Meet Dr. Janet Chao, Facial Plastic Surgeon

Dr. G (00:02):
You are listening to another episode of All the B's with me, Dr. G and my scrub tech Bri. Hi everyone. I'm Dr. Kat Gallus and you're listening to All the B's, the unfiltered plastic surgery podcast with me, Dr. G and not Bri today, but Dr. Chao.

Dr. Chao (00:24):
Hi everyone. I am Dr. Janet Chao and I'm so excited to be here on All the B's. I joined Restore SD last year, 2024, and I'm a fellowship trained facial plastic surgeon based here in San Diego at Restore and excited to be here with you today.

Dr. G (00:42):
Yes, and so we're excited to have you. It's been really fun having you join the practice. And as you know on this podcast, we usually share our love of the Daily Mail or pop culture by reading some articles and reacting to them. Any thoughts you want to share on pop culture before we get to know you? Where do you get your news?

Dr. Chao (01:07):
Yeah, I've had to do my research on the Daily Mail after joining this practice. It's the OR talk of the town. So I did skim this before coming on here today in preparation and the best article I thought I found most recently is Jocelyn Wildenstein, aka The Cat Lady has recently passed away. And admittedly I didn't really know who she was, but I did.

Dr. G (01:31):
Cuz you're too young.

Dr. Chao (01:33):
But I did take a good hard look at all the photos of her and wow, I think she's just kind of evidence that there is such a thing as too much plastic surgery in this world. I feel a little bad. She was definitely overdone and over the top kind of plastic surgery at its worst, so I think she's kind of a cautionary tale, but yeah. What did you think of that article?

Dr. G (01:58):
I thought it was interesting. I knew already, my sister and I keep tabs on pop culture, so if I miss something she definitely catches me up, and so she had texted me the article when she had let me know that she had passed away. I'm definitely old enough to know who she is because she was kind of a big deal in the nineties. She was a big deal before that too because she is notorious for having a huge divorce settlement in which she received billions of dollars and then turned around and squandered it all. So like you said, excess is everything she spent that money on.

Dr. Chao (02:37):
So she had a tiger, a pet tiger at one point, and I mean, icon.

Dr. G (02:44):
Kind of wanted to hang out with her just because you knew no expense was spared. But she did spend a lot of money doing things to her face that I'm not really sure who the plastic surgeon was or why she continued to add what looks like filler honestly.

Dr. Chao (03:04):
Yeah, I agree. She kind of lost any bony contours. It's all kind of, I mean I hate the word pillow face, but kind of describes that well, she's got, I don't know if it's fat like you said, or hyaluronic acid based filler, but just it's very over volumized.

Dr. G (03:23):
Her divorce was in 1999 and I think even back then, I don't know that it was even hyaluronic acid fillers, it was article so she could have collagen in there, all the things that are not as easy to reverse. And she was inspired by cat eyes, so she had definitely orchestrated a surgeon to make her eyes more feline. That's what she wanted.

Dr. Chao (03:55):
I did see in one of the articles in the Daily Mail that she insists that those are a genetic trait. She had naturally cat-like eyes when she was younger and there's a picture of her when it looks like she's in her twenties and she's gorgeous and totally does have that cat eye appearance. I think she maybe probably with gravity and laxity of the campus, she maybe wanted to maintain that and just went a little too overboard later on. But the other thing that I noticed were her brows were just like, she had this constant surprise look. They were just pulled up way too high. So I don't know, there's a lot going on there, but rest in peace Jocelyn, Catwoman.

Dr. G (04:41):
Yeah. Also, she owed a bunch of people money when she died, so sucks for them, but

Dr. Chao (04:47):
I did see that.

Dr. G (04:47):
It's just wild that she had, she was wanted for an arrest for money that she owed, I think with regards to jewelry and stuff. But yeah, she was one of the wealthiest divorcees on the planet and she had a 2.5 billion settlement and yet she died owing money at the end.

Dr. Chao (05:06):
How do you even spend $2.5 billion? I just can't even imagine.

Dr. G (05:12):
It's mind boggling.

Dr. Chao (05:13):
Yeah.

Dr. G (05:14):
That was our major point of Daily Mail this week. It's been a lot of stuff going on in the news. None of it is fun. But I also thought we would revisit Bri and I had talked about the Blake Lively Justin Baldoni thing when it had first come out and my question is what is it going to stop now?

Dr. Chao (05:40):
It's like ping pong. It's like whose point do I take now? What is going on? There's new information left. I feel like it's not going to get settled until it goes to trial and it's going to be another repeat Amber Heard Johnny Depp situation where we're all just on the edge of our seats. What are we going to see next?

Dr. G (05:58):
I do feel like it might turn into something like that. And also all I can think of is maybe we picked the wrong profession and we should have been lawyers because everybody is suing everybody in this. There's her suit against him and the producers, his suit against the New York Times. I'm sure he will counter sue her. There's a suit between the PR people.

Dr. Chao (06:23):
The real winners in this seem to be the PR, well, the few PR firms might be losing actually, but the attorneys. The attorneys for sure.

Dr. G (06:31):
Yes. They're the only ones that are going to come out winners in this. It's really wild. So I just wanted to circle back to that. Okay, well let's talk more about you. I would love to know how you ended up here with us in San Diego, right, because you're not from San Diego.

Dr. Chao (06:51):
I'm not, no, I grew up in Colorado, but I did go to USD locally for undergrad and I mean immediately

Dr. G (07:00):
University of San Diego for those of us who are not in the know right?

Dr. Chao (07:05):
University of San Diego, not UCSD. Not SDSU, but the small liberal arts college here in San Diego, which is an incredible place. But I immediately fell in love with San Diego. I mean the weather, the laid back culture, the healthy lifestyle. So I did go to GW for medical school, wanted to go there for its global health program, and then I did my residency at Yale and I just always had my sights set on returning to San Diego. I knew that it was a place I wanted to be as soon as I discovered it. So when I finished my fellowship, I was exploring different job opportunities and I thought about opening my own practice or joining a big group and came down here a few times. And then when I met you, we kind of just bonded and chatted over shared experiences being women in surgery, the challenges of running private practice, and it just kind of felt like I found the perfect partner. So I'm super grateful to have joined this awesome team and I really couldn't imagine being anywhere else now. I'm really glad it worked out.

Dr. G (08:11):
Yeah, we're super happy that you're here. I do remember you coming in, one of the other plastic surgeons in town connected us randomly. It happens not infrequently to me, and I remember when we were trying to figure out the best way to have you come on board, and I reached out to some other plastic surgeons that I knew that had had associates join. I still remember Dr. Steve Williams going, okay, well when you're recruiting, when you're trying to bring, I was like, oh, I've never, I actually,

Dr. Chao (08:44):
I haven't done this before.

Dr. G (08:47):
I wasn't recruiting and I wasn't looking for somebody to join, but you're not the first person to come by and say, Hey, I really want to come to San Diego and your name popped up as somebody who might be looking for a partner or an associate. And I am always willing to have that conversation and see, it's just that a lot of times people show up and they know they love San Diego, but then they realize it's expensive to live here or there's other circumstances that make it maybe not ideal. So the level of commitment to actually come, it's like the first time you go to Hawaii and you're like, I want to move here. And then you realize the reality of that would not be maybe the reality for you.

Dr. Chao (09:33):
Totally. I was all in though. I was committed. I was like, I'm there.

Dr. G (09:36):
Yeah, you were like, oh no, we're buying a house done, so.

Dr. Chao (09:39):
I'm there.

Dr. G (09:41):
I was like, okay, cool.

Dr. Chao (09:43):
Actually, I feel like one of the first dinners we had together was also with our practice consultant and she went to college where I went to college and we were in the same sorority and just all these fun connections.

Dr. G (09:54):
Yeah, I almost left mid dinner.

Dr. Chao (09:55):
You were like, do I belong here?

Dr. G (09:59):
I was introducing you two, but now you guys have more connections than I do, so I'm just going to step out while you guys talk about USD and whatever, sorority and

Dr. Chao (10:09):
Go Toreros.

Dr. G (10:10):
Okay. Well moving on, what is your favorite procedure and why do you like to do it or not? Well, your top procedure doesn't have to be your ride or die.

Dr. Chao (10:22):
No, I mean I do love all facial plastic surgery, but in particular I do love rhinoplasty. I feel like it's the perfect combination of both form and function. So you're creating a beautiful nose, but you're also improving how it works and how a person breathes. So it's got that kind of balance of function and aesthetics that I love. But also just one of the most rewarding things to do for another person I think is aging face, like eyelid surgery, facelifts. It's so awesome when you can take off a decade sometimes more of a person's life and bring them back to who they were and help them see themselves as being more youthful in the mirror and just bringing them more joy and confidence. So that's an awesome feeling. So hard to pick one, but I'd say those two kind of categories are some of my favorites.

Dr. G (11:13):
Okay. Well, so let's talk about rhinoplasty for a minute. Let me preface this by saying as a plastic surgeon, I'm trained to do rhinoplasty, but a lot of times the depth of plastic surgery or the breadth is such that you tend to narrow your focus down a little bit. One of the first things I gave up was not rhinoplasty, it was hand surgery, but one of the second things I gave up was rhinoplasty, which is funny because it just describes how vast plastic surgery is. Are you going to do hand surgery?

Dr. Chao (11:44):
It's the whole body. Some people have just the eyeball, you've got every organ.

Dr. G (11:49):
Everything, right. But yeah, I felt like rhinoplasty is best done by somebody who's going to do a lot of it pretty frequently. Every nose is individual. I grew up in the era of I feel like we're swinging back to it right now where everyone's nose was made to look the same in the nineties. I remember going out in Miami maybe a decade later and seeing all these older men who had the same scoop ski slope nose, and I was like, oh God, you can't turn that back. Then I feel like it settled out, but I feel like we're heading back in that direction. So what's your thoughts on making everyone's nose look the same?

Dr. Chao (12:33):
I think it's a bad idea. Not all our eyes look the same. Not all facial features and bone structures are the same. I don't know. I mean, I think like you said, the ski slope nose of the nineties is definitely kind of swinging back and I feel like it's now called the Barbie button nose or the Disney princess nose. I don't think plastic surgery is one size fits all. You can't just put an algorithm and be like, I'm going to do it the same way every single time. I just think that's a recipe for failure.

Dr. G (13:01):
There are definitely surgeons that do that. I do remember one of my friends that I trained with is practices up in Beverly Hills and he ducked into a room where this plastic surgeon was famous for putting the same size implants in everybody. He could do an augmentation in 11 minutes, but everybody got 550 ccs, which is bananas. And I do see that in presentations when people are talking about their work and they're showing their before and afters of rhinoplasty and I'm like, everyone looks the same. Their nose all ends up looking the same. They don't look the same because their faces, like you mentioned, are different, but the nose looks the same and I think it's odd.

Dr. Chao (13:50):
I guess that caters to a certain type of patient if you know that that's exactly the nose that you want and you've thought about it and you think that'll look on you, I guess you go to that plastic surgeon. But I think our approach here, and I feel like we're pretty aligned in that, is to talk to each patient about what their individual goal is and do what's right for that individual and that circumstance in life and kind of talk them through what's possible and personalize and individualize it. Because in my opinion, not everyone would look good with the same kind of nose.

Dr. G (14:24):
Yeah, I agree. Talk to me about your educational path.

Dr. Chao (14:31):
Yeah, so I started my educational or my adult educational journey at the University of San Diego, majored in biophysics and minored in math when I was there, and I graduated Phi Beta Kappa.

Dr. G (14:45):
How are we friends?

Dr. Chao (14:49):
I know. And then I went to school at GW in Washington DC, George Washington University and there I did global health. They do scholarly concentrations in public health. So I chose global health program and that was kind of my emphasis. I really wanted to do global surgery, could do a whole podcast episode on that. But after earning my medical degree, then I did my residency in otolaryngology head and neck surgery at Yale in Connecticut, and I trained in surgical procedures of just the face, head, and neck. So after that I did another extra year of fellowship through the A-A-F-P-R-S, which is the American Academy of Facial Plastic and Reconstructive Surgery. And I did mostly cosmetic procedures during that year. A lot of rhinoplasty, facelifts, and eyelid surgery almost exclusively. And through my education training, I really wanted programs that emphasized technical excellence, so getting a good surgical experience and medical experience, but also just kind of compassionate patient care and ethical patient care and doing the right thing for people. And I think that's all really shaped the kind of surgeon that I've tried to be today.

Dr. G (16:02):
Yeah, and I think that comes up a lot in training. Did you have a diverse patient population where you offered the opportunity to see people from different backgrounds, different ethnicities? How does that play out in your approach to the patient? All of those things I think are super important. Did you feel like when you were doing your facial plastics training in the Bay Area, did you do rhinoplasties on different ethnicities?

Dr. Chao (16:31):
It's a very diverse area in the Bay Area, so we had a pretty big encatchment as far as different demographics, different ages. I think kind of classically your rhinoplasty patient is like a 16-year-old white female. I mean, we did plenty of those too, but saw a lot of patients who are older. I've actually done a lot of older patients here since I've started as well, and I think it's just a difference in education now. People realize that this is a possibility for them later in life or maybe they have the finances finally to go through with it at a certain point. It's something they always thought about. So yeah, I think I saw a lot of diversity and I'm super grateful to Dr. Kim for that, for letting me share in his practice.

Dr. G (17:15):
Yeah, that's amazing. I mean, people would think, I mean besides from just the facial harmony of seeing patients with different noses, there are some things like thickness of the skin, how you heal. It's not like it's a huge scar for a rhinoplasty, but if you have that scar at underneath your nose or any other scar like a lip lift or something like that, your ethnicity matters because we all tend to heal differently. And as you know, people with either a Hispanic background, like myself, or Asian, like you or black, those were all in the category of maybe we're not so sure how that's going to go in terms of healing. Right?

Dr. Chao (17:55):
Totally.

Dr. G (17:56):
A little unpredictable.

Dr. Chao (17:56):
Totally.

Dr. G (17:57):
I mean, I've seen one of the worst keloid or hypertrophic scarring after otoplasty I've ever seen was on a white male, which was shocking to me. I ended up seeing him after he had had his otoplasty done for a scar revision. And again, it's hidden behind the ear, but it's a massive bummer when you have these huge scars back there. So anybody can have unpredictable healing, but we do know that if you have any kind of ethnicity that can maybe create a wrinkle there that you have to account for, especially when you're operating on the face.

Dr. Chao (18:30):
Yeah, totally. Luckily the face tends to be really well vascularized and heal a lot better than other parts of the body. So in particular eyelid surgery, you can pretty much get away with any skin type. It tends to heal really well. Lip lift, even the rhinoplasty scar, you can still definitely do, we have a Fitzpatrick scale for skin types, and six is the darkest, and you can definitely do a rhinoplasty on a Fitz six. You just have to be very mindful and precise when you're closing. But to that point too, I think some people also want to maintain their ethnic background. Some people have an Egyptian nose and they may have a dorsal bump and they're like, I still want to look like my parents and my sister and maintain that ethnicity. So lots to think about. Definitely everything is individualized when it comes to practicing.

Dr. G (19:24):
Yeah, I think that's a great point. Alright, so you did ENT at Yale. Obviously there's more to ENT than rhinoplasty. There's head and neck cancer, there's vestibular inner ear stuff. That's just the things I can come up with. Obviously you're the same surgeon that takes tonsils out. What led you to aesthetics?

Dr. Chao (19:49):
I think that for me, aesthetics really marries the science and the art of medicine in a really beautiful way. And also my mom is South Korean and I kind of just always grew up in this culture of beauty. For those of you who may not know, South Korea is considered one of the beauty capitals of the world. Skincare, lasers, plastic surgery, all very prominent in the culture. And so my mom actually worked for a skincare company and was just really beauty obsessed. It's very common for women to get plastic surgery as their 16th birthday present or when they go to college or whatever. So I was always kind of surrounded by it, always wanted to learn more about it, passionate about it. I love beauty and aesthetics and spend time kind of just looking into what's popular and happening in my free time, even just as a consumer.

Dr. G (20:47):
Have you been to South Korea?

Dr. Chao (20:49):
Many times.

Dr. G (20:50):
Yeah. Okay.

Dr. Chao (20:51):
I actually went to preschool there when I was younger, so I lived there for a little while with my grandparents and I've probably gone at least a dozen times. If I went now, I feel like it would be, we should go, actually.

Dr. G (21:04):
I know. I want to go.

Dr. Chao (21:06):
We could go and do a skincare hall. We could go.

Dr. G (21:09):
Yeah, maybe when it's a little settled there. Right now it seems like politically it's a little crazy, but yeah, I do want to go. I was mentioning this to a patient the other day. I was like, no, it's like the hub of plastic surgery. It is super common. People will go there from the United States to train, they'll do six month mini fellowships on Asian eyelid surgery. A lot of our laser technology comes from there. A lot of the lasers themselves, the inner core of the laser is manufactured in South Korea.

Dr. Chao (21:49):
The research and development going on out there is totally cutting edge. I think because it's so prominent and part of the culture, there's just a lot more investment in researching what the next best laser is going to be or the best skincare ingredient, the next best tool, all of that. And I did, as part of my global health experience as a medical student, I actually went out to South Korea and I lived there between the summer of my first and second year and then went back again the summer between my second and third year of med school. And I worked with an ENT department out there actually. And I did research on wound healing, and that was an awesome and motivating part.

Dr. G (22:33):
That's pretty cool. I went to, my mom is from Chile, South America, and I actually did a plastic surgery rotation when I was in medical school down there.

Dr. Chao (22:43):
No way. I didn't know that.

Dr. G (22:44):
And that's what sort of turned, they kept saying, you do not want to do something boring like pediatrics. And I was like, okay, calm down. And that's when I made my final call to, I'd always been interested and I kept debating whether, you get the same pushback, like, oh, lifestyle and are you going to be at such a long haul, blah, blah, blah. And they were like, no, you should do it.

Dr. Chao (23:08):
Yeah.

Dr. G (23:09):
It was cool. I saw aesthetic surgery there. I was part of their military kind of medical hospital where they did a lot of reconstructive surgery. It was really, that's kind of what turned my interest around there. Not as advanced as South Korea. But yes, we should definitely go and work on our 12 step skincare.

Dr. Chao (23:34):
Oh yeah. Get all the lasers. We'll do a whole day. It'd be so fun.

Dr. G (23:38):
Okay, so well, speaking of, let's talk about you growing up. You grew up in Colorado though, right?

Dr. Chao (23:45):
I did. So I grew up in Colorado, surrounded by the mountains, a lot of outdoor culture. Pretty much every friend, neighbor person I knew either ran skied, mountain bike, hiked, all of that. So it's just a whole outdoor lifestyle and culture. And I don't think I really fully appreciated it when I was growing up there until I moved away. And so I feel like that all is instilled in my love for wellness and balance and a healthy lifestyle. And San Diego's pretty similar in that way, but definitely influences how I approach my life and my work.

Dr. G (24:19):
And now pot's legal in both places. There we go.

Dr. Chao (24:22):
It's like I never moved.

Dr. G (24:26):
I feel like it's not really relevant for us as medical people in terms of the legality of pot.

Dr. Chao (24:33):
We're not using it.

Dr. G (24:34):
No. So we need to stay, I kind of need my mental faculties. However, I do think it impacts us in that we have to ask our patients. It's a more serious question, are you smoking marijuana, because people are evasive sometimes.

Dr. Chao (24:48):
Right, you ask, are you smoking? And they assume nicotine and say no. But then there's this huge population of people that's like, oh, but marijuana, that doesn't count. No, it does. It can affect, it can affect wound healing. We were actually doing some studies on whether or not it increased bleeding after tonsillectomies. I had an attending that swore that she said the worst bleed of her life came from someone who was a marijuana smoker and wasn't smoking post op, but she was like, I swear that was the reason why I like blood thinner. So anyway, interesting.

Dr. G (25:21):
Yeah. So yeah, we have to be wary of the California sober here in our population.

Dr. Chao (25:26):
California sober. Love that.

Dr. G (25:29):
Coming from an outdoor kind of environment and then coming here is a good match. I don't know. I don't know any different either. I love being outside and I have to live near the water, which would be my kind of take on things. Well, let's circle back to, we're going to talk a little, can we go back to rhinoplasty and pop culture?

Dr. Chao (25:56):
Yeah, let's do it.

Dr. G (25:58):
Okay. So my kids actually asked me to talk about this, and you're so careful about not wanting to insult anybody, but I might not be as careful. But anyway, let's talk about Nessa Barrett and the TikTok influencer and her nose as an example of maybe what not to aspire to or what to aspire to. She has that scooped up nose, that scooped up, scooped out nose.

Dr. Chao (26:29):
That ski slope.

Dr. G (26:32):
Yeah, that's really extreme. I don't know if I can pop it up so we can look at it at the same time.

Dr. Chao (26:40):
Yeah. So you mentioned that your daughters were interested in this, and so I admittedly looked into it. I didn't know who Nessa Barrett was, but it sounds like this might be her second rhinoplasty. I'm not sure. It might be revision, but I think it was done somewhat recently. Again, this is all just based on what I was able to find online, but definitely a really small kind of that Barbie button nose that we were talking about, really sloped. I think the things that I was thinking about when I looked at it is I'm hoping first of all, that it's not so narrow that she's having any obstruction, that she's still able to breathe. And then the other key point that I was thinking about was swelling for her. So it sounds like this is somewhat of a new rhinoplasty maybe just a few months ago.

(27:28):
And if that's the case, it takes the rhinoplasty a full year sometimes for all of the swelling to come down and for the final shape of the nose to take place. And so if a rhinoplasty looks really good, exactly how you want it to look, as soon as the cast comes off, sometimes that's a bad sign because the soft tissue is going to continue to shrink down and it could look overly pinched or overly small once that final shape kind of does take place. Having some structural instability or pinched nostrils are kind of the worrisome issues that I'm thinking about. But

Dr. G (28:04):
I mean, let's just start with, I thought there wasn't anything wrong with her nose to start. I don't know. I just feel like her nose doesn't have any, I don't know, looking at her pre rhinoplasty, what

Dr. Chao (28:22):
What are we fixing here?

Dr. G (28:23):
really changed there. The other thing is that there has been some discussion that she possibly had a lip lift. And when I was looking into that, a lot of people who are maybe accused of having, accused is a harsh word, whatever anyway, have been rumored to have had a lip lift, might perhaps just have a lot of upper lip filler. You have to take a look at what that length is between the top of their lip and the bottom of their nose. But it is, I feel like she might have had one, which, how do you feel about people who, I feel like lip lift is traditionally thought of as something, maybe you do it with a facelift, it's an aging, your upper lip gets longer, mine's pretty long, upper lip gets longer as you age for lots of reasons, bony absorption underneath, gravity, all those things. And so sometimes you can do facial rejuvenation, but again, if you don't pay attention to around the mouth area, it can be discordant. I feel like Demi Moore is an example of discordant there, but anyway, for different reasons. But what do you think about people who are 20 and just say, I want to lip lift. How would you address that?

Dr. Chao (29:44):
I think it's appropriate in cases where they have facial proportions that are off, that are genetically off, if they have a long upper lip to begin with. So they talk about the vertical thirds of the face. The distance between the bottom of your nose to the bottom of your chin should be the same as between your eyebrows to the bottom of your nose should be the same as your hairline to your glabella between your eyebrows. And then your upper lip should be a third of the length of that distance between the bottom of your nose to the bottom of your chin. So if it's significantly longer, I think that that's appropriate even in a 20-year-old. And if it's something that they've really considered and thought about the downsides and they're a good healer and they don't have too dark of a skin type, all of those factors. But in general, I would say wait, because your face is going to continue to change and age and you can't take it back. It's not like lip filler. You can't just go dissolve it.

Dr. G (30:48):
I read an interesting article where somebody talked about their journey of having a lit lift and is interesting because she was young in her twenties. She was tired of doing filler. She didn't really like that look, so she kind of wanted that upturned more prominent upper lip, but wanted to do it via lip lift, which I think she was a reasonable candidate for. And so like you mentioned, there are certain dimensions that you have to take into account, and also you need a minimum distance. So generally there's a distance that you need to preserve. So if your lip is already a little on the shorter side, you're only going to remove two or three millimeters as opposed to five millimeters or 10 millimeters in length. So what I thought was interesting, she looks amazing afterwards, she journeyed, her whole thing was that her biggest complaint was that she wished that the surgeon had taken more.

Dr. Chao (31:48):
Interesting.

Dr. G (31:48):
And she acknowledges that she thought it would be a more dramatic result. And he mentioned that that is probably his most common takeaway, but that you can always, after some time go and take one or two more millimeters, but you cannot put it back.

Dr. Chao (32:11):
You can't put it back. Totally.

Dr. G (32:13):
She understands the logic of what he's saying, but she still, that was her only regret. And I was like, that's, but she's not going back to take more. And I think if you revisited her, it was for Women's magazine, in five years, she probably would say she's good where she is. You know what I mean? She didn't need to take more. And I feel like if you had made it too dramatic, then everyone's like, what did you do to your face? And again, you can't take it back. You're now stuck with that. And that would've been your complaint afterwards is that he took too much. Right.

Dr. Chao (32:49):
Yeah. The other thing that's interesting, I think, and really in partnership with lip lifting is the veneer trend. I feel like people are getting veneers more and more, and they're getting it. They want dental show when they're talking or just in rest position. And you can make the veneers longer to get that dental show, or you can kind of combine it with a lip lift. And so I think there's a lot of dentists out there who were thinking about this too. And I'm glad there's a lot of cross multidisciplinary discussion going on about this.

Dr. G (33:25):
Right, this shouldn't occur in a vacuum. So we're meeting with one of the dentists on our floor who does a lot of vene to have that conversation. Cuz it's nice if they can say, Hey, I can do this. But it's kind of like a bandaid, and it's better if you can do a combination, adjust it from a combination of things. And I feel like if we're looking for an example of maybe when it was overdone, it would be Demi Moore. She's had her facelift revised, I believe. But there are some pictures circulating from maybe a year or two ago, and she has an unnatural appearance where her upper lip just seems really pulled up and short. I feel like that has been the latest kind of thing making the rounds is that or too much filler or filler overdone. Whereas for a minute it was all the eyelids. It was a lot of botched eyelid surgery. I feel like when Madonna showed up with a patch over her, do you remember she was at,

Dr. Chao (34:24):
I don't actually.

Dr. G (34:24):
VMAs? It was like five years ago. She showed up for some VMA or event where she was performing and she had this whole pirate vibe.

Dr. Chao (34:37):
Oh my gosh.

Dr. G (34:38):
And I thought, that's an interesting choice. And then one of my friends was a hundred percent, she has an ectropion or something up behind that. And I was like

Dr. Chao (34:46):
Oh my gosh,

Dr. G (34:47):
Oh probably.

Dr. Chao (34:49):
Had another lower bleph, had some chemosis she hiding under there.

Dr. G (34:53):
Yes. And I was like, oh, that's brilliant. I'm going to remember that. Just wear a patch. Like what? I mean, I think for the upper lip, if you needed to, you could wear, the nice part about that is you could wear a mask because these days you could just say, I have a cold, and no one thinks twice about it.

Dr. Chao (35:09):
Totally. And once it's healed, you can put a concealer there and lots of good makeup tricks.

Dr. G (35:14):
And then one more kind of easy peasy, not easy peasy, but easy facial modification that is trending in celebrity culture is the buccal fat pad removal. And I feel like you recently did one in our office.

Dr. Chao (35:32):
I did two last week actually.

Dr. G (35:34):
In male too, which again.

Dr. Chao (35:40):
Yeah, I think they were both great candidates, kind of had that rounder, fuller face. I think a lot of Asian patients actually have that facial structure where it's very round, so it can look really good in Asian populations. I think Chrissy Tegan kind of had that nice round, perfect face for buckle fat, and I think she looks great afterwards. But the one thing I would be careful of nowadays is with everyone taking Ozempic and Mounjaro, you're going to lose a lot of facial fat from that. And so yeah, just balancing out, taking out too much fat and you don't want to look gaunt, so it's got to be the right patient.

Dr. G (36:21):
Or do you?

Dr. Chao (36:23):
Yeah, I mean, maybe that's the look you want.

Dr. G (36:24):
If you're working the catwalk or something. Maybe. But I do think if you're going to look gaunt and you're 25, we know that's not going to age well over time.

Dr. Chao (36:35):
But yeah, I mean, in talking about very little downtime, I mean that procedure you do in the office, it's like 30 minutes under local anesthesia and you kind of just can go to work the next day. I think that's what both my patients did. There's very little like aftercare. You kind of drink some smoothies for a day or two and have soft foods, but otherwise the incisions are all inside of your mouth. You don't have any incisions on the outside that you have to cover up or worry about people seeing. It's a great procedure for the right candidates, obviously.

Dr. G (37:11):
Yeah, I think so. Okay. Well, so we've talked about what's all the buzz now. What do you see coming on the horizon for aesthetic medicine? What are you excited about?

Dr. Chao (37:24):
So there's a lot of advancements right now in regenerative medicine making healing faster and easier. We're kind of moving into this period in healthcare overall where there's this greater focus on wellness and longevity and then extending the healthy years of your life rather than just the number of years. So this is, we're kind of diet, exercise, wellness, supplements, and beauty all kind of come together. So I'm really thinking that the work being done in this space is fascinating. I'm excited to see what comes up. And I think you and I can probably expect to live into our hundreds. That's the way that things are going now.

Dr. G (38:05):
Yeah, I do. I agree with that. And I think your point of you want to live longer, but you also want to be healthy longer. So there's no reason to live to 103 if from 80 on you're in a bed. Right?

Dr. Chao (38:21):
Right. Exactly. So making sure you can do all of the activities that make you and that make your life exciting and make you happy.

Dr. G (38:29):
Yeah, I think so. I think regenerative medicine is going to take the lead, and we're already integrating some of that into our practice now. We do nano fat, PRP,

Dr. Chao (38:42):
Growth factor serums,

Dr. G (38:44):
Stem cell growth factors in our skincare. And all of that is definitely, you can see some nice results from that. And like I said, I'd rather have the stem cells of a 20-year-old rubbed on my face than my own aging. It makes sense to harvest some of that. So yeah, I think that's exciting to see how we're going to keep moving the needle in that direction. Where can we find more information about you, Dr. Chao?

Dr. Chao (39:16):
So you can visit the Restore SD Plastic Surgery website. On there, we have a lot of information about our practice in general, the types of procedures that we offer, our approach to patient care, we have some videos, you can set up a consultation, you can sign up for our newsletter. We've got some blogs, so just an overall great kind of hub to learn about the practice and about me as a provider. You can follow me on Instagram at Dr. J Chao for any updates. I try to post lots of stories, behind the scenes content, some befores and afters, tips for facial aesthetics, that kind of thing. You can also follow us at Restore SD Plastic Surgery as well. And then we have reviews on our website and on our Google page. Yeah. Oh, and our YouTube channel. YouTube channel as well, obviously.

Dr. G (40:08):
That's right. Yeah, like this podcast. So if you are listening today and you have questions, you need information about scheduling, financing, reviews, or photos, check the show notes for links. Thanks so much for spending time with me today.

Dr. Chao (40:24):
I loved it. Thanks for having me. We miss you Bri, but hopefully I filled in okay for you.

Dr. G (40:29):
Yeah, she'll be back next week. If you're listening today and have questions, need info about scheduling, financing, reviews, or photos, check out the show notes for links. Restore SD Plastic Surgery is located in La Jolla, California. To learn more about us, go to restoresdplasticsurgery.com or follow us on Instagram @restoreSDplasticsurgery. If you enjoyed this episode, please share it and subscribe to All the B's on YouTube, Apple Podcasts, Spotify, or wherever you like to listen to podcasts.