Restoring And Enhancing Beauty
Interviewed by Guest Writer
Wednesday - January 07, 2009
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Dr. Shim Ching
Cosmetic and Reconstructive Plastic Surgeon
Where did you receive your schooling and training?
I grew up in Vancouver, Canada, and I did most of my training there. I did my undergraduate in Montreal, then I went back to Vancouver for medical school. Then I went to Ontario for residency. After that I did some additional training overseas and ended up in California. From there I came to Hawaii.
Can you talk about what procedures are performed here at Asia Pacific Plastic Surgery Inc., and also the most common procedures that you do?
We have a really wide variety of surgeries that we do. As plastic surgeons, we are among the few surgeons who are able to operate on the entire body, from the head to the toe. So I do many kinds of things that include the areas of cosmetic surgery and reconstructive surgery. Often the two types overlap and the techniques are very similar.
The most common things I do are things like breast reconstruction. Sometimes we’re doing one breast and sometimes we’re doing both breasts, it really depends on the cancer. That’s something that’s very common that I do. On the other hand, I do a lot of breast augmentation, and that’s when someone wants larger breasts. I also do a lot of facial cosmetic surgery. There are a lot of people who want to look younger, so we’re restoring the face to something that looks younger. Then there are a number of people who want to change the shape of their face or features of their face, like their eyes, noses and chins.
For breast augmentation, besides the level of skills of the physician, what other factors determine a successful surgery? And what should women look for when seeking a physician to perform this procedure?
Some patients have the idea that wherever they go they’ll have the same surgery, but it’s very different. Each surgeon does the surgery very differently. I think it’s very important to see more than one surgeon so you can decide what approach is best for you. Things like attention to detail and using new techniques that minimize pain - and newer implants -make a big difference.
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Do surgeons tend to offer different techniques, or do many only specialize in one technique?
Some surgeons only do breast augmentation one way for every patient. What I prefer to do is to tailor the approach to the woman. Each person’s breast is very different, so one approach may not be the best for everyone. I have a preference for certain techniques, but I really try to choose the best way for the individual. What I like to do is endoscopic breast augmentation, so it uses a very small scar in the armpit. The nice thing about the armpit scar is there is no scar on the breast at all (usually the armpit area is very well-hidden). What we do with breast augmentation is we make a pocket for the implant, and that pocket will determine the shape of the breast and the symmetry of the breast. That’s the critical part of the procedure. If that pocket isn’t done correctly, the patient will end up with asymmetry or the breast looking unnatural. Unfortunately, that’s how some surgeons do the surgery - without looking inside the body. What I do is I use a special camera so I can look directly inside the chest. I think this makes for better results and shorter recovery time.
Can you discuss the differences between silicone and saline implants?
Silicone will often feel much more natural, and that’s because it’s a gel inside as opposed to water. The advantage with saline implants is that when I put them inside the body, I can collapse them and then fill them with water once they’re inside the body. I can minimize the incision with saline implants. In the case of silicone implants, they come pre-filled, so I have to make a hole large enough to squeeze them through.
Can you talk about a tummy tuck and who are the best candidates for that procedure?
It’s a very common procedure. It’s usually women who have had two or three children, sometimes only one child. What happens after pregnancy is that the skin becomes stretched and even the deeper layer of the tummy becomes stretched, so there’s bulging, excess skin, and there could be stretch marks and even extra fat in those regions. So what we do is we remove the extra skin, we tighten up the abdomen and we do some liposuction to reshape and contour the area.
If the skin is being pulled down for a tummy tuck, what happens to the belly button?
For a tummy tuck, what we’re doing is pulling the skin down and removing some of the skin, so we then make a new hole for the belly button - and usually that hole is smaller. Usually after having children the belly button doesn’t look quite as youthful, so we make a smaller hole and reposition it through skin that is really nice and smooth, because the other thing that people have after pregnancy is stretch marks.
You also specialize in Asian cosmetic surgery. What does that entail?
Eighty percent of our state is Asian, and there are some very specific things that Asians request in contrast to Caucasians. A lot of the surgery has originated in the East in countries like Korea and China, and that’s because the demand there is much greater. Asian patients are often requesting things like double eyelid creation. The other thing is nose reshaping. Asian patients often want their noses to be larger, as opposed to Caucasians patients who often want their noses to be smaller. So that’s also very different and requires different techniques. I studied in Korea, which I think is the leading country in these types of surgery, and the techniques are far more advanced than some of the techniques we have in the U.S. right now. I think it’s quite an exciting area.
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