Interview by Giulia Juliet Belkin
Beauty and body positivity are part of the cultural lexicon today. According to American Society of Plastic Surgeons the number of cosmetic procedures performed today grew by nearly a quarter of million, which means feeling beautiful and nurturing beauty plays an important part for many of us.
We sat down to chat to San Francisco’s premiere Plastic Surgeon, board-certified plastic surgeon, and the Vice-Chairman for the Department of Plastic Surgery at California Pacific Medical Center, Dr. Carolyn Chang.
Dr. Chang graduated with a Bachelors of Science degree with honors from Stanford University and received her medical degree from Stanford University Medical School, where she was the recipient of the Dean’s Award for Excellence in Clinical Medicine. Dr. Chang is a mother of two, who admires fashion and is the guest of honor at mosts glamorous events in San Francisco and beyond.
Giulia: What does beauty look like, according to a plastic surgeon?
Dr. Carolyn Chang: To me beauty comes in all shapes, sizes, ages, genders, and races. The unifying characteristic is an inner glow that outwardly radiates confidence, contentment, and comfort in one's own skin. Plastic surgery can help achieve that indirectly by improving certain features, helping to build self confidence. But ultimately beauty does not come entirely from external appearance. It comes from within.
Giulia: How did you begin your career in medicine and what made you decide to go into this avenue in medicine?
Dr. Carolyn Chang: I grew up in a scientific community so I always thought that science and research was the way to make a living. I excelled in and enjoyed the sciences but realized early on though that I wanted to do something more personally interactive than just that, and medicine seemed like a nice compromise. In medical school my mentor was a female plastic surgeon, the only one on staff at that time at Stanford where I did my schooling. She brought me into the operating room early on and I was hooked.
Giulia: What cosmetic surgery do you specialize in ?
Dr. Carolyn Chang: I perform all types of cosmetic surgery. I specialize in a natural aesthetic and that is what I am known for. My training and experience is unusual in that I had formal fellowship training in facial aesthetic surgery with one of the founders of the way we do facelifts today. And then when I started practice I joined a very busy prominent all female breast and body practice so I effectively had 2 fellowships. I am one of the only surgeons in the area that does breast and body equally as well as facial surgery as a result.
Giulia: Plastic surgery is huge today, what makes a doctor a good plastic surgeon?
Dr. Carolyn Chang: Experience, volume of surgery, and consistency is very important from a technical standpoint, but overall aesthetic judgement and attention to detail is what truly differentiates the best from the rest of the pack.
Giulia: What should patients know before going under the knife?
Dr. Carolyn Chang: Patients need to make sure that their surgeon and anesthesiologist and facility has the appropriate credentials, obviously, and that they have their postoperative recovery plan in place. But beyond that, they need to make sure that they understand all of the risks and benefits of the procedure that have chosen and that reasonable expectations of their result have been set. They also need to make sure that they are on the same "aesthetic wavelength" as their surgeon. Good comfortable communication with your surgeon is paramount to getting the result that you want.
Giulia: Do you ever say "No" to patients?
Dr. Carolyn Chang: Absolutely, I only operate on approximately 50% of all that I see for various reasons. One of those reasons is that I cannot achieve the result that the patient wants. An evaluation of whether someone has realistic expectations is important and another evaluation of whether the desired aesthetic is achievable technically is also necessary. In order for me to take someone on as a patient, I have to be 100% sure that they have something that I can fix or enhance and that they will benefit from that enhancement.
Giulia: Do you ever have patients who come in asking to look like celebrities?
Dr. Carolyn Chang: Not so often do I get that request. More often I get the request NOT to look like someone. You can guess who some of those celebrities might be!
Giulia: What are the most requested procedures in your practice?
Dr. Carolyn Chang: Tummy tucks, breast surgery, facelifts, and eyelids
Giulia: Women in San Francisco live exceptionally busy lives, what are the most effective procedures that have the least downtime?
Dr. Carolyn Chang: Eyelids and breast surgeries
Giulia: What about men?
Dr. Carolyn Chang: Liposuction and eyelids
Giulia: Most common problem I hear about these days is under eye bags or excess skin on the top of eyelids? What service would you recommend today?
Dr. Carolyn Chang: An upper or lower lid blepharoplasty (eyelid lift) will take care of bags under the eyes and extra skin. Upper lids can be done in the office under a local anesthesia. The lower lids need more anesthesia to be comfortable but can be done in some cases with no external scarring. both procedures have a short recovery period and are relatively painless.
Giulia: Can you share with us one or perhaps two treatments you are most excited about and why?
Dr. Carolyn Chang: When patients ask me what the one thing they can do easily that can make a big difference in freshening their look, I always think upper blepharoplasty. Most people from the mid to late thirties on up can benefit from a subtle upper lid eyelid lift, particularly if botox is not working for them anymore. It is a small procedure with very little recovery that can make a huge difference making someone look more youthful and refreshed. Another small procedure that can yield surprising results is upper arm liposuction. This too is a small procedure with an easy recovery that can really give someone a slimmer look.
Giulia: Would you call plastic surgery a form of art?
Dr. Carolyn Chang: In the world of surgery, plastic surgery is definitely artistic. And to be a good plastic surgeon one must have a keen creative and aesthetic sense. But I prefer to think of plastic surgery more as remodeling. As a plastic surgeon I am not creating something from nothing like a painter, but I am recreating something better from a previous foundation. It has always been my philosophy to enhance someone's features and not change them completely. I want to preserve the essence of someone's look and character so that they are the best version of themselves.
Giulia: You are not just a surgeon but also a mom to two precious kids. How do you balance work and family life?
Dr. Carolyn Chang: My life is very structured and there is very little free time. When I am working I often leave the house by 6 am and am not home until after 7 pm. Finding time to spend with my children is so important so I always try to be with them before bedtime and on the weekends. Having good consistent help with the care of them has been vital, but nothing replaces the quality time that I prioritize for them. The ability to spend days on end with them at home because of this horrible pandemic has been the biggest unexpected blessing.
Giulia: Would you want your kids to follow your path in career ?
Dr. Carolyn Chang: I think that medicine and especially surgery is a fantastically interesting and rewarding field. There are a lot of problems with the practice of medicine these days so in that sense I would not necessarily encourage it, but if any of them truly wants to pursue a career in medicine for the love of it, I would be their biggest cheerleader.
Giulia: It seems more than ever, people are opting to go under the knife to change their appearance. Is there any advice you would give to someone looking to change their body via surgery?
Dr. Carolyn Chang: I think the biggest thing to realize is that most often plastic surgery cannot drastically change someones overall appearance. It really works best to enhance what someone already has. The results though, can be quite stunning and transformative depending upon what the starting point is.
Giulia: What has the impact of the Coronavirus pandemic had on your line of business?
Dr. Carolyn Chang: The coronovirus has completely upended the entire medical field and the ability to deliver medicine. It has devastated much of medicine and ancillary medical services financially. Plastic surgeons for the most part are unable to deliver care, even reconstructive services, and so the near future is unnerving. The pandemic however will eventually be more manageable and things will not always be this dire. Medicine will recover, and people, no matter what, will always want to look their best.
