eat things that are better for you, or do a little more to make the planet a better place.  Or maybe you’d like to turn back time, in the mirror at least – a whole decade would be great, wouldn’t it?!


Surprisingly, there are a number of great smaller, relatively easy, pick-me-ups that can make a big impact.  These procedures are less invasive, concentrated in one smaller area, and require minimal downtime.   Here are my favorite suggestions for a more youthful 2010:

Spot Liposuction
It is amazing how achieving more definition in one spot area can give you a leaner, more defined appearance.  Some of the best spot areas to target include the arms and on the flanks (aka love handles).  Liposuction performed under the chin in the neck area can give you the appearance of a neck lift, and is a favorite among my younger patients who are just starting to see early sagging and bagging.

Incisionless (hidden incision) Lower Lid Blepharoplasty
This procedure is also known as a transconjunctival lower lid blepharoplasty and is a subtle way to peel back the years.  In this procedure, the incision is located on the inside of the lower lids, so the healing is less noticeable.  Excess fat that causes the look of under eye bagginess can be removed through these hidden incisions, giving the lower lid a firmer, smoother appearance.

Fat Sparing Upper Lid Blepharoplasty
This procedure is a more modern version of the traditional upper eyelid lift.  As a result, it is less invasive, easier to recover from, and more natural appearing, especially over the long term.  Traditionally, with an upper eyelid lift, the goal is to brighten the eyes by removing the excess skin that droops over the eye with aging.  Along with this, the excess fat around the upper lid is removed as well.  The newer fat sparing technique emphasizes a more conservative fat removal to prevent a sunken or unnatural appearance over time.  Because less fat is removed, the procedure is less extensive, and can easily be performed in the office under a local anesthetic.  This is not your mother’s eyelid lift!

If you would like more information on any of these procedures, please contact us.  We would be glad to answer any questions that you may have.

And Have a Happy, Healthy New Year – Cheers!

Dr. Carolyn Chang, San Francisco Plastic Surgeon

Introducing a Great New Skincare Line – Neocutis

I am so pleased to offer a new skin care line – Neocutis.  It is available only in doctor’s offices.  Like you, I am always skeptical when it comes to anti-aging product claims. And of course, no cream can possibly be as effective as surgery or therapeutic laser treatments.  But in the world of skin care products, I think that Neocutis is among the best there is for clinically proven wrinkle reduction.

Its flagship product, the Bio-restorative Skin Cream, contains the company’s proprietary ingredient, PSP™, the most complete protein blend of Human Growth Factors, Cytokines, and Interleukins available to rejuvenate and soothe skin.


Not only is it a great product for anti-aging, but it also helpful after facial cosmetic procedures to promote healing, a real plus in my clinical practice.  It can even be used in combination with other topical treatments such as anti-rosacea medications, anti-acne medications, or retinoids to help soothe and treat the skin.

The Bio-restorative Skin Cream’s effectiveness in helping to reduce the signs of facial skin aging has been shown in several clinical studies.

The detailed results of the anti-aging studies can be found by clicking the links below.

Clinical Data: 2 Month Study
Clinical & Histology Data: 6 Month Study
Reduction of Skin Wrinkle Depth

The Neocutis product line also includes an eye cream, a daily sunscreen moisturizer combo, as well as Blanche.  This product helps to even out the skin tone by treating hyper-pigmentation and melasma.  Blanche was recently chosen by Allure Magazine as the 2009 winner of the Best Beauty Editors’ Choice Breakthrough Award.


For more information on the complete line of products, visit

Dr. Carolyn Chang, San Francisco Plastic Surgeon

The Beauty for Life Study

What do people find attractive about themselves and each other?  The answers are surprising.  Recently, the American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery conducted a survey asking these very questions.  People in their 20s, 30s, 40, 50s, and 60s were each asked a series of questions.  Their answers are as follows.  They are not what you would expect!

“What aspect of physical beauty do you find most appealing in another person?”

People in their 20s-40s responded that they considered a fit, well-proportioned body to be most important.  For those in their 50s and 60s, youthful skin was the most important.

But when people were asked, “Which part of your body are you most concerned about,” the answers were different.  Only those in their 30s responded that they were most concerned about their body.  Everyone else was more concerned with their face!


Beauty standards that we have for ourselves are apparently not the same as those we have for others.

Other interesting findings in this study include the fact that in regards to the body, more people were concerned with their abdomen and hips than their breasts for each decade.  And when asked what “the most important reason to maintain your physical appearance” was, the overwhelming reason across all decades was to boost self-confidence.  The second most popular reason for those in their 20s was “to attract potential partners.” For those in their 30s, 40s, and 50s, the number two reason was “to increase professional opportunities,” and for those in their 60s, it was “to help make friends.”

You can access the original summary from the American Society for Aesthetic Plastic Surgery at

And the actual Beauty for Life survey results at

Dr. Carolyn Chang, San Francisco Plastic Surgeon

The Skinny About Dissolving Fat

From time to time, patients ask me whether the unwanted fat on their hips, or abdomen, or knees can be dissolved without surgery.  Inevitably, they have read or heard about a procedure that accomplishes this in the popular press.  I have even seen, over the years, patients that have had this procedure, called mesotherapy, and are now unfortunately suffering from some of its undesirable side effects.


Mesotherapy involves a series of injections of various substances that will dissolve fat cells.  Over time, the body absorbs the by-products, and the fat in the area disappears.  This treatment has been available in various parts of the world, including Europe, and increasingly in the United States, and has always been a source of controversy and speculation.

I recently came upon an interesting and alarming article detailing a study recently published in the journal Clinical Infectious Diseases.  This paper reported a series of difficult to treat infections after courses of mesotherapy in 16 patients.  The authors noted that surgical drainage was the most effective in treating these infections.

Other important risks to note about mesotherapy are that it can result in prolonged swelling and redness in the area of injection, and residual lumpiness and unevenness can occur.  The injection substances themselves are unregulated and vary from practitioner to practitioner.  The procedure is not FDA approved and not recommended by the American Society of Plastic Surgeons.

When it comes to mesotherapy – it is definitely an example of “if it’s too good to be true, then it probably is.”  For dissolving fat, nothing works better than a healthy diet and regular exercise, and maybe a little bit of liposuction, if all else fails!

Read the full article from Reuters : Fat-dissolving Procedure Carries Risk

Dr. Carolyn Chang, San Francisco Plastic Surgeon