By Allan Acton • October 13, 2025
Why this episode matters
Great clinical work changes how people feel about themselves—and that changes everything. In this episode, I sit down with Dr. Brian Coan, double board-certified plastic and reconstructive surgeon and founder of Care Plastic Surgery in Cary, NC. We dig into the engineering mindset behind great plastic surgery, how outcomes show up in real life (new confidence, new opportunities), and what a thoughtful, long-term aesthetic plan actually looks like.
“You’re not here for a facelift. You’re here for what the facelift makes possible.” — Dr. Brian Coan
Meet the Guest (and Why You’ll Care)
Dr. Coan trained in general surgery and then plastic surgery at Duke (2005–2008), with deep experience in microsurgery. That mechanical-engineering brain (MIT) plus whole-patient focus led him to build a 100% cosmetic practice with an on-site, fully accredited OR and a comprehensive med spa—so patients get continuity, safety, and outcomes under one roof.
From Engineering to Aesthetics: A Problem-Solving Discipline
Plastic surgery, done well, is engineering with biology:
- Toolbox + creativity: start with principles, then design a solution for a unique person.
- Whole-patient perspective: physiology, psychology, and long-term relationship > one-off procedure.
- Focus beats “do everything”: Brian chose to specialize in aesthetics to deliver meticulous, repeatable excellence.
What Patients Actually Want (Hint: It’s Not “a Procedure”)
Patients don’t want “a breast lift” or “a facelift.” They want confidence, ease, and permission to show up.
- Dr. Coan reframes consultations around the result you want to feel, then translates that into objective surgical plans.
- At 3–12 months post-op, he asks, “How did this show up in your life?” Answers: new work, new relationships, new experiences.
“We don’t have a ‘happy wand.’ We have tools and craft. The goal is the life change those tools unlock.” — Dr. Coan
Common Paths & Procedures (Real-World Patterns)
Younger/pre-childbearing: proportional breast augmentation or reduction/lift; targeted liposuction/body contouring.
Post-pregnancy or post-weight-loss: “Mommy Makeover” combinations—breast rejuvenation (add or reduce volume, reshape), abdominoplasty, possible liposuction or labiaplasty.
As patients age with the practice: facial rejuvenation—facelifts and blepharoplasty—plus skin work (resurfacing, injectables) for maintenance.
Start small or go comprehensive:
- Minimally invasive options are valid (limited longevity, lower commitment) for “toe-in-the-water” patients.
- Best results often come from a long-term plan that layers non-surgical maintenance with the right surgical moments.
Recovery, Plain and Simple: The Mommy Makeover Timeline
- Pain meds: ~5–7 days (sometimes up to 10).
- “Over the hump” feeling: 10–14 days.
- Back to desk work: ~2 weeks.
- Back to the gym: ~6 weeks.
- Looks good at 6 weeks; feels fully “me” by ~3 months.
Brian likens adaptation to a new bite after a filling: your brain needs time to map the “new you.”
The Three Big Question Buckets Patients Ask
- “Will I look like what I imagine?”
He drives clarity with objective language and visuals (e.g., “pretty” means what, exactly?). - Process & immediate recovery:
Anesthesia/pain fears are common; with the right protocol, plastic surgery doesn’t have to be miserable. Call if it is. - Long-term planning:
Safety, longevity, implants, future breastfeeding, and revision risk. Short version: modern implants are extremely safe; long-range burden is low, and plans are tailored.
When the Doctor Becomes the Patient
Brian’s own smile journey—braces, implants, and finally freedom from a lifelong concern—reshaped his empathy. That experience sharpened how he guides patients through cosmetic change: it’s not vanity; it’s identity.
How Care Plastic Surgery Works
- Location: Cary, NC (Harrison Ave & Weston Pkwy; convenient to RDU).
- Facility: Two fully accredited ORs, a dedicated aesthetic team, and a full med spa (lasers, resurfacing, skincare, CoolSculpting, injectables).
- Digital consults: HIPAA-secure photo uploads; Brian reviews and sets expectations (results, recovery, and costs) before the first visit.
- Consult length: ~60 minutes.
- Scheduling window: Often 2–6+ weeks, depending on case complexity and season (holiday blocks book early).
Key Takeaways for Listeners
- Identity > Procedure. The goal isn’t surgery; it’s how life feels after.
- Engineer the plan. Use principles, tools, and clear objectives—then personalize.
- Think longitudinally. Combine maintenance (skin, injectables) with well-timed surgeries.
- Recovery is manageable. With good protocols, discomfort is real but surprisingly reasonable.
- Confidence compounds. When people feel right in their skin, they show up differently at work, at home, everywhere.
Presenter Bios
Allan Acton, DDS
Dr. Allan Acton is the founder and owner of Cary Family Dental, where he’s spent more than two decades combining advanced technology with a down-to-earth, patient-first philosophy. A graduate of Virginia Commonwealth University School of Dentistry, he completed an AEGD residency at the University of the Pacific, is a Kois Center graduate, and holds a Fellowship with the International Congress of Oral Implantologists. Beyond credentials, Dr. Acton is known for creating real relationships with patients—helping them not only improve their smiles but also their confidence and overall quality of life. His passion lies in building teams and systems that make exceptional dentistry feel effortless for both patients and providers.
Brian Coan, MD, FACS
Dr. Brian Coan is a double board-certified plastic and reconstructive surgeon and the founder of Care Plastic Surgery in Cary, NC. With an engineering degree from MIT and advanced training at Duke University, Dr. Coan brings a rare mix of technical mastery and artistry to every procedure. His practice features a fully accredited surgical center and med spa, where he and his team focus on achieving natural, confidence-building results. Patients appreciate his calm, thoughtful approach and his ability to see both the science and emotion behind every transformation.
