The landscape of facial aesthetics is constantly changing, a reality discussed in depth in Episode 7 “Live & Well” podcast. with Beverly Hills plastic and reconstructive surgeon Dr. Cat Chang.
Known for her ultra-natural facial rejuvenation work, Dr. Chang moves through sophisticated techniques behind modern facelifts and an evolving approach to scarring.
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Joined by host Melissa Magsaysay, the two examine the limitations of non-surgical treatments and the innovations on the horizon, from patient-specific fillers to tissue-based implants designed to create more natural, long-lasting results. Amidst this wider debate about how faces age and how technology continues to evolve, one area remains firmly top of mind. The subtle features they reveal change before anything else… your eyes.
The Lift, Explained: Why Your Eyes Look Tired and Corrective Surgery That Really Works
Certain areas of the face age quietly. The eyes don’t. Even when you have slept enough, drink enough water and put on the best concealer. Even then, the lid area can look tired. According to Dr. Chang, it’s less personal and more normal.
Before discussing the surgical technique, he grounds the discussion in the simple truth behind premature aging. “The area where most people start to notice aging is actually the eyes,” he says, explaining that the skin is thinner and gets a lot of sun exposure. This helps address a fairly common complaint…looking less tired than you actually feel.
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Upper Eyelift: The 20 minute recharge
The heaviness of the upper eyelid, the softening fold, the hood, the shadow, these are the first signs of aging. Dr. Chang breaks down the biology before the solution. “As we age, we also lose volume, even around our eyes, and then the skin becomes thinner. And the result of that is excess skin that tends to build up over the eyelid. It can make someone feel like they look sleepier than they are.”
How does he approach it?
The goal is physical rejuvenation… not a new face. “What we’re doing is removing excess skin,” he says, noting that the incision hides perfectly in the natural crease. “Even with your eyes closed, you don’t notice the incision because it’s a naturally dark area.”
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A surprisingly easy experience
He describes upper blepharoplasty as simple and quick. “It only takes me 20 minutes to do… very easy, minimal pain. I don’t even prescribe pain medication,” says Dr. Chang, also noting that it’s one of the “highest patient satisfaction procedures” she sees.
Lower Eylift: Correcting bags under the eyes at the source
Here, the anatomy tells the full story. Dr. Chang explains that under the eye are three thick pads “held on by a membrane,” she explains. “This membrane loosens over time and the fat swells.” What does this mean? Well, the result is a shelf of puffiness and shadow that skincare can’t fix. “That’s something that’s really hard to improve with makeup because it’s a contour thing … there’s nothing you can do without surgery if you really wanted to improve the real problem.”
Her preferred approach, she says, leaves no external scar because it involves an internal incision on the eyelids.
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Because it redeploys (not removes) fat
Dr. Chang uses fat transfer to maintain long-term fullness. “I take these thick pads and slide them into the groove so the contour looks smoother.” However, while fat removal may look good early on, it can often backfire. “If you remove the fat in that area, 10 years later, you’re going to feel like you look very hollow.” And it highlights what might need to happen. “[Fat transposition] it is technically more difficult than simply removing fat.”
Recovery: A Realist View
Lower blepharoplasty requires a little more care but not significantly more downtime, and Dr. Chang uses light sedation for lower procedures. “I recommend a light sedation…propofol based. Breathe on your own…no tube.” Surgical time? About 40 minutes, he says. And yes, anesthesia matters. “The type of anesthesia used affects recovery.”
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Because skin quality still matters
Even the perfect surgical technique cannot change the underlying biology of the skin. Dr. Chang says surgery won’t change the quality of your skin. That’s why she uses laser treatments and targeted eye serums that rebuild collagen and elasticity. “The better the quality of your skin, the better and longer the result will be.”
elifts are growing in popularity for a reason… they address the first, most visible signs of aging. As Dr. Chang explains throughout her conversation with Melissa Magsaysay, the eyes reveal change long before any other feature, and with newer techniques, the natural structure of the face can be respected.
Listen to the entire conversation here on the Live & Well Podcast
