Jackie (00:00): I'm Jackie. Dr. Chang (00:02): Good to see you, Jackie. I'm Dr. Chang. So what are we going to talk about today? Jackie (00:07): I wanted to talk about regrets. And I wanted to know, have you ever had anything done that you regret having done? Dr. Chang (00:16): Why do I got to be the one to open up about this? So regret's a super important part of what we do, I guess, because everything we do is elective. You choose to do something, so you don't want to have regret, but of course not everything is perfect. I don't regret, but I don't do PRP anymore, at least right now for my hair. So PRP is called platelet-rich plasma. The way we do it is we draw blood, we spin it through a special centrifugion device that purifies the platelet-rich plasma, the growth factors, the stem cells. And we use that purified fraction to supercharge the skin and tissues. And particularly we use that in the hospital in joints and healing in orthopedics. (01:08): And in plastic surgery, in cosmetic medicine, we can use it in skin and in the face. And typically in hair restoration, we use it in areas of balding or thinning. And so I tell patients, this is a lot like fertilizer for the soil. And when you use those supercharged growth factors, they're from your own body. They're very natural. It's not pharmaceutical. So it's very safe, but it is a procedure. It is a little expensive and a little painful. So because of that, I don't do it that much to myself that much because I'm a little bit of a baby. It means that I got to lay down and let somebody from the office stab me in the head. Jackie (01:55): That's what I was going to ask. Okay. So you don't do it to yourself? Dr. Chang (01:59): No. Jackie (02:00): Nor have you. Dr. Chang (02:02): Oh no, no. I don't do it to myself. I wouldn't trust that I would be able to do it evenly. There's a certain amount of pressure that you have to be able to apply because it's a tight space. Your scalp can expand. And in areas where your hair is thin or at the top of your head, you don't see it very well. So even if you're trying to find a bald spot or try to see it, it's hard to see it. (02:26): I do think it's a great treatment. I do think if your provider gives you good pain control and you're not a baby like me, it's pretty good. And for our patients, we do a whole bunch of things. We do some cooling sprays to cool the skin. We use a special vibration device to reduce the prick. And we use a local numbing medicine to sort of make sure that it's least amount of pain is possible. We also have some nitrous oxide that you can breathe to take the edge off. So I think for patients it's quite comfortable, but when I'm the patient, I think that sometimes it's a little bit of an ordeal for me. And also I need to have a little bit of downtime. So I wouldn't say I regret it. I definitely like it, but I think that it is something I don't do much anymore. Jackie (03:13): How many times have you done it? Dr. Chang (03:15): Like two or three times. Like two or three times. I do a lot of the other stuff for hair. I do some supplements, Neutrofil. I do the Finasteride and Minoxidil. I do have a laser cap. So I'm doing these other things. I'm throwing the kitchen sink, I'm just not also throwing the faucet, you know what the hair loss thing? The other thing is that at the time that I was doing it, I had a nurse injector in the practice named Stacy who was wonderful and she's a great injector, but she was not so good at doing the numbing block that I teach everybody to do. And so I just haven't gotten up the courage to have them do it for me yet, which maybe I will. But as I said, if I give the office crew a little opportunity to stab me, they might get a little carried away. Jackie (04:02): That's true. Dr. Chang (04:03): I'll have to be in their good graces. Jackie (04:05): I know we just got the SkinPen and we were trying it out for hair loss and on the head and Dr. Jenny was just trying it on me. So I felt the feeling of a few stabs to the head. And I can't imagine PRP. I was like, wow, these people are so strong. Dr. Chang (04:23): That's interesting because ... So the SkinPen is this microneedling device. It kind of vibrates and oscillates to make small little pokes. The interesting part is that it's got to go deeper because your hair takes up some space. So it's hard to get in down to the skin and the scalp. So I've done it for patients as well. I personally like doing the manual injection with a syringe, but it is quite popular in med spas and other hair places to use that skin pen. But it's no joke. You got to be numbed up pretty good. I want everybody to be comfortable. Even when I was a resident, when I'd numb up, let's say a finger laceration, I would numb that thing. Totally. I want extra numbing because I don't want somebody to say, oh, I can still feel that. Jackie (05:08): Yeah, that makes sense. Well, I wanted to talk about regret because I don't know if you saw Jessi from Mormon Wives. Dr. Chang (05:16): I've heard, but I don't know anything about the Mormon Wives. So we're going to have to rewind a little bit. Jackie (05:21): Yes. They're Mormons from Utah. They're all mothers and they all got together to make these TikToks together. So these girls are sharing everything online. So they're sharing all their procedures. I think in season one, one of the girls got a labioplasty and all the other girls are there and she's like, "Do you want to see?" And you're just like, "Whoa, this is crazy." Dr. Chang (05:48): Oh my God. Jackie (05:49): Yeah. Yeah. So this girl, Jessi, I think she's already had a rhinoplasty. I thought she had already had a bluff, but perhaps she had a lower bluff. But basically she's really in the news now because she just had another procedure and everyone's like girl again. And she also- Dr. Chang (06:09): How old is she? She looks young. Jackie (06:11): I think she's got to be like 32 is my guess. Jessi (06:17): All right. Let's get ready and talk about the surgery I just got. I feel like I have to preface every single video I post late. All right, let's get ready. Jackie (06:24): Yeah. So she posted like a month ago her completely bandaged up, like full face wrap, swollen and everyone's like, "What did she get done?" So then she- Sort of like Dr. Chang (06:37): A teaser. Jackie (06:38): Yeah, exactly, exactly. And everyone's like, "Why are you touching your face?" So then she finally unveils her face and she got an upper bluff, fat grafting, CO2 laser, but after the fat grafting, she's swollen, but also more puffed up from the fat grafting and she's getting a lot of backlash. And she recently was like, "I don't like the way I look. I want my old face back, but I'm in the healing stage." And they kind of took that headline, "I don't like my face. I want my old face back." And they're running with that as a headline. So it's like, does she have regret or is she just trying to say that to please her followers? Dr. Chang (07:31): I saw something, maybe it was a clip that you guys sent me or somebody sent me that she said, "Well, like what you just said, I don't like my face right now, but it's in the process and I'm working." She also said, "I'm working on her. I'm talking to my therapist or something like that, right? Jackie (07:46): Yes, yes. Yeah. Dr. Chang (07:48): So it's so much to get into. She's just kind of doing a lot at a young age. She's vulnerable, but exposing herself on social media to essentially the opinion of strangers. Jackie (08:04): Yes. Dr. Chang (08:06): It's kind of wild to be so open and vulnerable, I think, huh? Jackie (08:13): Yeah. Well, what would you do if she was one of your patients? And she hears some feedback from friends and family after getting something done and she's getting negative reviews and then comes in and is like, This is not the face I wanted. Dr. Chang (08:30): Well, there's a couple layers to that. I saw that she either talked about the doctor, I think his name was Dr. Ward, but I don't know him, but she talked about the doctor in one clip and I sort of think it's a mixed bag. When you work with somebody who's an influencer or somebody who's giving you this shout out, you think, oh, well, it's going to be great, but there's so many haters. I'm sure there are people saying, "Oh, the doctors did a botch job, or you should sue the doctor," all this stuff. Jackie (09:04): There are comments saying that, yeah. Dr. Chang (09:06): Or like, "Oh, I would never go to the guy." And then they kind of dig up stuff from this doctor's past that is totally not necessary to do, just to try to prove that their point online that they're right and they did their research. And why did you see that this doctor, I don't know, had a complaint against him. So I think that this is this tough side of social media, exposing yourself in such a way is that you're going to get opinions from all the people, all the trolls, all the haters. Jackie (09:39): Yeah. Dr. Chang (09:39): It's much harder to get love. Jackie (09:41): Definitely. And I also think she is still so early post-op. So to be posting your face every single day, it does change week to week. She probably is still healing. So it's like, give this girl a break. But I think obviously the general population does not understand the healing process. And so I think it's also pushing this poor girl to be like, "Oh my God, I made a huge mistake." Dr. Chang (10:11): Yeah. I wonder how much of this is her actually feeling bad about it or- Jackie (10:18): That's a good point. Yeah. Dr. Chang (10:19): Does she just love the engagement? I mean, she's getting a lot of engagement. Jackie (10:23): A lot of engagement and the new season's coming out soon. Dr. Chang (10:28): I mean, maybe she's just an evil genius. Maybe she just- Jackie (10:30): I think a lot of these girls are evil geniuses. I mean, look how much money they're making. Dr. Chang (10:34): The beauty industry is so pervasive in a community like Salt Lake City. I often think of the people and the women, men and women being so beautiful out there, but they do so much. Jackie (10:47): They do so much. Dr. Chang (10:47): A lot of aesthetic procedures, hair, makeup, whatever they're doing, fitness, nutrition, plastic surgery. They do all this stuff to maintain this beauty standard and it's not easy. Jackie (11:04): Right. Well- Dr. Chang (11:04): They're putting in the work. Jackie (11:06): Yeah. And also more Mormon lore, but Jessi was best friends with this girl, Demi. And it seems like with all these procedures they're getting, they're all kind of morphing into one. All their faces are starting to kind of look alike. Dr. Chang (11:24): Oh, no. Jackie (11:26): Yeah. Yeah. Dr. Chang (11:28): So that drives me crazy because that scares other people. You know what I mean? Jackie (11:33): Yeah. Dr. Chang (11:34): It drives me crazy because I often tell patients or their significant others who are with them, I think those bad results or those results where they all start to look the same or just people call bubble face or puffy pillow face and stuff like that. It's when people start doing too much of the same thing. So if you keep injecting your lips once, okay, great, twice or once every couple of years or whatever, but if you keep doing it over and over and over and over again, you start losing the baseline of what is normal and you start getting into extreme because you're trying to find a little difference with each treatment. Jackie (12:11): Yes. Dr. Chang (12:12): So at some point, the differences are starting to get distortions. You need a doctor or an injector or a provider that just says to you, "Okay, this getting a little out of hand, you don't need to do all that. It's not looking natural anymore." And maybe that's your goal. Maybe your goal is to have big fake lips or big fake boobs or whatever, big upturn Barbie nose, you just have to be honest with what you're looking for. But the distortion is a real problem, and especially if you're jumping around from provider to provider, that's a real problem. Jackie (12:46): Yeah. That's a good point. And that's why I'm so eager to see her results play out because is it just swelling or is it, like you said, she just keeps repeating the same treatments and now it's just like- Dr. Chang (13:00): Distorting. Jackie (13:00): Distorted, too over done. Dr. Chang (13:03): Yeah. And the other flip side of that is patients are getting things that are a little too extreme or too much too early. A young person that doesn't really need to have an eyelid lift, yeah, you can find skin to take off on somebody, but is it going to make a significant difference where you can appreciate how much better they look or is they going to look exactly the same? You just cut off skin, gave them scars and now their eyelid is tighter and it looks a little more bizarre actually. There aren't very many 30 year olds who need an upper bluff. It's just not that common. It happens. Not a lot. Jackie (13:46): Interesting. Dr. Chang (13:47): So I think people have to be very discerning, find the right level of someone who's cautious and has good judgment is to sort of like, "Okay, this is reasonable or not just because we can do it doesn't mean we should do it. " Jackie (14:06): Right. Yeah, exactly. And someone who's filming themselves all day, every day, the public's going to pick apart any little differences that they're noticing. Dr. Chang (14:18): Yeah. I definitely think that you have to be very strong to be exposed on social media. You really have to know, be sure of yourself, be confident in the decisions you've made and understand how absorbing or ignoring hater comments, because it's like a mob mentality out there. Jackie (14:40): Yeah. Dr. Chang (14:41): You get one person saying something, then somebody else says, "Oh yes, I agree." And then it becomes gang up on you. Jackie (14:47): That's definitely what I've seen in the comments for this Jessi girl. It's like one person's like, "Well, you didn't need to get that done." And then it's like, "Well, your face is puffy." And then now everyone's like, "You look like a monster." Dr. Chang (15:00): TikTok isn't really as I'm the expert as Reddit, but I see some of that on Reddit, people will post a result and say, "Oh, is this a bad result or did I get botched or is something wrong?" And then people will just respond with this level of confidence and expertise and you're like, "Who is user five, four, three, two, one?" Jackie (15:24): Is it just someone just sitting at home, hiding behind their keyboard, zero medical background? Dr. Chang (15:31): I think they're ballsy. I mean, really to say stuff that some people say, you're like, "Wow, that's a lot to say for being essentially someone who monitors plastic surgery forums or Twitter accounts and stuff and becomes an expert from social media, essentially." Jackie (15:48): Yeah. Dr. Chang (15:50): But I think that people should just be a little kinder to each other, let them just do their thing and see how it all plays out. Absolutely. And then you say, if it looks bad- Little heel. And you just be like, as long as she's happy with it, you don't got to beat her up. I mean- Jackie (16:07): Yeah. Yeah. I think it'll definitely be interesting to follow her journey and see if she finally comes out and says, "I shouldn't have done it. " But then you turn into, then do you get another procedure? Dr. Chang (16:19): Well, what's her personality like on the show? Is she crazy? Is she pretty vanilla? Like what's her persona as a character? Jackie (16:28): Yeah, she was not super crazy, but then her and that girl, Demi, that she's literally morphing into now that they look identical. They got into this big fight. And so she kind of became way more popular in the last season. So then that's why it was kind of interesting. It's like- Dr. Chang (16:46): Because of the drama of the fight, they basically focused on her in the- Jackie (16:49): Yeah. So then I'm like, I wonder if, because she's getting more screen time, is that why she felt so inclined to get another surgery? That's my thought. Also, there were cheating rumors, divorce rumors. So is it because she's unhappy there? Lots of layers to it. Dr. Chang (17:06): Right. Oh. Jackie (17:07): Right. And- Dr. Chang (17:09): I better not be caught watching this show. Jackie (17:10): This is a very important thing. The girl that she's face morphing into was also involved with the same cheating scandal, same guy. So everyone's like, "Are you trying to look like her?" Dr. Chang (17:24): Wait, the Demi girl and- Jackie (17:27): Jessi. Dr. Chang (17:27): Jessi, they're both involved with the same guy, romantically involved with the same guy? Jackie (17:32): Allegedly. Dr. Chang (17:34): Are they both married? Jackie (17:35): They're both married to not this guy. Dr. Chang (17:38): Ooh. Jackie (17:38): Oh yeah. Dr. Chang (17:38): This is crazy. Jackie (17:39): I know. You got to watch. Dr. Chang (17:40): Is this a real show? Jackie (17:41): Yeah, you got to watch. Dr. Chang (17:42): Are they just contrived? Jackie (17:43): It's so crazy. It's so crazy. And you always remember, there's a few that occasionally drink, but majority of them are sober and you're like, these people are having this crazy drama, crazy fights, dead sober. And it's the best entertainment. Dr. Chang (17:57): Got nobody to blame. You can't blame, oh, I was drunk. Jackie (18:01): Yeah. Dr. Chang (18:02): Wow. That's crazy. Jackie (18:04): Another thing I noticed on the show, they all get Botox and filler, which fine, but they all get nitrous when they get Botox. And I'm like, "Is this just a gateway for you guys to dip your toes into- Dr. Chang (18:19): Because they want to get high a little bit. Jackie (18:20): Right. Yeah. Dr. Chang (18:21): Just feel a little loose. Jackie (18:22): I don't know. I was like, I've never seen nitrous for a Botox treatment." Dr. Chang (18:27): That's crazy. Jackie (18:27): Personally, yeah. Dr. Chang (18:29): Did they make a big deal out of that? Was that a thing? Jackie (18:32): It was like a talking point on the show. Yeah. Dr. Chang (18:35): Yeah, that's very- Jackie (18:35): Yeah, we're getting our nitrous for our Botox. Dr. Chang (18:37): Very abnormal. Jackie (18:37): I was like what? Dr. Chang (18:39): Well, that's really interesting. Growing up in the Maryland area, we had a lot of, actually a lot of Mormon families and some of the biggest families in the DC metro area are very successful Mormon Mormon families. The Marriott Corporation is a Mormon family. And I know another plastic surgeon whose son I went through the residency interview things with and everything like that. And they have their roots out in Salt Lake City too. So it's really interesting to hear within that group of the community of people, all the different cultural things. Jackie (19:18): Oh yeah. I'm sure they can't be like the Mormon church probably isn't super happy with. Dr. Chang (19:23): Yeah. Right, right. Jackie (19:25): But yeah, it's just interesting because they're really normalizing plastic surgery and doing whatever makes you feel happy, which is awesome. But yeah, just the little things you pick up on. I was like, Botox nitrous? What? Dr. Chang (19:41): Yeah. Yeah. Well, exactly. I'm sure other people probably don't pick up on that, but you know that's a little bit unusual. Jackie (19:49): Yeah, this is not the norm. Dr. Chang (19:49): It's kind of like really getting a little extra treatment there. Jackie (19:54): Yeah, exactly. Dr. Chang (19:56): So, all right. Well, maybe you guys will have to feed me some good stuff from there because I don't know if I can get involved in this show. Jackie (20:02): I will. Dr. Chang (20:02): The show is kind of intense. Jackie (20:04): It is. We'll follow her face journey here. Dr. Chang (20:07): Yeah. I think it'll be interesting to see how she reports she's feeling and her eyes look really wide open. She has pretty high brows, but she also has them kind of threaded and arched and I don't know, what do you guys color them a little bit? Jackie (20:26): Like a tint. Dr. Chang (20:27): Tinting. Yeah. Jackie (20:28): Lift and tint. Dr. Chang (20:28): There's a lot going on in her pictures and her selfies and stuff like that. You know what I mean? So it's hard to totally see that, but- Jackie (20:36): Right. And then you always have to assume there's some sort of filter on. Dr. Chang (20:41): Right. There's some filtering. It's tighter now because she just had the procedure, right? It was within the last month, right? Jackie (20:48): Yeah. I think it's like month and a half tops. Yeah. Dr. Chang (20:51): Yeah. Yeah. It takes time and everything settles a little bit and becomes more natural looking too. Jackie (20:56): So I feel like there is a moment or a thought that passes through everyone's head after having a procedure or something done. You do look different than what you're used to seeing in the mirror. So how would you describe the difference between that fleeting thought and what Jessi from Mormon Wives might be experiencing full regret? Dr. Chang (21:20): Yeah. I think that there is the physical part of recovery and then there's the emotional and psychological part of recovery. In some types of surgery, for instance, facial surgery, I think the emotional and psychological aspect is a lot more significant than in body and breast surgery. Patients that have had like a big facial procedure or lasering or eyelids done and your face is swollen and red or bruised, it's natural to look at yourself during the recovery process and say, "Oh my God, what did I do? " And you've had a lot of things going on. You've had medications, the adrenaline has left your system and you kind of have these big sort of endorphin rushes and then lows and you kind of say, "Oh my God, am I going to be okay? Did I make a huge mistake?" So regret is a normal part of the process. (22:17): We often say there's a rollercoaster of emotions and sometimes there are days when you may feel like, "Wow, that looks so good. I'm so happy I did this. " And some patients are also just up there. They just uppers and they're Jackie (22:29): Yes. Dr. Chang (22:29): Great. Oh, finally we've got it done and I'm so happy and they're all the way." But the common path is a little bit of a rollercoaster, which has big swings at the beginning and then settles down at the end. And I think that particularly for face, I often tell my patients the emotional and psychological recovery is something you should be prepared for. Sometimes those feelings will creep in, call me, let me know how you're feeling. I will pick you up as best I can and I just want to tell you, if you're expecting it, it won't be as scary. Jackie (23:00): Yeah. Yeah. I think that's huge to set that expectation. Dr. Chang (23:05): Right. So that's what we try to do. That's what I think really helps people get through these things. And then in the end, people of course are really happy and have a great experience and they don't even remember those low points, but I think that if you go into surgery with a positive attitude and you recover faster, trying to be optimistic, those patients that have a really upbeat personality really outperform the ones that have a negative and an anxious outlook. And so we really try to pump patients up. We have a lot of cheerleaders in our practice and in the surgery side of things, and we really try to make sure that people have the right psychological preparation as well as physical preparation. Jackie (23:54): Yeah, that's huge. Dr. Chang (23:55): Yeah. Jackie (23:56): All right. Dr. Chang (23:57): Okay. Well, patients here, we got to go. Jackie (23:59): All right. Dr. Chang (24:01): But we'll see you next week. Thanks for listening to Secret Services, the podcast where we see everything and say nothing except right here. I'm Dr. Christopher Chang, double board certified plastic surgeon located in Tysons, Virginia. Follow us on TikTok @CongressionalPsurgery or on Instagram @congressionalplasticsurgery. To send us a classified message or to hear more episodes, go to secretservicespodcast.com. Links to everything we talked about on today's show are available in the show notes. Oops, patient's here. We got to go.