Your No-Judgment, All-Answers Guide to Plastic Surgery with Dr. Carolyn Chang
Show Snapshot:
Can plastic surgery truly turn back the clock? Midlife hits and suddenly everyone's getting "work done" or at least Googling “What did Kris Jenner’s facelift cost?” Today's show offers no-judgment cosmetic surgery smarts from a top physician. Dr. Carolyn Chang is a Stanford-trained surgeon who trained under a pioneer of the modern facelift, and who makes top-doc lists like Harper's Bazaar's top beauty surgeons and W Magazine's best for revisional work. Dr. Chang specializes in undetectable, natural results; she joins me to explore facelifts, brow lifts, blepharoplasty, and more. Learn what makes a modern facelift virtually undetectable, costs, recovery time, the limits of skincare versus surgery, why fillers can backfire, how to find a surgeon, and so much more. Plus, the one thing Dr. Chang wishes everyone knew about plastic surgery that might surprise you.
Transcript:
Katie Fogarty 00:03 Welcome to A Certain Age, a show for women who are unafraid to age out loud. I'm your host, Katie Fogarty. Beauties, celebrities like Kris Jenner are suddenly transparent about their facelifts, but are they telling the whole story? This week, I'm joined by Dr. Carolyn Chang, a Stanford-trained, board-certified plastic surgeon who makes the list of top docs in the US year after year and is renowned for natural-looking results that defy detection. Dr. Chang is a frequent media expert for Vogue, Harper's Bazaar, Town and Country, Allure, and more. San Francisco-based, she has a clientele of Silicon Valley business leaders. Now she's here to discuss the Kris Jenner effect, what celebrities aren't telling you about their procedures, when surgery makes sense versus skincare alone, and how to approach facial rejuvenation with holistic expectations and zero shame. If you are curious about facelifts, blepharoplasty, lip lifts, and brow lifts—what they do, how much they cost, how long they last, and more—stick around. We have a show that will set you straight. Welcome to A Certain Age, Dr. Chang.
Dr. Carolyn Chang 01:15 Thank you so much for having me, Katie.
Katie Fogarty 01:18 I appreciate you taking time out of your busy schedule to join me for this conversation. I know you're set to see patients shortly, so I want to dive right in. Let's start with a biggie: facelifts. I did my prep for the show. I read a recent article where you were interviewed by Town and Country. You said, quote, 'The modern facelift doesn't look like a facelift.' What's going on? How have facelifts changed over the years?
Dr. Carolyn Chang 01:42 Well, I think overall, all of plastic surgery has evolved, just like the rest of medicine. And the standard now is not so much to show off what work you've had done, but really just look the best that you can look. And so as plastic surgeons, as artists in that way, we've adapted to those ideals, and our techniques are modified in an aesthetic way to make things look just a lot more natural. So we're not looking to show that you've had a facelift done. I think that's a big difference from the previous sentiment. And you describe plastic surgery really as a science and an art, right? So what's going on with the science? Are facelifts being conducted in different ways than they had been in the past? You know, it's a really interesting topic. I talk with my patients all the time about these things. All of medicine, and plastic surgery as well, is—especially surgery—it's technically based, and so it's very rare that you have a technique that comes out of nowhere. All of the foundations are always built on each other, and they evolved over time. And so these days, when you hear about the term deep plane or SMAS facelift, those are really common in the popular literature and on Instagram and social media. It's really just an evolution of techniques. The basic principles that all of these new techniques are based on is really this SMAS dissection. And so it's just an evolution of things, and so we use the basic principles and we evolve into more modern techniques. Okay? And so is deep plane something that's been going on forever, or is it something that's a newer technique? So let's talk about the meaning of deep plane and SMAS facelifts. So I think the biggest difference that you need to know is that the deep plane is one specific technique, whereas the SMAS facelift is many techniques, and so you can't really compare them one to one. The real anatomic basis of the facelift is the SMAS layer. That's an actual anatomic layer. It's named in an anatomy textbook. The deep plane is just one way to manipulate that SMAS layer. How does a patient and a doctor working in tandem choose the correct one for an individual? Well, I think that's a really important thing. You have to talk with your physician about what they think would be the best technique for you. In my practice, it's pretty simple. I tell the patient I'm going to do what you need. So if you're someone with pretty severe aging, then you're going to need a full, extended SMAS dissection, which is really a true deep plane type of a lift, whereas if you're someone who's a lot younger, earlier, or maybe you are on your second or third facelift, you don't need as much, then we might tailor that back a little bit. So the more you do, the more risk there is, the more healing there is. And so I like to keep things just at what you need and not too much. Well, this is a great segue into a question I had, because we talked at the top of the show about Kris Jenner. She was very public about her—I believe it was her second facelift—and looked incredibly refreshed when somebody like a Kris Jenner, with a lot of high visibility, showcases their procedures. Does that help or hurt your practice? You know, are patients coming in with more realistic expectations or less realistic?
Katie Fogarty 05:00 Expectations about what's possible.
Dr. Carolyn Chang 05:02 Well, I think in general, the Kardashians as a whole have been really good for business. You know, they're very public about things that they do, and they look different, and everybody's looking day after day, year after year, so they see changes. Has it increased the business? I think it has. I think there's been a lot of things that have increased the business. First of all, there's a de-emphasis nowadays on fillers, and we're swinging back to surgery as a whole for facial rejuvenation. And then on top of that, you have these beautiful rejuvenations—Lindsay Lohan is one of them, Kris Jenner—you know, they came in rapid succession, and I think it's just an increased awareness of what's possible with surgery and with the decreased use of fillers and the not wanting to look so puffy. I think all of those factors have increased the business overall and the awareness, for sure.
Katie Fogarty 05:50 The question of fillers is something I wanted to ask you about, because I know that many women start them as baby steps. They're using fillers, and in my reading to prep for the show, I saw that some surgeons think injectables are a good way to preserve facial volume as you age, but others think that injectables, over time, speed up the aging process. Where do you land on injectables?
Dr. Carolyn Chang 06:11 Well, I think it depends on how you use the injectables as to what effect you get. Injectables, when they were first developed, were really for very small imperfections. You know, if you had a line here or a divot there, or you wanted a little more volume here, they were great, because your face was really in pretty good shape, and you were just doing some touch-ups to camouflage relatively small imperfections. And then over time, as we got more comfortable using fillers, and as they became more widespread, fillers started to be used as a way to volumize the face in a more tremendous way, in that it would not only provide the volume, but it would also provide lift—just due to tension, really. You know, if you put a lot in your cheeks, then the whole face is going to pull up a little bit. And that's where I think we got into trouble, because if you do deflate those fillers, you'll see a lot of—what we call hypovolemia, which is deflation—and sometimes you can even see extra skin and increased bagging as a result of it. So I think really, the long and short of it, in more simple terms, is its judicious use of fillers, I think, will not cause any problems. I think it's when you overdo it.
Katie Fogarty 07:23 That pillowy effect that you talk about. We see that sort of inflated face. Let's talk for a little bit now about this sort of Kardashian aesthetic. They're all incredibly beautiful women. They really have defined a certain look. It's high cheekbones, it's the pillowy lips, they've got these snatched jawlines. They very much look like a Kardashian. Do you see this Kardashian effect where people want these Instagram-famous faces? You specialize in a very natural aesthetic. How do you navigate the gap between what a patient comes in with and what they might want in terms of transformation?
Dr. Carolyn Chang 07:57 Well, that's a really interesting question. Every surgeon has a distinct aesthetic, and there's no surgeon in the world that says, 'I want to make you look unnatural,' or very few anyway, and so everyone says, 'I do a natural look.' But I think the proof is really in the pictures. So the answer to your question is, how do I navigate between sort of a Kardashian-maximus look versus what my patients really want? People seek me out for a specific aesthetic, and that is to really keep themselves looking like themselves. And so I have very few people that ask me for very extreme things. Now I will say that the general trend and the general aesthetic in the United States, for sure, and probably the world, is a little bit more of a 'done' look. And so people do really want to see a nice crisp jawline, and they want to see high cheekbones, and they want to see themselves looking the best possible way that they can using those same principles. And so I do think you can have a natural result, and you can have it look a little bit more on the glamorous side if you want to, but you don't have to go extreme like the Kardashians are.
Katie Fogarty 09:02 It sounds like people are coming to you for what you're known best for: this sort of natural look and kind of restoring where they were. I think everyone wants to look like they've had 24 hours of great sleep, right? I can see why people come to you for that kind of refreshed look. So I want to dive into it in a few minutes—you know, how much it costs, what the recovery is, who is the right candidate. But let's sort of do a bit of a rewind for a moment and start with when people are choosing facelifts and why. Because not everybody necessarily wants that. So let's talk about skincare versus procedures at first, and non-invasive versus surgical solutions. So as a sort of stepping-up point before we get into the facelifts, which is a bigger, more expensive, heavier lift—so serums and creams can certainly nourish the skin, right? But I know that many women probably wonder: when does the efficacy stop? How much can they restore what can be lost? So what can we expect from things like topicals, retinoids, growth factors? What are some of the limits of topicals, and when do they work?
Dr. Carolyn Chang 10:08 Well, let me just sort of overall give you an overview of what I like to tell patients about these topics. One really important thing to understand is that when we age, we have skin textural problems and we have skin contour problems. So we see the sun damage that occurs. We see the dehydration, the fine wrinkles—that's all texture, that's all skin quality. And then we also see the jowls, and we see the folding around the mouth, and we see the eyelids droop—and that's contour. And so really, when you talk about non-invasive things—i.e., serums and lasers and that sort of thing—you're talking really more about skin quality, fixing skin quality problems. That's texture, that's moisture level, that's fine wrinkling, that's pigmentation. And when you're talking about surgery, you're really talking more about fixing structural problems—that's lifting up the cheeks, that's correcting the jawline. These are things that you have to do surgically in order to actually move and tighten tissue. And so the two really work in tandem. Now I will say that keeping up with good skincare will help you stave off aging in the right kind of circumstances, because you're not allowing the skin to get as sun-damaged and lose as much elasticity. And so I always encourage good skincare from day one. When I was growing up, my mother, at age seven, made me slather on a really thick Elizabeth Arden night cream. I remember it was orange-peach, and it's ridiculous thinking about it now—a seven-year-old with this really thick, greasy cream all over her face. But it really did help me. I mean, it helped keep my skin looking hydrated and tight as long as possible, and that, with genetics, does stave off a facelift. And so at some point in time, the creams aren't going to do it, because they're not really designed for lifting and tightening per se in the same way that surgery is.
Katie Fogarty 12:02 And so they're addressing these textural changes that happen with the sun spots and sun damage and loss of collagen. Some non-surgical solutions claim that they do help with things like skin laxity. So this could be like Ultherapy or microneedling. Walk us through how that does address skin laxity, and then when it stops being the right solution, right?
Dr. Carolyn Chang 12:27 So then you're talking about sort of the intermediate types of things that bridge between the textural and the structural. So things like Ultherapy—they are radiofrequency treatments—and lasers like CO2 lasers or Fraxel. What they do is they cause damage under the skin, in the dermal layers and sometimes even deeper. And when you cause damage, it can work for you in a good way, in a positive way—it can cause skin contraction. And so that's the principle behind these. So not only will some of these things help you in terms of texture and fine wrinkling, they can also help you in terms of actual skin tightening. And so that's where they are, sort of the intermediate thing. So you're someone who started off with great skincare, now you're seeing early signs of aging, you might move to some of these modalities because you don't have a lot of aging, you just have a little early, and so that can tighten things up just a little bit more until you really can't win the battle anymore and you're looking at real structural issues. So I do think that they are important modalities in maintaining the longevity of youthfulness.
Katie Fogarty 13:37 We are heading into a quick break, but when we come back, we're going to take up facelifts again. What is an average price tag? What is the recovery like? How long can we expect the effects to last from one? We'll be back in just a minute. Dr. Chang, we're back from the break. When we went into it, you were saying that there are early modalities—we can be using serums to protect our skin texture, we can use intermediate steps when we see the initial signs of aging, but at some point, for some people, there comes a moment when the next step is surgery. So I'm sure the average cost—you know, there's a wide range probably across cities in the country—but I'm curious, what are we expecting to pay for a facelift? What's a range?
Dr. Carolyn Chang 14:24 Well, I think that's—as you said—it is a difficult—you know, something in New York City or San Francisco is going to cost completely different than something in, let's say, the middle of the country or the South. It has to do with cost of living. It has to do with cost of personnel and equipment and rent and all of those things. It also has to do with the expertise of the surgeon, the seniority or the notoriety, so to speak. So you read about these facelifts that cost $100,000 to $300,000, and then you read about these facelifts that cost $10,000 to $20,000. I would say in the Bay Area, which is probably a little on the higher end, but very representative of a major American city, I would say that you could expect to pay somewhere between $30,000 and $50,000 for a facelift. You can certainly have more or less, depending on what you're needing to do. But that would be a good estimate for me in my area.
Katie Fogarty 15:19 And if you had to guess how much something like a Kris Jenner facelift costs, is this like hundreds of thousands of dollars? What do you think we're looking at?
Dr. Carolyn Chang 15:27 I think there's probably a little bit of an inflation in her price for multifactors—you know, a lot of factors. I think one, it's in New York City, so that's more expensive. And two, she's a whole high-profile person, so I would guess it's in the hundreds of thousands.
Katie Fogarty 15:44 And so when we're talking facelift, you said there are a couple of different kinds. It depends upon whether somebody's coming in and needing, like, minor tweaks or a major overhaul. What kind of recovery are we looking at? Because I actually was surprised in my prep to learn that the recovery is faster than one would imagine.
Dr. Carolyn Chang 16:02 Yes, it is, actually, but it also depends on your tolerance for, quote-unquote, looking different than yourself. So I routinely will tell my patients, and I think this is a pretty good standard, is to really block off two weeks of your time. Now, during the time when everyone was wearing masks and all of that, you could push it forward, obviously, because you're covering a lot of your face. But nowadays, people are back to the office or back to seeing everybody socially all the time. So two weeks, I think, hiding from your normal activities should be sufficient. But really at that time, in my hands, only about 50 to 60% of the swelling is gone. And so then I tell people, around three weeks you're feeling good enough that you can exercise. It's safe at that point to do it. But if you really, really, really want to feel sort of—be more event-ready or picture-ready, or you're giving some public speaking, or you're throwing a party—then I would say give it a full six weeks. But at that point, you're still really not done either. I say at that point about 80 to 90% of swelling is gone, the scars have definitely settled down, everything looks really good, but your final result is really going to be more in the three to six months or even a year range, when all of those final variations in swelling and the healing of the scars is all finally complete. So it's really a process, but two weeks for sure, for a real lower face and neck lift.
Katie Fogarty 17:29 I had a friend who went through a deep plane facelift recently, and she shared that she had a lot of tingling and sort of nerve impacts afterwards, and that her surgeon said that that could last potentially forever. Is that rare, or is that common?
Dr. Carolyn Chang 17:45 Well, I mean, everything's potential, I suppose, but I think in general, I don't really hear that 'forever' word. Okay? Because really what the tingling is, is it's the nerves coming back to life. And it can be deep itching. It's sort of reassuring and irritating at the same time, but it's just your nerves perking up, and they really—that should really stop. That's been my experience. It stops certainly around a year.
Katie Fogarty 18:10 Okay, gotcha. And so how long do the effects of this last? You mentioned before that some people are coming in to have more than one. So maybe this is a two-part question. How long can we expect with a facelift today using the latest technology, how long can somebody expect the effects to last? And can you have more than one? And if so, what's the recommended cadence?
Dr. Carolyn Chang 18:32 So I think the standard answer to that question—because there are variabilities, obviously, in people's ability to maintain facelift results—but in general, most plastic surgeons are going to quote about 10 to 15 years. And so if you really are doing a true comprehensive lift, then what you're doing is you're putting the tissues back where they started, and that means not only the skin, but the underlying tissues. And that's a really strong rejuvenation. It's going to last the test of time. And the reason that is, is because you're starting your aging process over again from a much earlier set point, anatomically. And so I think it's very reasonable to expect in those kinds of comprehensive facelifts that you're going to get at least 10 to 15 really good years before you really start thinking, 'Oh, I might need a touch-up.' But the good news about it is that you will never reach the point—you'll never be worse than where you started. And so in that sense, you've cheated time for about a decade. And that's the fabulous thing about lifting.
Katie Fogarty 19:30 And so this comprehensive facelift—again, it's so individual based on a person's face and their own desires to get going. But I'm curious about when you think that most people, in general, should start. Because I'm thinking about, like, knee replacements. I know that a lot of people push that off because they're like, 'Oh my gosh, I need it to last a really long time.' What is the correct—not the correct age, because you can't pick a magic age—but what is the general range when you would recommend that people get going if they're looking to cheat time, as you said?
Dr. Carolyn Chang 20:02 Well, I talk about this with patients all the time. I have some really distinct, very specific recommendations. So the first thing is that I need to see that you have something to fix. So I'm not a real believer in doing a facelift just to do a facelift. I think you really need to have some early aging. I feel more comfortable offering people surgery in that timeframe. And then you have to be mentally ready. So in other words, one example is someone comes into my office, they sit down, they say, 'Should I wait till I have more to fix? Should I, quote-unquote, save up aging and do it all at one time?' Well, my answer to that is no. If you're mentally ready to do it, you should do it as soon as you're ready, because you're going to be shortchanging yourself all those years of looking younger, and you're not going to have as long a benefit of looking younger, and your aging is not as graceful over the years. And so there's no benefit to waiting. However, if you're not ready, you're not ready. You can't force yourself to do it. So the basic principle is: when you have something to fix and you're ready to do it, and you perceive that it's the right thing for you, you don't wait, you just do it.
Katie Fogarty 21:12 And so let's talk about timing about some other types of facial rejuvenation, because I know that there are brow lifts and lip lifts. There's the blephs, treating your eyes. Do you think that people should start off with these smaller, intermediary kind of rejuvenations? Do you ever build them into a complete facelift? Is somebody coming in and getting like a buffet of options? Walk us through the different choices.
Dr. Carolyn Chang 21:39 Well, I definitely am an à la carte surgeon, that's for sure. So we formulate the treatment plan according to what people are interested in doing, because it's a lot to bite off doing a whole facial rejuvenation if you haven't really been thinking about it for a long time and mentally getting prepared for that. And a lot of times you don't need it. Sometimes I see people in their mid to late 30s, and they really just have a little bit of extra eyelid skin. And in that case, we will do, oftentimes, just rejuvenation on the top third of the face. And that's perfectly fine, because it will keep them looking younger for longer. And then when they're ready to do the lower part, they may not do the upper part, so they may do it in parts. I think Demi Moore was probably a great example of that. She's the iconic personality showing you how to age gracefully. And then there are women that come in later, at a much later age, and they haven't done anything, and then they are ready to have a full rejuvenation. So it's really going to be a customized thing. And then sometimes I have someone in their 70s that really only wants to do her eyelids, and that's fine, too. So you're always going to get a benefit. You'll get a bigger benefit if you do the whole thing, but you're not necessarily one needing it or wanting it at that time, and that doesn't mean that it's the wrong answer.
Katie Fogarty 22:53 And so what's the difference between doing your eyelids and a brow lift? I mean, what is the brow lift trying to achieve? Walk us through the distinction between the two.
Dr. Carolyn Chang 23:01 So the brow and the eyelid are two anatomically distinct structures. So you have brow skin that falls down over time because it ages and it drops, and that amount of skin that is dropping over time is adding to the hooding in your upper lids. And then you have actual upper lid skin that's getting redundant just from loss of elasticity, loss of volume, sun damage, all of those things. So when you do a rejuvenation on the upper third of the face, the perfect way to do it in someone who has at least moderate signs of aging, there, is going to be to do the two together, because you're treating both the brow skin that's fallen down and the lid skin. But the truth is, oftentimes, if you do one or the other, you will get a nice improvement. You just may not get a complete improvement.
Katie Fogarty 23:49 Now, your approach is to create a natural-looking face. This is where the artistry comes in. We said at the top of the show that you see plastic surgery as a balance between science and art. And I know from spending time on your site that you are trying to bring people back to perhaps where they looked when they were younger chronologically, right? That's where the artistry is coming in, and the transformation is to sort of restore versus transform. So my question specifically around like the blephs and the eyes is that we've seen on social media some really unkind commentary, I think, about famous actors, including—oh my gosh, I'm blanking on his name right now because of midlife brain fog. Oh my gosh, he's like the very handsome with the bright blue eyes. In any event, he's changed. Bradley Cooper! Bradley Cooper, thank you so much. This is the midlife charades, Dr. Chang. Thank you for helping me. But Bradley Cooper had slightly hooded eyes, and now he has a very different look. Or we look at Mandy Moore, where she had something done, and her hooded eyes now have like sort of deeper eye sockets, and they actually look different. So if somebody doesn't want to look different and they're getting their eyes done, how do they communicate that with a surgeon? You know, how do they make the right choice? Walk us through how we can do that procedure but still look and feel like ourselves, just as if we've rolled back time.
Dr. Carolyn Chang 25:17 Well, the truth of the matter is that most people look very similar to what they looked like before with eyelid surgery. So these people, I'd have to look at their before-and-after photos, but I think a lot of times, maybe they have extra hollowing of the face from loss of volume just over time. And then when you take the extra eyelid skin off, you see that hollowing definition more, and that's what's causing the problem. So it might just be that they needed a little bit more surgery, maybe some fat grafting, for instance, to bring back the volume and get that youthful look that they had before. Sometimes it's just over-aggressive resection. So I think it's just really important to show pictures to your surgeon of what you used to look like and then have a realistic discussion as to whether or not that's achievable. Because sometimes it's not achievable. It can depend on what's happened with your bony structure and the volume around your eyes, and so it can be complex that way. And that's why some people's blepharoplasties look great, and some they look good, but they just don't look quite like themselves. But I do think that it can be a conversation that can be nailed down between you and your surgeon.
Katie Fogarty 26:33 So if a facelift is giving us maybe a 10 to 15-year lifespan, what are you expecting with blepharoplasty or brow lift or a lip lift? How long do they last?
Dr. Carolyn Chang 26:44 Well, I think those can—I mean, I think a lip lift can last forever, because you're doing quite a transformation there. But the eyelids, in general, people don't necessarily need the complete blepharoplasty done again. I occasionally will see that, but they seem to last quite long. And, you know, they may later on down the line just have a little bit of skin taken off in a much more conservative fashion, but I would say a good 10 to 20 years as well. I mean, I've seen people that kind of had it done, maybe in their 30s, and now they're in their 60s, and they still look great. So it can last for a long, long, long time, for sure.
Katie Fogarty 27:20 And what are the average range of price tags for those treatments?
Dr. Carolyn Chang 27:25 Well, those in my office—if you just have a straightforward blepharoplasty for the upper lids—I can actually do them under local, which is a great thing, because then you're not—first of all, it's less intimidating. You don't have to have anesthesia. You're also saving the financial portion of the operating room and the anesthesia. So those price tags can be as low as maybe $10,000. If you start to introduce the operating room—let's say for brow and lower lids, I tend to do those under more of a general anesthesia with an anesthesiologist in the operating room—then it starts to get more into the $20,000 range, that sort of thing.
Katie Fogarty 27:59 When you were talking earlier about communicating with your surgeon, showing the pictures of you before, working to see what they've done with their own patients, I would love to hear your thinking right now for listeners thinking, 'I'm curious about this, but I want to find the right doctor.' One of the big themes of this show is I've interviewed more than 100 doctors on this show across a range of topics—menopause, pelvic floor health, bone health. And the reality that I've learned is that not every doctor is up on the current science. Sometimes women struggle to find a menopause-trained practitioner. So obviously, if we're doing something as important, as visible, as working with a surgeon on our face, how would you coach a listener to find the right doctor? You know, if they don't live in San Francisco and they can't come to see you, if they aren't able to travel, what is the recommendation on sourcing a doctor that you're going to really align with?
Dr. Carolyn Chang 28:58 Well, you know, I find that most people find almost anything important, like a physician, through multiple sources. So they might start to do a little research, just locally, online, and then they might talk to their own doctor. I think doctor referrals are really valuable, especially if you're talking to someone who is familiar with the field—i.e., a dermatologist or an anesthesiologist or even a nurse. Those medical practitioners that have intimate knowledge of what practitioners are capable of are really, really, really accurate and valuable information. And then also friend referrals or friend-of-friend referrals—so people that have actually had things done by that practitioner. I think those are just as valuable as the practitioner—the other doctor—referrals. So I do think that it's worth your time to do a little bit of searching and not just jump into something just because you read about that person that Kris Jenner had, for instance, and assume that that's going to work for you. Because the other thing you have to realize also is that physicians have different aesthetics and different approaches and different cultures in their office, and that may not be the right one for you, despite their great results. So you have to match the personality, the aesthetic, and the expertise that you're looking for. But I think in general, you start talking to people, and you start looking online, and you start doing a little research.
Katie Fogarty 30:25 Yeah, that's fantastic advice. Ask your friends—women have great recommendations across everything.
Dr. Carolyn Chang 30:32 Everybody knows somebody that's done something, exactly.
Katie Fogarty 30:35 So that's terrific advice, because that's how you really do source the right kind of person for you. Last question: when someone's walking into your office, once they've landed the doctor—I am sure that you are talking patients through, and you know, men and women, because I know that you operate on both. I imagine that you hear an array of fears regularly. People walk in with probably a level of anxiety about like, 'Is this going to go well, and will I look crazy afterwards?' There's probably a level of anxiety. How would you coach a patient in managing their anxiety around the process and really having great communication about what the results are going to look like with their own practitioner?
Dr. Carolyn Chang 31:20 Well, I think that the number one thing that people are afraid of is the loss of control over this entire process. And I think that's a natural response to this. And the stakes are high. The surgery itself is not, quote-unquote, dangerous per se. It's—at the end of the day—it's skin, so you're not working with vital organs and those sorts of things and that type of acuity. But the stakes are high because it's the way you look, whether it's your breast or your face, it's still the way you look, and it's very visible. And then you also have to place a level of trust. And it's like when you go on the airplane, you can't control it, you just have to believe that you're in good hands. And I think that that's really the number one thing that's important in my office is to make people feel comfortable with their choices. So we have a tremendous amount of education that's given. I'm extremely transparent with what happens during surgery. If I don't think you need a procedure, I don't think you need a procedure, and I tell you why. If I think you do need one, then I tell you why. There's actually very little sales going on in a really good cosmetic surgery practice, I feel like, because they're being completely honest with you, and you're buying what you truly think you need to buy. The other thing that's really helpful is my staff—between the three of them, they have 45 years of experience with plastic surgery. So anyone that calls is going to get an intelligent person talking them through whatever questions they have. And we also provide a tremendous level of support on the back end, because a lot of times people are really anxious on the back end as well. You know, they're looking at themselves and they don't know what to do. And so we customize that, too. So I think it's really about feeling comfortable, allowing someone to feel comfortable with the process as much as they can. And so what I tell people all the time is that it's normal to be afraid. Absolutely. You'd be a strange person if you weren't. But you have to be in a mindset where you know it's scary, you're afraid of it, but you're convicted that it's really the right thing for you to do. And once you get there, you're in the right office, and you're going to do well.
Katie Fogarty 33:30 Yeah, that's fantastic perspective. Okay, actually, final, final question, even though I said the last one was—because I'm curious about this. Like, what do you wish people knew about plastic surgery and this whole process that you think that they don't understand?
Dr. Carolyn Chang 33:43 You know, I wish people knew that it really isn't scary. It's not—it's something that we do day in and day out. I've done thousands of cases at this point in time. And the vast, vast, vast, vast majority of people have a great experience. And you know, if you go to someone who's experienced, you'll be well taken care of, and all of those horror stories that you hear are really not the norm. And I also wish people knew just how transformative it really can be. It's not just skin-deep. It can really give you a lot of confidence and shed a lot of baggage, really. You know, I have women all the time tell me, 'You know, this is something I thought about every single day, and now I don't think about it at all.' And that really is powerful, and that really is life-changing. And I think oftentimes it just gets discounted as being something so superficial and vain, and you don't really talk about the true benefits that you get psychologically and from a confidence and personality standpoint.
Katie Fogarty 34:45 That's a wonderful note to end on. And I also love your airplane analogy. There's a lot of things that we put our trust in. We recognize that people are trained for the moment, and we give ourselves over to it, and we land. So you do, you do. We all land. We want to walk off that plane, right? Dr. Chang, thank you so much for being with us today to walk through these different options—you know, what they cost, how long the recovery might be, and why people are considering this. So I truly appreciate your time today. Before I say goodbye, though, how can our listeners find you and follow your work?
Dr. Carolyn Chang 35:20 Well, there's no plastic surgeon that can't be found. That's good. So I have two main things, actually—I'm on TikTok as well. So the social media on Instagram is @CarolynChangMD, and it's the same on TikTok. And I do a lot of tutorials. Basically, there is also a photos page and a personal site if you want to know more about me. There's also a website, which is www.DrCarolynChang, and that's D-R-C-A-R-O-L-Y-N-C-H-A-N-G.com. And Katie, I just want to say thank you so much for having me. This is one of the podcasts where I think of as being really in-depth and really getting to the meat of facial surgery, and I appreciate that.
Katie Fogarty 36:05 Well, thank you so much for being with me today. I learned a lot, and I appreciate your time. Thank you. This wraps A Certain Age, a show for women who are aging without apology. I thought this was such a fascinating conversation. I've been super curious about learning more about plastic surgery. It's everywhere. It's buzzy, it's on Instagram, it's in the news. It was really fun to talk to a top doctor, learn the ins and outs, the cost, the recovery, what it can do, what it can't do for you as you age. Truly a fascinating conversation. I'm really grateful Dr. Chang came on to share her expertise with us, because we're not all San Francisco-based, and it was wonderful to do this deep dive with a top doc. If you learn something new, if you took something away from the show, I would love to hear about it in an Apple Podcast or Spotify review, because reviews help other listeners find the show. Special thanks to Michael Mancini, who composed and produced our theme music. See you next time, and until then, age boldly, beauties.