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

01/17/2026

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natural facial plastic surgery, subtle facial plastic surgery, conservative facial plastic surgeon, facial harmony surgery, facial plastic surgery results, facial plastic surgery recovery, facial plastic surgery consultation

01/15/2026

😳 A previous deep plane, FULL facial rejuvenation left this beautiful, young patient with results she didn’t like and scarring she didn’t love. She still felt like her eyes were dull and asymmetrical.

I did NOT think I was going to get to share her revision photos, and I’m grateful that she has let me.

In my opinion, she was too young for the level of invasiveness in the traditional, deep plane facelift and necklift approach that she had.

Our revision focused on her eyes and brows after that previous surgery. They were still heavy, they were still asymmetrical - these were either unaddressed or under corrected in her last procedure.

This is where I come in, this is the space I live in! I helped her with a very straightforward strategy to achieve this level of brightness 🔆 and symmetry that she was missing from her procedure before.

Sometimes, the revisions are for somebody who is frankly in trouble. Things went poorly, they were botched, the outcome is bad, call it whatever you want to. These are deeply emotional cases, with a lot of people remaining locked in after their bad outcome, not leaving their homes, with a complete change to their social and personal lives.

Other times, the outcome was just suboptimal and they didn’t quite get the results they were expecting. Many people in this situation or with equivalent results walk around relatively happy, not even knowing that their outcome could be any better than it is.

This latter situation is challenging with its own complex nuances that differ. Work was already done, the low hanging fruit was already picked, some of the higher hanging fruit is now even harder to reach because of the aftermath of the prior procedure, and the patient is hyper sensitive and especially in tune with what is now different, but not necessarily better. They got their 7/10 or even 8/10 result, but they know there is more.

Usually, the things that were ignored, left behind, not addressed, or not done well are the most challenging aspects at baseline, and they made even more difficult afterwards.

What do you think of her results?

01/13/2026

THIS OR THAT: FACIAL PLASTICS EDITION💉

Agree or disagree? Tell me below 👇🏻

Plastic surgery invisible incisions scarless technique facial optimization filler fat transfer

01/12/2026

Are you a good candidate for forehead Botox?🤔

What you NEED to know about heavy brows + Botox 🙅🏻‍♂️ Botox brow lifts

Commonly, heavy brows are 💯 genetic, yet neuromodulators (Botox, Dysport, Xeomin, Daxxify) are often the first treatment option offered.

This is flawed logic.

Usually it starts with, “I have lines on my forehead and a heavy brow,” (sound familiar?) and then with a complete lack of understanding, Botox is put in the ONLY muscle that can lift our brow. 🧐

We have to elevate our order of thinking - anatomically and three dimensionally!

This beautiful 33-year-old had that challenging situation, and of course had tried Botox twice in the past - it had failed miserably both times, giving her an odd eyebrow shape, making her feel more heavy in some places, and overcompensated in others.

The misunderstanding that Botox is going to lift a heavy forehead is prevalent, even pervasive, but it’s quite simple logic that weakening the ONLY muscle that lifts our forehead is not going to provide a brow lift - in fact, it will do quite the opposite, instead causing the majority of the brow to drop, except for any portion that is untreated and overcompensating (which is usually the outside edge).

🖖🏻 This gives a very oddly peaked brow shape, commonly called “Spocking.“

Many will talk about the tug of war balance that exists with the depressor muscles, and utilizing Botox to weaken those downward pulling muscles (like the corrugator, procerus, and orbicularis oculi), but this is different than putting Botox in the only elevating muscle for a forehead that is already heavy.

In these genetically heavy forehead situations, they really need to be supported surgically, and I am often able to do so with an invisible approach - where I perform a completely scarless upper eyelid blepharoplasty (you will not see this that often, if at all anywhere else) and my scarless approach to a ptosis repair.

All of this - quite literally without one visible scar or access! 🤯🙌🏻🪄

For a video of these results, check out (look on the right under ”reels”)

What are your thoughts?

01/10/2026

🎧 The transition into anesthesia - EVERY detail of your surgery and opioid-free, benzodiazepin- free, neurocognitive-protected anesthesia is thoughtful and dialed in, even this pre-IV sedation transition time.

🧠 Delta Waves and Theta Waves are two types of brain waves associated with overall brain health and function. They play a significant role in sleep, relaxation, and healing processes.

🎯 I use targeted binaural beats to enhance Delta and Theta brain waves. Binaural beats are an auditory phenomenon when two slightly different frequencies are presented to each ear. The brain perceives a third l, middle frequency or tone, which is the difference between the two frequencies.

Delta Waves
Delta waves are slow brain waves, typically in the frequency range of 0.5 to 4 Hz. They are most commonly associated with deep, restorative sleep and certain unconscious states.

🔐 Delta waves are a key part of my unique IV sedation protocol. You just aren’t going to find this elsewhere!

Delta waves have benefits before, during, and even after your anesthesia:

🧬 Deep Sleep and Physical Healing: Delta waves are dominant during the deepest stages of non-REM sleep (slow-wave sleep). This phase is crucial for physical restoration, healing, and recovery, as it supports tissue repair and the release of GROWTH HORMONE!

🧘🏻‍♂️ Reduced Stress and Anxiety Pre-Operatively: The deep sleep associated with delta waves helps reduce stress and anxiety by allowing the body and mind to rest and rejuvenate. This also REDUCES the amount of anesthesia we need!

🦠 Enhanced Immune Function: Delta wave activity during deep sleep is linked to improved immune function, as this is when the body produces more immune cells and processes.

❤️‍🩹 Emotional Healing: Delta waves contribute to emotional healing by facilitating the processing of emotions and memories at a subconscious level.

WELCOME TO THE NEXT LEVEL®️ - truer words cannot be spoken here!

Do you have any experience with Delta waves, Theta waves, or binaural beats?

01/08/2026

Third time is a charm for these eye bags and droopy eyes! ✨

Mickey’s (76) eyes here needed tertiary (3rd time) revisions = fixing TWO prior procedure attempts that she had.

That means significantly more complicated surgeries, more hurdles, more problem-solving, and more creativity!

I do a lot of revision (fix it) surgeries, including especially complicated ones like this. The beautiful part is - these just make me even better with my primary, first time surgery patients!

Mickey is absolutely lovely and traveled to me for this challenging full set of revisions with my EnigmaLift®️.

She had significant lower eyelid bags and had lost some of the life in her upper eyelids after her prior two surgeries.

We were both very excited to reconnect at the 15 month mark here.

Mickey’s eyelid revisions were very complex = requiring correction of size, shape, symmetry, position, aperture, quantity, and quality! What do you think? How did we do?

The revision situation also creates significantly more challenge in the ex*****on of each procedure from my end, and it makes the recovery more challenging from her end. 
Revision surgeries are more challenging from an ex*****on standpoint, as the tissue that we are working with is not starting in its native position, and the quality of the tissue has changed from prior scarring and fibrosis. 
Mickey was beautiful to start, I am grateful for her and I have had a great time getting to know her. We both were very up for the challenge of revisions, working together (I love this situation!), and our relationship got stronger through this process!

With much of my work being revisions, I am very upfront about it - Mickey was beautiful to start, and I am grateful for her and have had a great time getting to know her.

WELCOME TO THE NEXT LEVEL ®️

natural facial plastic surgery, subtle facial plastic surgery, conservative facial plastic surgeon, facial harmony surgery, facial plastic surgery results, facial plastic surgery recovery, facial plastic surgery consultation

01/07/2026

What I Believe the Future of Facial Surgery Actually Requires

The future of facial surgery is not being driven by trends.
It is being shaped by anatomy, perception, biology, and time.

The longer I operate, the clearer it becomes that the face is not a collection of features to be adjusted. It is a living, dynamic system interpreted by the brain, influenced by physiology, and judged subconsciously long before a conscious opinion is formed in the mirror or via before and after photos.

Here is what I believe will increasingly define meaningful, durable, and desirable results.

Read below for more on each one.

1. Beauty Is a Neurologic Event:
Faces are processed emotionally before they are evaluated visually. Small changes in eye aperture, symmetry, or tension patterns can radically alter how a face is perceived. The most successful outcomes feel familiar, calm, and uniquely human because they align with how the brain expects a beautiful face to move and communicate.

2. Surgery Begins Before the Incision:
Physiology matters. Sleep quality, stress response, metabolic health, and inflammatory tone influence outcomes as much as technical ex*****on. Anesthesia choice, intraoperative environment, and perioperative strategies shape results in ways that cannot be corrected later.

3. Healing Is an Active Process:
Tissues do not simply recover. They respond to signals. Blood flow, lymphatic movement, mitochondrial function, and inflammatory regulation determine whether surgery restores resilience or accelerates aging. Recovery biology is not optional. It is part of surgical design and ultimate success.

4. Time in the Operating Room Matters:
Rushed surgery is too common. Speed is a point of pride with many surgeons, but it leaves signatures. Thorough precision requires time. A slow, methodical, and deliberate approach allows tissues to be handled gently, decisions to be reassessed in real time, and anatomy to guide each step. The highest-quality results come from surgeons who are willing to take the extra time to do what is needed, rather than compress it to complete “their” procedure.

CONTINUED IN COMMENTS👇🏻

01/06/2026

BLIND RANKING FACIAL PROCEDURES 🫣

What should I rank next? Tell me in the comments👇🏻

natural facial plastic surgery, subtle facial plastic surgery, conservative facial plastic surgeon, facial harmony surgery, facial plastic surgery results, facial plastic surgery recovery, facial plastic surgery consultation

01/04/2026

SCARLESS lower eyelid rejuvenation with my EnigmaLift®️✨ to reposition (not remove) her fat pads, paired with my regenerative protocol for her skin and fat pads.

My mindset for the surgery (and most of my procedures) revolves around repositioning fat pads - nothing is cut out, nothing removed or thrown away, everything just replaced.

This is not the norm. It is significantly more technically demanding and takes much more time in surgery.

Like many of the procedures I do, despite the extra investment of time, focus, and energy - it has become unquestionable for me that this is the right procedure to perform for my patients to give the level of results that meet the standards of excellence that I want to deliver.

From the 10,000 meter view - It actually blows my mind what we are able to accomplish completely scarlessly with this mindset and strategy - ZERO visible access - not one suture visible.

We also rejuvenated her skin with my customized laser cocktail and regenerative medicine protocol 🪄

Our result is undoubtedly exceptionally beautiful and natural, while also serving as a wonderful example of how that regeneratively focused, non-surgical adjunct can improve the finest details of those results. 🎯

What do you think of her results?

Done with under-eye bags and dark circles making you look tired? If you’re ready to feel like your best self, click the link in my bio! 🔗

natural facial plastic surgery, subtle facial plastic surgery, conservative facial plastic surgeon, facial harmony surgery, facial plastic surgery results, facial plastic surgery recovery, facial plastic surgery consultation

Chesnut MD Cosmetics

01/17/2026

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