Chesnut MD Cosmetics, 510 S Cowley Street, Spokane, WA (2025)

12/20/2025

Let me explain…

1. A Botox browlift is flawed logic…it will just expose your heavy forehead.

You have one muscle that lifts your forehead. When your forehead gets heavy strains to help lift your brows and to help you see - this is why you have forehead lines. It is not because you are animated. Weakening this one muscle with Botox often creates heaviness - this is an aha moment for many. Support your heavy forehead and brow vs immobilizing its only hope of being functional.

2. That new tightening device…
It doesn’t lift anything.

No matter what the branding says, there’s no laser, ultrasound, or RF device that repositions deep anatomy. Real lift = surgery.

Deflating and contracting your SMAS (a layer built to hydrate and glide) is crazy. Don’t do it.

3. Bad plastic surgery?…
It’s more likely bad filler.

More and more commonly I have patients who want to avoid the “bad plastic surgery“ that so and so had - most often they are actually seeing bad filler results and attributing it to surgery.

4. The goal isn’t to change your face…it’s to restore the one you had.
Rejuvenation not transformation.

My surgeries are not about transformation (changing you into something you never were), they are about rejuvenation - moving you back up your age and curve. The most powerful results are not the most “different” or dramatic ones. They are the results that give you back the look that matches how you feel inside.

5. Fillers don’t lift…
The more you chase lifting, the more unnatural you look.

Filler does not defy the laws of gravity. When fat pads descend, trying to add mass to magically levitate them back up with a gel or biostimulant leads to distortion.

Send these to someone who needs to hear these hard truths!

12/18/2025

Our neuroanatomy quite literally interprets Megan’s face differently now. Megan had 3 maxillofacial surgeries prior to me - a unique situation😮

Look at her forehead, brows, and upper lids, the hollowed “A frame“ changes, even on the lateral (side) views. The bony sub structure of her entire facial skeleton affected this, and I got to reposition her fat pads while structurally re-volumizing them with stem cell rich fat to create what is an entirely new presence and perception for her.

You can appreciate the long-term volume and contour correction that she will get to enjoy.

Megan’s prior maxillofacial surgeries were absolutely life-changing from a functional standpoint, but she noticed changes in the overlying facial fat pads, muscle, and skin that followed.

She noticed significant changes surrounding her eyes 👀

During surgery, I saw significant changes:

•Scar tissue in the deep fat compartments (from hardware placement and removal)

•Lower eyelid fat pad herniation

•Volume shifts due to movement of the facial skeleton

My job was to restore harmony between bone, muscle, fat, and skin.

Once her bony structure was in place, it was my time to reposition the overlying soft tissue to match.

Every plan I create is 100% customized. No face is the same, and Megan really exemplifies that after maxillofacial surgery.

More to come on Megan’s results! Follow her journey here👇🏻

What questions do you have about Megan’s procedure? Drop them in the comments!

Dr. Chesnut, EnigmaLift®️, eyelid surgery, upper bleph, scarless eyelid surgery, plastic surgeon

12/17/2025

Julie (53) 7 month follow up after a *full facial* (and even hip joint stem cell - see below) rejuvenation with my EnigmaLift®️ 🤩

Julie’s full facial EnigmaLift®️ rejuvenation =
-Invisible access brow support
-Upper lids *revision from previous surgery*
-Ptosis repair (bilateral* see below)
-Scarless lower eyelids
-Face and neck lift - deep plane preservation style (you can see the elevation and replacement of the deep structures of her neck: muscles, glands, etc)
-Stem cell rich fat transfer done my special way 😉
-My optimized laser cocktail
-Manual filler removal
-Stem cell hip injection using her own fat derived stem cells by .md

Her ptosis (droopiness) repair of her eyes is maybe one of the least dramatic or least obvious aspects of this outcome, yet one of the most powerful and most important to her and me, which we discussed beforehand . It was a very tricky to repair based off of some unique and very dynamic factors happening in her lower eyelids and her brow.

Achieving these types of results in her eyes is often overshadowed by what happens in her neck and jawline (especially in side-by-side before-and-after photos) - yet walking around in real life, this is what people are seeing!

As I asses our results at this time point, I look specifically along her jawline and neck. Over the past several years this has been an area that I analyze very closely to make sure that we are not over sculpting, over hollowing, and overdramatizing the neck and jawline angle in a way that looks age inappropriate and unnatural.

It’s subtle, but as is typical at this time point, if you look really closely you can often still see a hint swelling in some key areas, namely in the muscular structures of her neck. (Myositis) The healing process is approaching a stable state around this timeframe, where things start to really improve, redness continues to fade, and swelling continues to go down.

What do you think of her results so far?

Follow along her entire journey

Scarless surgery, neck lift, jawline contouring, facelift, browlift

12/16/2025

Can you tell what I did here? I believe this type of eyelid restoration is arguably one of the most restorative types I can do 🙌🏻

This is volume restoration of the upper eyelids. It is underappreciated, under performed, and very difficult to do!

This is a topic I lecture about at the international level, with a strong connection to eyelid surgery and old-school techniques that used to hollow out the upper eyelids😱

It’s rare that you see results of eyelid volume restoration, and it’s something that I love to do.

There are multiple techniques to perform it - most of those techniques are adjuncts to revise (fixi prior) “eyelid lifts” or old-school eyelid surgery.

I find this is an often underappreciated part of the revision.

In her full face photo, you may also notice the improvement of volume throughout her entire face, especially around her mouth - which complements her eyes and changes the subtle undertones in how your neuroanatomy interprets her face, her emotion, and her nonverbal communication.

What do you think of her results?👇🏼

Dr. Cameron Chesnut, Clinic 5C, Scarless Eyelid surgery, upper bleph, upper eyelid surgery

12/14/2025

4 hills I’m willing to die on as a facial plastic surgeon ⛰️👇🏼

These positions are forged from years of operating, revising complex cases, studying facial anatomy from the inside, and watching where the misdirection of the aesthetic industry.

1. Fillers DO NOT lift.

They blanket. They add volume. They cannot reposition descended anatomy. Gravity still wins, no matter how good the marketing sounds.

2. Most “skin-tightening” devices are oversold.

Heat and hope is not a strategy. These technologies have a role in improving skin quality, NOT as a replacement for structure, anatomy, or true lifting. Marketing has blurred that line far beyond what both the data and real life results actually support.

3. More filler is almost never the answer.

I see it all the time, filler caused an issue and the provider’s solution for their patient is to add more filler. This is where perception drift begins. Small additions feel subtle at first, until contours, light reflection, facial expression, and facial identity slowly change. Most of the “off” faces people instinctively recognize started with the belief that a little more would fix it.

4. You should prepare for surgery like an athlete prepares for competition.

Training, mindset, recovery, sleep, nutrition, inflammation control, and metabolic health all matter. Surgery is a physiologic stress, and outcomes improve dramatically when patients are prepared, not just scheduled.

*Fun fact = add visualization to this list, and it’s the same way that I prepare to be at peak performance for your surgery.

This mindset is the foundation of my practice: durable, natural, regenerative results - thinking in decades and using as minimally of invasive of techniques as possible with an absolute next level vision of your whole human outcome both before and after your surgery.

Which one do you agree with most?
Drop a comment below and let’s talk. 👇🏼

12/13/2025

DO NOT have “eyelid surgery” or an “eyelid lift!”

I said this in yesterday’s video and had some interesting responses. 🤔 Julie (53) is a perfect example of what I’m talking about - she had an upper eyelid surgery as a “eyelid lift“ shortly before she saw me and ultimately achieved these results.

What do you think her eyelid results went from:
4-6 out of 10 to maybe 9-10 out of 10? 40%-ish result to 90+%-ish result? This is what I see often.

She actually says that her lids were quite a bit “better“ (or maybe just different IMO) after her previous surgery, yet you can certainly see that there’s was still massive room for improvement.

I see this often, and I read it a lot yesterday in the video 💬 - where somebody had a previous lid surgery and they say it’s much better than it was before, very similar to Julie here…

My strong, and very result-supported opinion as to why:

1 - “different“ is often interpreted as “better.” I always encourage people to look and think critically, as this can become problematic when people chase “dramatic” to emphasize different

2 - there is a partial improvement from the procedure they had, yet the results certainly leave something on the table. Often times, I find that patients don’t even know what was left on the table, that they have an incomplete result, and they don’t have a full comprehension of what was possible or what natural, quality results look like. This was Julie‘s situation until she looks critically.

3 - post decision rationalization 🧠 also called cognitive dissonance reduction. When somebody already had eyelid surgery and made this important and costly, identity relevant decision, any information conflicting with this decision creates a psychological discomfort, and most will defend the choice instead of reevaluating it. This is a classic human cognitive bias (I love to nerd out on human thought models).

Julie’s results here should provide some simple encouragement to stay open minded and curious, just like she did.

Want to hear Julie’s procedure plan? Tell me in the comments!

Follow along her entire journey

12/11/2025

How do you take an already beautiful face and enhance it?

This is one of my greatest and most frequent challenges, and here we see a perfect example of that challenge.

Notice the eased strain in her forehead. The more satisfied and content look in her eyes with softer contours. Tune into the soft and smooth contours around her mouth and chin, where she was previously contracted.

Before she looked uneasy, displeased, with a touch of angst and a harshness. Even the qualitative improvements in her fat pad structure and skin surface communicate her internal health better.

Yes, she was undoubtedly beautiful before, just as she is after, but these subtle nuances carry the code to improve improvement without changing who she is.

I leverage a heavy knowledge of our neuroanatomy and how our brains process faces, interpret expressions, decipher age, health and vitality, and ultimately how we judge beauty.

Her subtle and beautiful results came with my EnigmaLift®️.

Her primary goal was to haven a 💯🥷 stealth outcome.

Let me help you see what to look for:

We reshaped the brow fat pad and perked laterally while taking tension off of her forehead to reduce wrinkles.

An upper eyelid restructuring with fat pad transposition restored a crisp, even shape and volume to her upper lids.

A scarless lower eye bag removal with fat pad transposition utilized her pre-existing, stem cell rich fat pads to simultaneously reduce her eyebags, eliminate her tear trough, and blur the transition from lid to cheek.

My stem cell rich fat transfer volumized multiple areas of her face, subtly, to add strength and structure to her temples, cheek, lower face, jawline, around her mouth and smile lines.

I used some of this stem cell rich fat directly to regenerate the structural quality of her skin.

My customized cocktail of lasers alsi restructured and strengthened her skin, reduced wrinkles and evened out pigmentary discrepancies.

What do you think of her results? Tell me in the comments 🤗

12/10/2025

Far from a “stupid line,” this one is going to ruffle feathers across multiple fields 😳

Fillers are the seed oils of the beauty industry 🫢

I’m not saying all fillers are bad, nor that you must avoid every omega-6 fat. I’m saying you should be curious and discerning about both, because the literature has not kept up with what happens in the real world.

Both were introduced with simple promises: harmless, easy, low-risk fixes that fit neatly into a marketing narrative. Neither has been used or consumed the way it was originally studied.

Filler research focused on small volumes, focal areas, and short timelines. Real life looks nothing like that. We now see years of layered injections, mixed rheologies, off-label locations, and high cumulative volumes. The emerging literature now reflects what I routinely find during EnigmaLift® procedures: old filler sitting in planes it was never intended to occupy, persisting for years, migrating, reactivating, and subtly distorting the micro-anatomy that influences identity, symmetry, and emotional communication.

Seed oils follow a similar pattern. Nutrition studies often examine omega-6 intake in controlled settings at far lower percentages than what exists in today’s ultra-processed food environment. Whole-food omega-6 intake is not the same as a diet where 15–20% of calories come from highly refined, repeatedly heated oils. Quality and quantity matter in physiology just like they matter in facial anatomy.

Most people are told filler lasts 6–12 months. New data and surgical experience show otherwise, which the industry is finally beginning to acknowledge. Similar shifts are happening with seed-oil research as we learn more about oxidation products, membrane integration, endothelial effects, oxylipin signaling, and low-grade inflammation.

My approach restores structure, contour, and tissue health using regenerative principles so the face looks refreshed while remaining unmistakably you.

What questions do you have about filler longevity, migration, or removal?

Drop them below 👇🏼

12/09/2025

Most people don’t know this, so they don’t even think about it - not all anesthesia for surgery is the same.

The differences in anesthesia carry significant implications for your neurocognitive function. 🧠

The drugs we choose, how they are combined, the route we use, the dose, the physiologic environment we create during surgery - these factors can determine whether you bounce back quickly, or whether you don’t quite feel the same afterward.

Post-operative cognitive dysfunction (POCD) - often called brain fog - is not random, it is not mysterious, and it is avoidable.

POCD the significantly more frequent and severe with some of the most common anesthetic agents. There are better options.

I use dexmedetomidine for its neuroprotective, anti-inflammatory properties and its remarkable ability to restore the architecture of sleep rather than fragment it.

I use low-dose ketamine (the dose is wildly important) strategically for NMDA modulation, BDNF support, and cognitive resilience.

I avoid benzodiazepines and opioids because they worsen neuroinflammation, impair memory consolidation, and prolong cognitive recovery.

I design the entire metabolic environment my surgical anesthesia around the brain - this includes ketones, electrolytes, hydration oxygenation, detoxification pathways - to protect it from the physiologic stress of anesthesia.

We all have a cognitive reserve, and traditional anesthesia can draw too much from it. At 45, you may only feel it temporarily. At 65, you might notice it lingering. At 85, a bout of anesthesia can push you over the edge of your reserve - without a full recovery.

I work to make you look rejuvenated and refreshed, more energetic and vibrant. I want to protect your brain while we do it so that you can continue to match that look!

Dive into my entire conversation with to learn more 🎧

Questions? ask them below👇🏼🔥

12/09/2025

Neck liposuction? Kybella? Your neck is NOT aging because you have too much superficial fat! 🙅🏻‍♂️

Your neck is aging because of laxity and descent of the deep structures of your neck.

This means that the large majority of people are NOT great candidates for superficial procedures like liposuction or Kybella that focus on the fatty layer right under the skin.

This fatty layer right under the skin is wildly important to a normal neck contour.

It needs to be maintained, while the deep structures are the neck are elevated for proper contouring.

Far too often, I see people who have significantly abnormal contour regularity in their neck from these types of liposuction procedures.

Not only was it the wrong procedure for them in the first place, but by removing that layer of fat under the skin, it also exposes the underlying structures even more (as this young woman mentions about the two muscular bands, often looking very bizarre and prematurely aged.

I spend a great deal of time correcting this type of issue, and it can be a great challenge. The anatomy is disrupted, and there is often significant scarring from those seemingly minimal procedures.

In general, I get very hesitant when anybody is talking about taking fat out of their face, or in this case the neck.

That fat is valuable, it’s gold, and often it is not the main culprit as to the aging changes that are happening.

Have you seen this? What do you think? Tell me below!

12/07/2025

Long-term follow results after full facial rejuvenation with my EnigmaLift®️ for this next level surgeon in her own right!

Melissa and I took a thorough, yet minimal access plan to address the specific and unique point SHE was at in HER aging - nothing cookie cutter here. She told me to do what I thought was best, with the underlying goal of rejuvenating and keeping a natural look.

For her, that meant:

☝🏻EnigmaLift®️ minimal access, deep plane extended facelift with deep neck contouring and lift - this is what many people would call a “mini lift,” which for me is a smaller version of the lift that I typically perform, still with appropriate release. ***Overall, it pains me to say the name mini lift, as I don’t agree with that classification, as the nomenclature is poor, and most of the time it’s a hot garbage title utilized for marketing.
I digress…

✌🏻 EnigmaLift®️ temple and forehead repositioning + upper eyelid surgery with medial fat pad transposition + ptosis repair

🤟🏻 EnigmaLift®️ scarless lower eyebag removal with fat repositioning and midface lifting (not all eyelid surgeries are created equal, these are important and complex nuances!)

👊🏻 Stem cell rich optimized fat transfer

✋🏻 Customized laser cocktail

I am honored to have been trusted by a colleague! As she entered her 50s, Melissa had multiple procedural options and roads that she could have gone down, we had to discuss and choose our plan carefully - I think her results back up that trust and support our choice of trusting the right procedural combination!

Melissa is a fellowship trained eye surgeon, an ophthalmologist with extra training in a surgical subspecialty. She mostly lives in Scottsdale, Arizona, and I am grateful that she made the trip to come see me!

Melissa was in a very good spot on her aging curve, and we had multiple options to talk about during her consultation, including utilizing my Invisible Access EnigmaLift®️ to address some of the aging changes along her midface and jawline.

What do you think of her results? Tell me in the comments!

Chesnut MD Cosmetics

12/20/2025

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