FAQs on the most common products, devices, and surgical procedures in plastic sugery

This page provides a short description on the most common products, devices, and surgical procedures used in plastic surgery.  For further information, you can click onto the link in the section that will take you to their full descriptions if it is available

Face and Skin

Products and Treatments : What is...

Acne is the most common skin condition in the U.S. affecting nearly 50 million Americans at any time.  Acne is caused when hair follicles become clogged with oil and dead skin cells. It can often be persistent and unsightly,

Acne is can be treated by:

  1.  Benzoyl Peroxides – Works in three major ways. It kills germs, unblocks clogged pores and minimizes inflammation.
  2. Antibiotics – Oral antibiotics such minocycline and doxycycline are commonly used to kill bacteria.  Topical antibiotics such as clindamycin can used directly on the skin
  3. Retin A – Works by unblocking clogged pores and recycling healthy skin
  4. Forever Clear BBL – A cutting-edge acne treatment that uses the power of light to comfortably and effectively clear acne without expensive creams or toxic medicines.

BBL is the world’s most powerful IPL (Intense Pulsed Light) device on the market.

Each Forever Clear BBL treatment uses Blue Light BBL, Yellow Light BBL, and Infrared Light to painlessly:

  • Destroy acne-causing bacteria at its source, deep down in the pores.
  • Reduce the inflammation and acne-associated redness
  • Tighten inflamed skin

Many patients will see results with just one treatment with no downtime.

Brown sun and age spots are some of the first signs of aging and sun damage.

Treatment options include

  1. Creams such as hydroquinone and retin A.  Hydroquinone is a bleaching agent while Retin A increases cellular turnover.  Over-the-counter creams will generally not have high enough concentrations to be effective.

  2. Forever Young BBL – Cutting edge technology providing the most powerful and effective IPL option.  

The Forever Young BBL uses Broad Band Light to alter skin melanin and rejuvenate cellular DNA.  Instead of spending time and money on ineffective skin care products many of our patients have turned to the Forever Young BBL to make their skin more vibrant and youthful; reducing brown and red pigmentation problems, promoting collagen, and rejuvenating cellular DNA. It is the most popular laser treatment in our clinic.

What to expect from the Forever Young BBL:

  • Treatments take 20-30 minutes
  • Up to 80% improvement after a single treatment.
  • Most patients will benefit from adding a Micro Laser Peel and a Profractional Laser Peel ( Triple Laser Package )

Fine facial lines and wrinkles are a result of UV sun damage, the breakdown of collagen, and a decrease in skin hydration. The Micro Laser Peel and the Profractional Laser are ablative lasers designed to reverse these changes.

  • The Micro Laser Peel precisely ablates the surface skin in order to remove UV damaged skin
  • The Profractional Laser ablates deep columns of skin that can reach to the deep dermis. This allows for skin contraction but it also encourages new cell grown and organizes new collagen

Results depend on the depth of treatment. Recovery from a maintenance treatment can be as little as a day; but recovery from aggressive treatments can be as much as 7 days. Many patients will benefit from the addition of the Forever Young BBL ( Triple Laser Package ).

Scars are an inevitable part of tissue injury. Surface scars can be caused by surgical cuts or traumatic lacerations.
Scars should ideally heal as pencil thin white lines. However, this is not always the case. Depending on where the scar is located, how it is put back together, the surgical skill of the surgeon, and the diligence provided to the prescribed after-care of the cut, the scar can either heal well or heal poorly.

Strategy in revising scars:

  • Surgical scar revision can be applied to cut out the scar and start from scratch in more ideal conditions.
  • Laser scar revision can also be used to either primarily treat a raised or unsightly scar or used secondarily to improve the results of a surgical scar revision.

The Profractional Laser creates micro-columns of laser ablation to the scar. New collagen is regenerated and dermal cells are reorganized to provide a smoother, more uniform skin surface.

Unwanted fat bulges can be treated by either liposuction or one of the newer non-surgical devices such as Sculpsure or Coolsculpting. Liposuction is significantly more effective, but requires surgery and recovery time. The benefits of the non-surgical devices are that they can provide fat reduction of about 20% without surgery.

SculpSure is the world’s first FDA-cleared laser treatment for non-invasive lipolysis of the abdomen, flanks, back, inner thighs, outer thighs.

SculpSure is a technological improvement over the older Coolsculpting technology because it can selectively target fat while leaving the skin alone. The technology provides the following benefits over Coolsculpting.

  1. Less complications
  2. Result is much smoother
  3. Significantly less pain

What to expect from Sculpsure:

  • Treatments take 25 minutes
  • Most can see up to a 20% reduction
  • Minimal pain
  • Return to work the same day
  • Optimal results seen at about 3 months

Laser systems can be used to permanently treat visible vessels, broken capillaries, spider veins, and vascular lesions from your face and body. The ClearScan laser system by Sciton can quickly selectively target and remove the unwanted vessels.

Conditions that can be treated with the Clear Scan Laser include:

  • Rosacea
  • Redness
  • Facial Veins
  • Telangiectasia
  • Spider Veins
  • Broken Capillaries

What to expect from ClearScan vascular laser:

  • Each treatment area takes 30 minutes
  • Most patients can see up to a 80% reduction
  • Minimal pain and discomfort
  • Return to work the same day
  • Disrupted vessels are absorbed over 2-4 weeks

SkinTyte offers a fast, safe and effective method for tightening skin without surgery. SkinTyte uses advanced infrared light technology, and patient tailored filters to deeply heat dermal collagen while continuously protecting the treated epidermis with sapphire contact cooling. With no need for a topical anesthetic, the energy is delivered in rapid, gentle pulses to promote contraction and partial coagulation of the collagen, initiating the body’s natural healing process, leading to the appearance of firmer tissue.

SkinTyte factoids:

  • SkinTyte is a nonsurgical alternative to surgery
  • Can be used in the face as well as the body :
  • Used for lifting the jowls and neck
  • Used for arms, abdomen and thighs
  • Optimal benefits require 4 treatments 1 month apart
  • 80% satisfaction rates
  • Useful for all skin types
  • Return to work the same day

Botox Cosmetic is the single most popular cosmetic procedure performed in the United States.  It is used most commonly to treat wrinkles of the face caused by hyperdynamic muscles including the horizontal forehead wrinkles, the vertical wrinkles between the brows, and the crow’s feet wrinkles, but has many other uses including:

 

  • Reduce the  horizontal forehead lines
  • Reduce the vertical lines between the brows
  • Reduce the crow’s feet lines
  • Reduce the vertical lines above the lip
  • Lift the brow
  • Reduce the dimpling of the chin
  • Reduce the bunny lines on the nose
  • Decrease the banding of the neck
  • Decrease of the width and fullness of the jaw
  • Lift the corners of the lips ( a.k.a grumpy cat )
  • Reduce tension and migraine headaches
  • Reduce the horizontal line between the nose and upper lip
  • Treat TMJ pain
  • Reduce excessive underarm and palm sweating

Juvederm Ultra XC is the original hyaluronic acid injectable filler.  It is an extremely soft gel that is ideal for lip augmentation. Juvederm will last about 1 year after the treatment and potentially 2 years after the second treatment.  Because of the soft and forgiving nature of the filler, Juvederm can be used for any area of the face and is often the material used if a patient has never used a filler before.  

Juvederm Ultra factoids:

  • Lasts 9 months to a year
  • Favorite filler option for lip augmentation
  • Favorite filler for under-eye hollows
  • Favorite filler along with Voluma for nasolabial folds

Voluma is the second most commonly used hyaluronic acid filler.  It is a soft gel but not quite as soft as Juvederm Ultra. Voluma will last about 2 years.  Voluma is ideal for volume replacement where volume has the potential for lifting and sculpting tissue.  This is true in the cheeks, temples, and jowls. It is also my favorite material for the non-surgical nose job procedure:

Voluma Factoids:

  • Lasts 1.5-2 years
  • Favorite material for adding bulk for lifting and sculpting tissue
  • Favorite injection sites include the under-eye hollows, the cheek, the temples, the lip philtrum, and the chin.
  • Favorite material for the non-surgical nose job

Volbella is a newer injectable hyaluronic acid filler.  It is a soft injectable gel that is thin enough to help correct the lip lines.  We only use Volbella after using Juvederm to plump up the pink upper lip and Voluma to plump up the upper lip philtrum.  If there are still persistent lines, then Volbella is a great option.

Volbella factoids:

  • Lasts 9 months to a year
  • Favorite material for upper lip lines after adding lip volume with Juvederm and Voluma

Sculptra is an excellent injectable filler that is ideal for large surface areas.  Patients who have lost a lot of weight or who have a gaunt appearance are ideal candidates for using Sculptra.  Aside from using your own fat, Sculptra is the most cost effective filler provided that you are a good candidate.  

Sculptra is made from poly-L-lactic acid (or PLLA) which is a synthetic form of lactic acid.  Benefits of Sculptra include:

  • It is the longest lasting filler lasting 2-3 years
  • It comes in the highest volumes per syringe
  • Sculptra stimulates the body to produce your own collagen which provides even more volume.

Sculptra Strategy:

  • Strategy can include using sculptra for bulk and large surface areas plus Juvederm, Voluma, or Radiesse for isolated areas such as the under-eye hollows and lips

Restylane is a hyaluronic acid alternative to Juvederm XC.  It is an extremely soft gel that is ideal for lip augmentation.  Restylane is used interchangeably with Juvederm XC. It will last about 1 year after the treatment.  

Because of the soft and forgiving nature of the filler, Restylane can be used for any area of the face and is often the material used if a patient has never used a filler before.  

Restylane factoids:

  • Lasts 9 months to a year
  • Favorite filler option for lip augmentation
  • Favorite filler for under-eye hollows
  • Favorite filler along with Voluma for nasolabial folds

Fat transfer is a plastic surgery procedure to provide natural volume to areas of the face and body that have either lost volume or can cosmetically benefit from more volume.  The face, breast, hands, and buttock are the most commonly treated areas.

In the face, volume replacement with fat transfer can be more cost effective and natural than using commercial fillers like Juvederm or Voluma.   Common sites for replacement include:

  • the under-eye hollows
  • the lips, the cheek bones
  • the temples, and the
  • nasolabial folds

The fat is obtained by a special liposuction procedure, processed to obtain pure fat,  and then transferred in small syringes. Most patients will return to work in a week.

Fat Transfer facts:

  • Surgery time: 1-2  hours
  • Facility:  Office or the Surgery Center
  • Return to work:  1-2 weeks
  • Cosmetic goals – Provide cost effective and long lasting volume

The Triple Laser Peel is the single most popular and effective laser package available.  This is because the Triple Laser System directly targets the 3 most obvious features of skin aging including pigmentation changes ( sun and and age spots ), textural changes ( fine lines and wrinkles , large pores ) and deteriorating collagen ( skin sagging and fullness ).  The package includes the following laser systems:

  • The Profractional Laser
  • The Micro Laser Peel and
  • The Forever Young BBL

The benefits include:

  • Treat fine lines and wrinkles
  • Build collagen
  • Remove UV damage
  • Improve surface texture
  • Treat pigmentation problems
  • Provide anti-aging benefits to the cellular DNA.

Because all patients are different.  The Triple Laser Peel is customized to your needs and recovery time requirements.  A light version is designed for younger patients with less signs of aging and a pro- more aggressive version is available

Laser Hair Removal provides a permanent solution to dealing with unwanted hair.  The most popular areas to treat includes the legs, back, underarms, and upper lip.  The most effective and advanced laser system is the High Speed LightSheer DUET. It is the most advanced and effective laser system available today because:

  • Its larger hand piece allows the procedure the be performed much quicker than other lasers; this means less pain and less time in the office.  A typical let can be treated now in less than 30 minutes.
  • The suction-assisted technology pulls the skin into a chilled and better targeted handpiece.  This makes the the procedure relatively painless and yet more effective.

As with any hair removal device, multiple treatments are required in order to ablate the hair follicles in their growth cycles.  

The miraDry procedure is the most effective long-term treatment for the reduction of excessive underarm sweat and odor.  The procedure uses precisely controlled energy to eliminate underarm sweat glands. Because the sweat glands don’t grow back once they are  eliminated, the results are dramatic and lasting.

Other treatment options, including antiperspirants and toxins, aim to temporarily disable the sweat glands for various durations – requiring repeat treatments to maintain effectiveness.  Only the miraDry procedure gives you lasting results with a non-invasive solution. You are a candidate for miraDry if :

  • You have excessive sweating of the underarms
  • You go through several shirts a day because of underarm sweating
  • Antiperspirant doesn’t touch your underarm sweating.
  • You want a permanent solution to your underarm sweating for a reasonable price
  • You don’t want surgery to treat your underarm sweating

Unwanted fat bulges can be treated by either liposuction or one of the newer non-surgical devices such as Sculpsure or Coolsculpting.  Liposuction is significantly more effective, but requires surgery and recovery time. The benefits of the non-surgical devices are that they can provide fat reduction of about 20% without surgery.

SculpSure is the world’s first FDA-cleared laser treatment for non-invasive lipolysis of the abdomen, flanks, back, inner thighs, outer thighs.  

Sculpsure is a technological improvement over the older Coolsculpting technology because it can selectively target fat while leaving the skin alone.  The technology provides the following benefits over Coolsculpting.

  1. Less complications
  2. Result is much smoother
  3. Significantly less pain

What to expect from Sculpsure:

  • Treatments take 25 minutes
  • Most can see up to a 20% reduction
  • Minimal pain
  • Return to work the same day
  • Optimal results seen at about 3 months

CoolSculpting is a simple, non-surgical treatment to reduce the appearance of stubborn localized fat. A vacuum and chilled applicator are placed over the fat that needs to be reduced. The vacuum sucks fat into the applicator where it is subjected to freezing temperatures. The cold causes exclusively the fat cells – which are more sensitive to the cold than the surrounding cells – to die while leaving the surrounding tissue in place. 

Quictk Facts about Coolsculpting:

  • Patients can expect up to a 20% reduction in fat content in the areas that are treated.
  • Aesthetica has the most advanced Coolsculpting devices on the market… And we have 2 of them !
  • More devices means more speed 
  • The new devices have less complications, little to no pain, and no recovery time
  • Aesthetica now has coolsculpting for neck fat
  • Most patients can return to work immediately on the same day

Dr. Chang has recently been featured in New Beauty magazine and is listed as one of the “Top Doctors” in Virginia by Health and Beauty magazine. According to Allergan, the company which provides BOTOX® Cosmetic and Natrelle breast implants, Dr. Chang’s office provides more BOTOX® Cosmetic treatments and facial fillers such as JUVÉDERM® than any other single practitioner in Virginia.

Loudoun Now asked their readers to share their recommendations about their favorite places, people and businesses last June 2018. The response was enthusiastic. More than 5,000 names were submitted as nominations in the poll’s more than 200 categories. Dr. Phillip Chang was voted as one of the best plastic surgeons in Loudoun, Virginia.

Nose and Ears

Nose reshaping surgeries ( also known as rhinoplasty ) is are cosmetic surgery procedure that allows you to reshape your nose.  Depending on your individual needs, we can treat:

  • Noses that appear too large
  • Noses with humps
  • Noses that are crooked
  • Noses with bulbous or wide tips
  • Nostrils that are too large or wide
  • Noses that are deformed due to trauma or cancer

Surgical options include a closed rhinoplasty or an open rhinoplasty.  Both are mostly performed under general anesthesia at the surgery center.

Open rhinoplasty is used mostly for patients that need refinement of the nasal tip.   Most patients are out of work for about a week. Some patients may only need a non-surgical nose reshaping using injectable fillers.

The closed rhinoplasty technique is used mostly for patients that need to address a nasal hump or wide nasal bones.

Septoplasty is the surgical correction of defects and deformities of the nasal septum – a displacement of the bone and cartilage that divides your two nostrils. During septoplasty, your nasal septum is straightened and repositioned in the middle of your nose. It’s an outpatient procedure performed under general anesthesia.

An osteotomy is a surgical operation whereby a bone is cut to shorten or lengthen it or to change its alignment. It is sometimes performed to correct a hallux valgus, or to straighten a bone that has healed crookedly following a fracture.

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Body and Extremities

Hands can be rejuvenated. The hands age in predictable ways:

  • The skin, which is constantly exposed to the sun developes sun and age spots
  • The top of the hand begins to lose volume resulting in thin and wrinkled skin

Hand rejuvenation is directed at treating these two problems. Volume is replaced using injectable fillers such as juvederm, sculptra, or a fat transfer. The pigmentation changes are treated using the Forever Young BBL to remove the brown sun and age spots.

What to expect from hand rejuvenation:

  • Injectable fillers take 10 minutes
  • Fat transfer ( instead of filler ) takes 1 hour
  • Forever Young BBL takes less than 30 minutes
  • Return to work immediately

Brown sun and age spots are some of the first signs of aging and sun damage. Fortunately, these skin conditions can easily be treated using the Forever Young BBL which uses Broad Band Light to alter skin melanin and rejuvenate cellular DNA.

Instead of spending time and money on ineffective skin care products many of our patients have turned to the Forever Young BBL to make their skin more vibrant and youthful; reducing brown and red pigmentation problems, promoting collagen, and rejuvenating cellular DNA. It is the most popular laser treatment in our clinic.

What to expect from the Forever Young BBL:

  • Treatments take 20-30 minutes
  • Up to 80% improvement after a single treatment.
  • Most patients will benefit from adding a Micro Laser Peel and a Profractional Laser Peel ( Triple Laser Package )

 

Unwanted fat bulges can be treated by either liposuction or one of the newer non-surgical devices such as Sculpsure or Coolsculpting. Liposuction is significantly more effective, but requires surgery and recovery time. The benefits of the non-surgical devices are that they can provide fat reduction of about 20% without surgery.

SculpSure is the world’s first FDA-cleared laser treatment for non-invasive lipolysis of the abdomen, flanks, back, inner thighs, outer thighs.

SculpSure is a technological improvement over the older Coolsculpting technology because it can selectively target fat while leaving the skin alone. The technology provides the following benefits over Coolsculpting.

  1. Less complications
  2. Result is much smoother
  3. Significantly less pain

What to expect from Sculpsure:

  • Treatments take 25 minutes
  • Most can see up to a 20% reduction
  • Minimal pain
  • Return to work the same day
  • Optimal results seen at about 3 months
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Breasts

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Scars are an inevitable part of tissue injury. Surface scars can be caused by surgical cuts or traumatic lacerations.
Scars should ideally heal as pencil thin white lines. However, this is not always the case. Depending on where the scar is located, how it is put back together, the surgical skill of the surgeon, and the diligence provided to the prescribed after-care of the cut, the scar can either heal well or heal poorly.

Strategy in revising scars:

  • Surgical scar revision can be applied to cut out the scar and start from scratch in more ideal conditions.
  • Laser scar revision can also be used to either primarily treat a raised or unsightly scar or used secondarily to improve the results of a surgical scar revision.

The Profractional Laser creates micro-columns of laser ablation to the scar. New collagen is regenerated and dermal cells are reorganized to provide a smoother, more uniform skin surface.

Fine facial lines and wrinkles are a result of UV sun damage, the breakdown of collagen, and a decrease in skin hydration. The Micro Laser Peel and the Profractional Laser are ablative lasers designed to reverse these changes.

  • The Micro Laser Peel precisely ablates the surface skin in order to remove UV damaged skin
  • The Profractional Laser ablates deep columns of skin that can reach to the deep dermis. This allows for skin contraction but it also encourages new cell grown and organizes new collagen

Results depend on the depth of treatment. Recovery from a maintenance treatment can be as little as a day; but recovery from aggressive treatments can be as much as 7 days. Many patients will benefit from the addition of the Forever Young BBL ( Triple Laser Package ).

Vaginal Health

SkinTyte offers a fast, safe and effective method for tightening skin without surgery. SkinTyte uses advanced infrared light technology, and patient tailored filters to deeply heat dermal collagen while continuously protecting the treated epidermis with sapphire contact cooling. With no need for a topical anesthetic, the energy is delivered in rapid, gentle pulses to promote contraction and partial coagulation of the collagen, initiating the body’s natural healing process, leading to the appearance of firmer tissue.

SkinTyte factoids:

  • SkinTyte is a nonsurgical alternative to surgery
  • Can be used in the face as well as the body :
  • Used for lifting the jowls and neck
  • Used for arms, abdomen and thighs
  • Optimal benefits require 4 treatments 1 month apart
  • 80% satisfaction rates
  • Useful for all skin types
  • Return to work the same day

Stress urinary incontinence is the unintentional loss of urine resulting from some physical triggers such as coughing, sneezing, running, or heavy lifting. Up to 70 percent of women are affected after any vaginal deliveries. Treatment options including behavioral modifications, oral medications, kegel exercises and even surgery have often been unsuccessful and unnecessarily invasive.

The most promising treatment options appear to be the diVa Vaginal Rejuvenation Laser with or without the injection of PRP stem and growth factor injections which has a 90% success rate in our office.

diVa Vaginal Rejuvenation Protocol

  • 3 treatments 4 weeks apart
  • Each treatment takes less than 30 minutes
  • Minimal pain and discomfort
  • Return to work the next day
  • PRP stem and growth factor injections can be added at the same time for improved results

diVa Laser Vaginal therapy is a breakthrough technology that can effectively provide vaginal tightening without the need for surgery. The diVa uses Hybrid Fractional Laser Technology that is cleared by the FDA for the ablation and coagulation of soft vaginal tissue. The result is

  • an increase in the thickness and elasticity of the vaginal wall,
  • an increase in vaginal moisture
  • an increase in sexual satisfaction and
  • an incredible improvement in stress urinary incontinence

The diva Laser Vaginal treatment allows women to feel more like their younger, vital selves.

Key Facts about diVa

  • The treatment requires 3 twenty minute sessions
  • Minimal pain and discomfort
  • Return to work the next day
  • 90% satisfaction rates

diVa Laser Vaginal therapy is a breakthrough technology that can effectively provide vaginal lubrication without the need for surgery. A decrease in vaginal lubrication is an unfortunate result of age, menopause, metabolic diseases, and cancer treatment. The diVa uses Hybrid Fractional Laser Technology that is cleared by the FDA for the ablation and coagulation of soft vaginal tissue. The result is

  • Increase in vaginal moisture
  • Increase in vaginal tightening along with the thickening and elasticity of the vaginal wall
  • an increase in sexual satisfaction and
  • an incredible improvement in stress urinary incontinence

The diva Laser Vaginal treatment allows women to feel more like their younger, vital selves.

Key Facts about diVa

  • The treatment requires 3 twenty minute sessions
  • Minimal pain and discomfort
  • Return to work the next day
  • 90% satisfaction rates

Liposuction

Surgical lift of the mons pubis

Fat Transfer

Diva Laser Skin Tightening

Surgical Skin Reduction

Laser Hair Removal provides a permanent solution to dealing with unwanted hair. The most popular areas to treat includes the legs, back, underarms, and upper lip. The most effective and advanced laser system is the High Speed LightSheer DUET. It is the most advanced and effective laser system available today because:

  • Its larger hand piece allows the procedure the be performed much quicker than other lasers; this means less pain and less time in the office. A typical let can be treated now in less than 30 minutes.
  • The suction-assisted technology pulls the skin into a chilled and better targeted handpiece. This makes the the procedure relatively painless and yet more effective.

As with any hair removal device, multiple treatments are required in order to ablate the hair follicles in their growth cycles.

Body Contouring

Non-Surgical

Anti-Aging & Skin Care

Vaginal Health

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