Dr. Larry Fan, MD

Dr. Larry Fan, MD Larry Fan, MD, is an award-winning, board-certified plastic surgeon dedicated to helping you achieve your aesthetic goals with precision and artistry.

At 77 Plastic Surgery, you will find a rare combination of exceptional patient care from our highly trained staff, medical and surgical expertise from our internationally recognized, Board Certified plastic surgeons, and cutting edge plastic surgery procedures.

08/28/2026

Rippling can make a well-sized implant look obviously augmented.

Most patients focus on which implant to choose. But one of the biggest risk factors isn't the implant. It's how much of your own tissue covers it.

And that can be assessed before surgery.

Rippling is when the implant's folds or edges become visible through the skin. Once it shows, correcting it may mean fat grafting, changing the implant, or revising the pocket.

I assess tissue coverage with a simple pinch test. But it isn't a pass/fail number. It tells me where your coverage is thinnest and what needs to change in the surgical plan.

Thin coverage doesn't mean you can't have implants. It changes three decisions:

The implant. A more cohesive implant holds its shape better and may show fewer folds under thin tissue. No implant guarantees zero rippling.

The pocket. Placing part of the implant beneath the chest muscle adds coverage where it matters. But the muscle doesn't cover the whole implant, and every pocket choice has trade-offs.

Fat grafting. Fat can be added over the areas where coverage is weakest, either during the original surgery or later if rippling develops.

So the more useful question isn't "which implant do you use?"

It's: How thick is my tissue? Where is it thinnest? And what are you changing in the plan because of it?

No surgeon can promise rippling will never happen. But your risk should be evaluated beforehand, and your surgeon should be able to explain exactly how that assessment shapes the implant, the pocket, and the need for extra coverage.

Considering implants? My Smart Woman's Guide to Breast Augmentation covers the essential questions to ask about options, risks, and long-term care.

Comment SMART and I'll send it to you.

08/26/2026

You don't need more filler. You probably need less.

Filler was built to replace volume. But most of what bothers you at 50 isn't missing volume. It's tissue that moved.

The ligaments holding your cheek fat in place stretch. The fat pads slide down. The fold that shows up beside your mouth isn't a hole that needs filling. It's the shadow of a cheek that fell.

So when we fill that fold, we're stacking weight on top of something already sagging. The crease softens for a few months, then comes back deeper. Meanwhile the face gets wider at the bottom instead of higher at the top.

That's the look people describe as "she's had something done" without being able to say what.

There's a second problem nobody warned you about.

We were told hyaluronic acid dissolves in 6 to 12 months. MRI studies have found filler still sitting in the face years later. Not all of it. Not in everyone. But enough that a woman getting syringes twice a year for a decade is carrying more than she thinks.

I'm not anti-filler. I use it. But it's a volume tool, and you may have a sagging problem. Using the wrong tool harder doesn't make it the right tool.

Before your next appointment, ask one question: is the thing missing, or has it fallen?

If it's fallen, filler is the wrong answer, no matter how good the injector is.

Follow for more.

08/25/2026

Most people get at least two of these wrong.

The answers aren't what you'd expect, and they have less to do with age than almost anyone assumes. Filler versus surgery, small versus full, one technique versus another. Every one of these comes down to timing and judgment, not a number.

Watch through and keep score.

How many did you get right? Drop your number below.

08/24/2026

It's easy to judge people who get facelifts. Until you look in the mirror and don't recognize what's looking back.

Rosie O'Donnell called plastic surgery a betrayal. Not casually. Morally. She swore she'd never touch her own face.

Then she lost 50 pounds in her 60s, and her face didn't just age. It deflated.

She tried to accept it. Told herself she'd earned every line. Still felt, in her word, haunted.

When she finally decided to do something, her 13-year-old stopped her cold: "I wouldn't be able to respect you if you did it."

Six months of paralysis. Then a realization: letting an ideology decide what she could do with her own body wasn't freedom either. Just a different authority holding the pen.

She had a lower deep plane facelift. And the visible result, in her words, was zippo.

Not one friend noticed. Not a stranger. She was thrilled.

Because nobody noticing isn't failure. It's the point. She didn't disappear into someone else's face. She still looks like Rosie, just rested.

After significant weight loss, restoring a deflated facial structure isn't vanity. It's structural.

You don't betray yourself. You just stop arguing with the mirror.

08/20/2026

"Breast implants have to be replaced every 10 years."

Most women have been told this. It isn't true.

Replacing an implant just because it turned ten could mean having surgery you never needed.

So if the calendar doesn't decide, what does? Three things:

→ A problem with the implant
→ A change in your breast
→ A change in what you want

Here's the catch: a silicone implant can rupture without changing how your breast looks or feels. Which is why the real safeguard isn't scheduled replacement. It's monitoring.

The FDA recommends an ultrasound or MRI starting 5–6 years after surgery, then every 2–3 years. Normal exam, normal imaging? No automatic surgery.

Implants aren't lifetime devices, and the chance of a problem does go up over time. But you're not on a countdown clock. You're on a checkup schedule.

And if you're considering implants, don't wait until after the surgery to learn what you should have asked before.

Comment SMART and I'll send you my Smart Woman's Guide to Breast Augmentation.

08/18/2026

Everyone asks about size. Almost nobody asks about shape.

Her left breast was nearly 100cc larger than the right. The obvious fix is a bigger implant on the right, and it would have been the wrong call.

Her right breast was tighter, narrower, higher. Her left had more skin and sat softer and lower. Scoliosis narrowed the right side of her chest wall. Same implant, two very different outcomes.

The implant is only one part of the final shape. Skin, tissue, and chest wall decide the rest. I call this implant-tissue matching.

If I'd corrected the full size difference with implants alone, the tighter right side would have gone firmer and rounder while the left stayed soft and low. Better numbers. Worse result.

We chose 355cc on the right, 305cc on the left. Fuller, more balanced, naturally shaped. Not identical, because implants can't make two naturally different breasts identical. But she looks like herself.

Could we have pushed further? Fat transfer on the right, maybe a small lift on the left. She didn't want the extra scar for a small gain in shape. Knowing what not to do matters as much as knowing what to do.

If your breasts are asymmetric, ask your surgeon one question before you book anything:

If we correct the size difference, what happens to the shape?

A surgeon who hasn't thought that through isn't ready to operate on you.

Comment SMART and I'll send you my free guide to breast augmentation.

08/17/2026

A 28-year-old is flying to Istanbul for a facelift tomorrow. She's wanted it since she was 18.

Wanting surgery doesn’t make surgery appropriate.

A facelift treats visible signs of aging. It can't prevent aging, and it can't freeze a young face in time. I haven't examined her. But from this video, I don't see an aging problem worth the scars and the risks.

Then she mentions the jokes people made about her lips. That's what concerns me most. Surgery can lift a lip. It can't erase what people said to you.

Her face, her life, her choice. But the surgeon has a choice too, and a duty to only recommend an operation they believe will help more than it can hurt.

The real question isn't whether she had the right to ask for a facelift. It's whether her surgeon should have said yes.

Should a surgeon ever tell a patient no? Comment Below

08/12/2026

What makes a facelift so natural it's undetectable?

Most patients assume it means doing less. It doesn't. Natural isn't about doing less. It's about rejuvenating the face without leaving behind the telltale signs of surgery.

Take this patient. A 56-year-old executive whose face looked more tired and heavy than she felt.

What made her look tired wasn't one feature. Her brows and upper eyelids were heavy. Her cheeks had descended, deepening the folds around her mouth. And laxity through her lower face and neck had blurred her jawline.

So I chose my extended deep plane face and neck lift, the procedure I call the Mona Lisa Lift. Releasing the retaining ligaments let me restore the cheeks, jawline, and neck together as one plan. Her submandibular glands had also dropped, so I lifted and repositioned them with a sling rather than removing them. A temporal lift addressed the heaviness around her upper eyes, and radiofrequency microneedling improved her skin quality.

Here she is six months later. Her brows are elevated. Her eyes look more open. Her cheeks sit higher. Her jawline and neck are defined. The improvement is obvious, but no single area looks overcorrected.

She looks natural, but not because the change was small. It wasn't. I corrected each area as much as her anatomy required, without pushing any feature too far.

That's the secret. The rejuvenation should be obvious. The operation should not.

Considering a facelift? Comment LIFT and I'll send you my guide to evaluating results, comparing surgeons, and knowing what to ask before you decide.

08/11/2026

Can you fix jowls without surgery?

The honest answer is no. And here's the part the aesthetics industry won't explain.

Jowls aren't just a jawline problem. They're a symptom of global structural descent. The soft tissue that used to sit higher in your face lost its support and collapsed below the jawbone.

The industry will sell you jawline filler to hide the sagging, and energy devices like radiofrequency and ultrasound to tighten the skin. Here's the physics of why they fail.

When you add filler to a structure that's already fallen, you're just adding bulk. That's exactly how the lower face ends up looking wide, heavy, even masculine.

And when you use heat devices, you get mild tissue contraction. But contraction is not elevation. Shrinking the skin does not physically lift a heavy foundation back up where it belongs.

Want to see how your face actually works? Go to a mirror. Place your hands flat against your cheeks and gently lift the tissue diagonally upward. The jowl vanishes.

To actually fix the jowl, you have to physically restore the architecture. And that often requires a facelift.

So tell me below.

When you do the mirror lift, does your jowl disappear?

08/10/2026

Sometimes, the absolute worst thing a plastic surgeon can do is give you exactly what you asked for.

Karamo Brown's experience with buccal fat removal is the ultimate cautionary tale that proves exactly why.

He had gained seventy pounds. The internet ruthlessly pointed it out, and he felt deeply insecure.

He wanted a quick fix to slim his face. So, he asked a surgeon for the biggest aesthetic trend at the time: buccal fat removal.

But buccal fat excision is a highly specific structural procedure. It is not a treatment for systemic weight gain.

It was the absolute wrong procedure for the wrong reason. Any ethical surgeon should have looked at him and said, no.

But his surgeon said yes. They treated a permanent medical procedure like fast fashion, and gave him exactly what he asked for.

Because they operated for the wrong reasons, the surgery became a nightmare. Dense scar tissue blocked his salivary ducts.

His face ballooned, and he lived in chronic, excruciating pain for a year and a half while smiling on national television.

He eventually found a reconstructive surgeon to fix the damage. Trends come and go, but the lesson here is permanent.

This is exactly why world-class plastic surgeons say no. Our job is not to sell you the procedure you saw on social media.

Our job is to diagnose the truth and protect your anatomy.

If you want an elite result, demand a surgeon who prioritizes long-term truth over short-term trends.

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77 Van Ness Avenue APT 302
San Francisco, CA
94102

Opening Hours

Monday 8:30am - 5:30pm
Tuesday 8:30am - 5:30pm
Wednesday 8:30am - 5:30pm
Thursday 8:30am - 5:30pm
Friday 8:30am - 5:30pm

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