Chesnut MD Cosmetics, 510 S Cowley Street, Spokane, WA (2026)

03/14/2026

Can devices “lift” and “tighten” 🤔 Let’s look at this 🍆 for our answer.

The key points are =

Devices deform and dehydrate (in their attempt to lift and tighten), but what we really want is a qualitative rejuvenation of the skin envelope.

As you see here, the same device can do both. One option is wildly damaging in an attempt to chase empty promises of lifting, the other one gives beautiful, long-term qualitative results.

“Devices” can mean radiofrequency (RF), RF microneedling, focused ultrasound (HIFU), plasma, sound waves, lasers, magnetic stimulation, hole pouching, light sources, the list goes on and on.

DEVICES WORK BEAUTIFULLY when their intent is to regenerate and rejuvenate the qualitative structure of our skin - I love lasers specifically for this. This means building what everybody thinks of, collagen - but if you have been follow along with me at all, you know ELASTIN is paramount here.

If you are on the fortunate end, these treatments just deliver little to no results - which is the most common situation, and one to be thankful for when you understand what can happen.

*For anyone who claims they have or deliver exceptional results with these devices, please let us all see the standardized photos. The industry overall is waiting for them, and they are yet to be reproduced. I also often hear providers told me that their patients are “really happy“ with some of these treatments. That is great, but that is actually not well linked to delivering reliable and quality results, as we all know.

On the less fortunate end, these devices used with the intent to lift and tighten can permanently damage the wildly important deeper structures of our face. It’s something I see every week. 🫣

Again, devices can ABSOLUTELY deliver beautiful results when used with the right intent.
Like many things in life… Intent is everything.

*Only one 🍆 was harmed in the filming of this video.

What questions do you have?

Facial plastic surgery, facial plastic surgeon, facial plastic surgery near me, facial plastic surgeon near me, best facial plastic surgeon, facial plastic surgery consultation, facial rejuvenation surgery

03/13/2026

Pores + Aging 🕳️ Everything you need to know about these structures in your skin, how they change overtime, and what you can do about it.

In all likelihood, this is MORE than you ever wanted to know about these integral skin structures 🤗

There’s more to them than just puberty. Your pores change with age and contribute to the aging appearance of your skin.

Strategies to address these aging pores are varied and range from tropical treatments to lasers and even surgical lifting procedures, which help pre-distribute crowded for density as skin structures fall with the underlying structural changes.

Any questions I didn’t answer in here? Please let me know in the comments!

Facial plastic surgery, facial plastic surgeon, facial plastic surgery near me, facial plastic surgeon near me, best facial plastic surgeon, facial plastic surgery consultation, facial rejuvenation surgery, facial rejuvenation procedures, natural facial rejuvenation, surgical facial rejuvenation, facial aging treatment, facial aging solutions,

03/12/2026

Tricia absolutely loves what she sees when she looks in the mirror now. She sees herself again.

She said when she looked in the mirror for the past several years, all she could see was her eye bags and her hooded upper eyelids. These were throwing her off, she didn’t feel right, and she didn’t know exactly what to do with it.

Tricia is 50 years old, and her initial suggestions from providers when she started to look into what she should do were all based off of short-term mindsets, myopic views, and flawed logic. Suggestions ranged from filler (of course) to surgical options that included cutting her fat pads out.

These would have very likely changed her entire essence, and made her look even less like herself.

Luckily, she found me and we took a whole different approach with my EnigmaLift®️ that included SCARLESS repositioning of her eyebags (as opposed to cutting them out), an invisible improvements of her forehead and upper eyelids that give her the appearance of being vibrant and well rested, with zero evidence that we were there.

We have been moving smoothly through the recovery phase, and now 3 months out she is red carpet ready, and we will still see significant improvements from here!

We rejuvenated her entire upper face and eyelids in an invisible fashion. Forehead, temple, upper lid, lower lid, midface - You won’t see an incision, scar, or access point anywhere.

Uniquely in our field, I did NOT to remove any of her fat pads. Removing them often creates hollowing and leads to an odd look with lack of support for the eyeball, in my opinion.

I instead of repositioned all of her fat pads, which I think intuitively makes sense. Those fat pads are valuable structural tissue that can be moved into a more youthful position to smooth the contour between the lower eyelid and cheek while maintaining volume, eyeball support, and ultimately identity.

Follow along here

What questions do you have about eyelid bags, filler, or fat repositioning around the eyes?

03/09/2026

Laura (56) is looking as vibrant as she feels, 9 months after our refresh.

Laura now looks in the mirror and sees something she loves, something that is cohesive with her values, and there are no signs that anything was done.

Laura and I achieved this goal - to look how she feels (which means she looks incredible and vibrant) - and she got there quickly, efficiently, and reliably through my fully customized plan for her.

Welcome to the next level®️

She had a minimally invasive, full face EnigmaLift®️ rejuvenation:

-forehead support
-upper eyelid surgery
-scarless lower eyelid surgery
-scarless ptosis repair
-scarless midface lift
-preservation style, minimal access deep plane facelift
-deep neck lift and contouring
-LoveLift deep plane lip lift and corner lift

This is the most common thing I hear from my patients: they look in the mirror and it doesn’t match their expectations, it doesn’t match what they feel inside, and sometimes it even seems to have happened quickly.

This is frustrating, and on a very core neurobiological level it creates cognitive dissonance and mental friction. We want to remove that dissonance and friction.

Our entire project together sends you skyrocketing forward with that friction removed, and it does so with an experience that is incredible, completely next level in every single step of the process, and with results that will be durable for your decades ahead.

From preparing you for your procedure and my
neurocognitively 🧠 protective anesthesia protocol through your optimized recovery and your incredible long-term results - there’s nothing else that can make you feel this way and give you these types of results.

You will feel like the most elite professional athlete.

It certainly isn’t for everyone, you have to value these types of results and this type of process.

For those that understand, there’s nothing else quite like it.

If you’d like to see her pre-op and post- op videos, comment “LAURA” and I’ll send you her full journey!

What do you think about her results at 9 months? Let me know in the comments!

Facelift before and after, Dr. Chesnut, EnigmaLift®️, Facelift, scarless surgery, facial plastic surgery

03/08/2026

Here is what you need to know about PDGF (Platelet Derived Growth Factors) - it is all over your social media right now, and has become one of the most hot button topics in aesthetics. Why?

My interest here specifically lies in the overall regenerative medicine atmosphere, and how this affects it.

(Read & watch to the end for my personal thoughts)

Some are calling it the next big thing in regenerative aesthetics - others are calling it snake oil. Which one is true?

KEY FACT:
Right now, PDGF is only approved for topical use, not injection.

I think it’s really important to understand that type of regulatory context versus differences in clinical use, and this is not new territory. Many things are used off label or for experimental use - from those peptides I just mentioned (which have also picked up a lot of popularity lately), to years of off label use for things like Botox or hyaluronidase (highly likely you’ve had these label if you’ve had them).

The key difference for those last two is that they were improved for injection, just utilized in other places that were not specifically FDA study. PDF is not approved for injection, only for topical use.

My personal take - back to first order thinking:
Are we asking the right question, or better said… What are you trying to treat?

There’s undoubtedly a tissue interaction that is regenerative with PDGF and our soft tissue, but is it going to address the thing you are after? I often see it used for the lower eyelids, including lower eye bags, which is just a recipe for dissatisfaction and poor results, as it’s not going to change that anatomy.

What have you heard about PDGF? Hype or snake oil? Tell me in the comments!

Dr. Chesnut, facial plastic surgeon, hot topic, aesthetics, PRP, injections

03/07/2026

Laura now looks in the mirror and sees something she loves, something that is cohesive with her values, and there are no signs that anything was done.

Laura and I achieved this goal - to look how she feels (which means she looks incredible and vibrant) - and she got there quickly, efficiently, and reliably through my fully customized plan for her.

Welcome to the next level®️

This is the most common thing I hear from my patients: they look in the mirror and it doesn’t match their expectations, it doesn’t match what they feel inside, and sometimes it even seems to have happened quickly.

This is frustrating, and on a very core neurobiological level it creates cognitive dissonance and mental friction. We want to remove that dissonance and friction.

Our entire project together sends you skyrocketing forward with that friction removed, and it does so with an experience that is incredible, completely next level in every single step of the process, and with results that will be durable for your decades ahead.

From preparing you for your procedure and my
neurocognitively 🧠 protective anesthesia protocol through your optimized recovery and your incredible long-term results - there’s nothing else that can make you feel this way and give you these types of results. You will feel like the most elite professional athlete.

It certainly isn’t for everyone, you have to value these types of results and this type of process.

For those that understand, there’s nothing else quite like it.

If you’d like to see her before and after photos and other videos, including preop, comment “LAURA” and I’ll DM it to you!

Facelift before and after, Dr. Chesnut, EnigmaLift®️, Facelift, scarless surgery, facial plastic surgery, natural plastic surgery

03/06/2026

This beautiful Malibu morning with and flowed between riding the assault bike (oven mitts on) in the hot sauna, dumbbell training underwater in the chilly pool, and this sunshine-fueled long-format breathwork on the pool deck☀️

We moved through this structured sequence about 4 times, each round takes about six or seven minutes. It’s revealing once you get rolling with it.

Here was the sequence:

First came 15 forceful mouth breaths. This was the sympathetic, activating ignition. This type of breath work creates a low carbon dioxide, high oxygen environment that typically you can feel with some tingling in your fingers and face. Pure stimulation. This is what many call Wim Hof breathing 🧠

Second was more controlled nasal inhales with vibrational exhales. This is a deliberate vagal nerve signal and a conscious shift toward parasympathetic (resting) tone without squashing the energy we just created.

Third, we transitioned to slow nasal breaths with a controlled sigh. This creates a balance between drive and recovery. I felt this as a combined coordination of the two states, and it was a nice challenge to balance the two without one overpowering the other. *If making the audible sigh feels awkward to you, know that it does for everybody else too, give it a try and own it!*

We ended each round with a controlled flush, gentle breaths. My body, and my nervous system appreciated that smooth landing!

One round complete! This paired of beautifully were hopping in the frigid pool and controlling our breath holds in there between dum exercises, which certainly built some more neurological discipline and made us even harder to kill. Thank goodness for the hot sauna!

Have you tried a breath work exercise similar to this? Tell me in the comments!

03/05/2026

Vertical lip lines are very common, yet frequently mistreated (they are also referred to as smokers lines or barcode lines).

They form because of the repeated action of the underlying orbicularis oris muscle, a sphincter type muscle, on the overlying soft tissue of the lip, notably the fat and the skin.

This repeated movement over time causes a physical breakdown of that overlying soft tissue. This is a qualitative change - and that’s where the issue enters:

The most common treatment for this area is putting filler in the lines. On some level, I see why people do this. If you over-inflate a balloon, the surface of it will be less wrinkly. When it comes to lips, we see that overfilled balloon metaphor walking around out in the world all the time.

That mindset is treating a qualitative problem with quantity, which simply over inflates the lips, including in the skin based portion above the pink (vermilion) portion of the lip.

This is also the perfect set up for filler migration, putting it right in this highly mobile, highly muscular area.

I instead prefer to leave the lip a normal anatomic size and instead focus on the tissue quality and make it function properly.

Treating the lip with a qualitative lens means utilizing laser resurfacing and a more regenerative protocol, often with fat and fat based stem cells.

This better restore is the form and function of the lip.

Overfilled lips attract attention with both abnormal lip size and blunted movement. Our neuroanatomy is hyper in tune to this area, and it picks up on those abnormalities quickly.

Interestingly, when lips have been overfilled and that filler gets modified with dissolution, the qualitative changes that exist as a result of that filler in the lips - tissue expansion atrophy, dehydration, etc - can often be improved significantly with a similar regenerative medicine strategy. I regularly use stem cell rich nanofat for this.

What questions do you have about vertical lip lines? Ask me below!

refined facial aesthetics, non overdone facial surgery, longevity focused facial plastic surgeon, future proof facial surgery, anatomy driven facial surgery

03/04/2026

From angry and confused to calm and competent - your facial position and animation say it all! 🤨-> 🙂

Wild isn’t it? Angry and confused is an emotional combination that communicates a lack of competence, often associated with aging and neurocognitive changes.

Our brain, specifically our amygdala, makes this judgment near instantaneously. These types of neuroanatomical facts drive my procedural planning and ex*****on.

My obsession with neurobiology creates a very unique mindset to operate from, and it allows me to give the most natural and reliable results with the most minimally invasive procedures possible.

That means looking like yourself afterwards, not overdoing anything, and having no signs of surgery - all with the simplest, safest experience and the most durable, long-term outcomes possible.

EyePapi™️ - we optimized Bill’s (69) neurocognitive communication with my EnigmaLift®️ scarless and invisible brow contouring plus upper eyelid rejuvenation, paired with my scarless lower eye bag removal and midface. He has incredible results early on!

He also had my fat-derived stem cell acne scar treatment (and Mohs micrographic surgery for the removal of a basal cell carcinoma skin cancer right between his eyes).

These procedures were supplemented with my customized laser cocktail and stem cell rich fat transfer (a beautiful combination for the scarring).

He is four months out from his cosmetic procedure and one month out from his skin cancer procedure in these photos 🙏🏼

Upper and lower eyelid work on a man is a completely different ball game than it is on a female, and Bill exemplifies that, with a very masculine facial shape at baseline.

What do you think of his results?

male facial plastic surgery, male facial plastic surgeon, men’s plastic surgery, plastic surgery for men, male cosmetic surgery, facial rejuvenation for men, natural results for men, masculine facial aesthetics, male facelift, deep plane facelift for men, male neck lift, male eyelid surgery, male blepharoplasty,

03/02/2026

Who “needs” Botox after surgery.

What happens when facial structure and musculature are replaced to their original positions.

Where our brain focuses to process facial beauty.

When natural expression is restored.

Why your brow and forehead look more relaxed and less strained after lifting.

How this ties in to the future direction of all lifting procedures.

Facial plastic surgery that preserves identity, restorative facial surgery, anatomy driven facial plastic surgery, facial plastic surgeon for high performance individuals, facial plastic surgery for natural aging, advanced facial rejuvenation techniques, facial plastic surgeon focused on longevity,

Chesnut MD Cosmetics

03/14/2026

03/13/2026

03/12/2026

03/09/2026

03/08/2026

03/07/2026

03/06/2026

03/05/2026

03/04/2026

03/02/2026

Address

Telephone

Website

Alerts

Shortcuts

Share

Category