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

04/04/2026

Illuminated by the hyperbaric chamber at 5:30AM every morning before surgery…

This is the first part of my preoperative flow state entry routine, and here are the ideas you can take from this for your own life.

I don’t use caffeine, I don’t use ni****ne (I don’t want any part of my performance to be reliant on a substance or a nootropic). Instead, I’ve built this reliable framework to achieve the elusive flow state, and I’ve been perfecting it over the past 12 years.

This is all aimed at achieving a state of peak performance, every single surgery.

Flow state is a neurocognitive and physiologic state that is hard to access, energetically expensive to sustain, and requires a great deal of recovery afterwards.

Getting into flow requires a steadiness in your emotional regulation as well as your nervous system physiology, which the chamber is beautiful for. Flow also requires the perfect calibration of arousal and a clarity in your purpose. All of those happen here.

My life essentially revolves around being ready for peak performance in these key moments. What I eat, when I eat, when I sleep, how I sleep, my emotional output, my cognitive load, my physical training - all of it is upstream of my capacity to get into this state reliably.

The first stage of my routine is spending time in the hyperbaric chamber. This is one of the same chambers that my patients use during their own recovery protocol, which is a fun connection.

At this depth of preparation, the hyperbaric chamber becomes something close to sensory deprivation, and I’m using that window to finish the weeks of procedural visualization I’ve been building around the specific anatomy unique to every single patient, and I review every decision I’m going to make once I’m operating that day.

By the time I walk into the OR, I’ve already invested weeks of thought and planning into each patient.

Part 2 of my routine gets me prepped in a very similar way.

Guess what it is in the comments and I’ll reveal it soon 👀👇🏼

Hint: 🔴🌡️🧖🏻

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natural results facelift, natural facelift surgeon, best natural facelift surgeon, natural looking facelift, fac

04/03/2026

2 year follow up for Yasi (45), after a mix of SCARLESS revision and Invisible Access EnigmaLift®️ procedures to address her eyes, lips, face and neck - including filler removal.

Yasi DOES NOT HAVE EVEN ONE scar or access point anywhere on her face 🤗

She did have a prior lip lift, before me, and part of our procedure was meant to blend the asymmetries and abnormalities created by that isolated lip lift into a more natural outcome.

Yasi is a multinational colleague of mine 🇪🇸🇺🇸 and I am so grateful for her trust, and so proud of where she is two years out.

Before surgery she had all the typical questions about being young, beautiful at baseline, and many thinking that she didn’t need anything done.

Two years down the line, and two years older, Yasi feels better, looks better, and has a sense of cohesiveness between those two that she was losing with her prior filler.

You can follow her entire journey at

Technical time 🤓

The first thing you’ll notice (thanks to your temporal lobe 🧠) is Yasi’s eyes. We significantly opened the aperture and improved the symmetry of her eyes to provide more brightness, more fullness to her upper eyelids, and to restore the three dimensional contour of her brow and upper lid.

We overall wanted to take her eyes from bordering on dull and tired to being bright and full of life - reflecting the curiosity that helps define her! (this is one of the first things I noticed about her personality)

Again, there are no incisions on her eyelid to achieve this.

I will also encourage you to take a look further down the rest of her face, jawline, and neck. You can see the fat pad elevation, the improved contours, the improved shadows, and the correction of the masculinization that filler had given her in these areas - with the restoration of her soft, feminine features and facial shape holding beautifully at two years. *This filler masculinization is underappreciated and under talked about, in my opinion.

Two years. No scars. No signs. Just her 🙌🏼

There’s always a lot to say when it’s a younger patient - let me know your thoughts in the comments below! 👇🏻

04/02/2026

I start proactively working with my patients towards better results from their procedure for weeks to months before we ever take a step towards the operating room.

This process is a little bit different for everybody depending on where their baseline is at, and I’m grateful that many of my patients are already doing most of the things they need to optimize their health before we start, so they are often very familiar with all of these strategies.

This all comes from my athlete’s mindset that I use for both myself and for you in your surgical preparation and recovery. The better we can be going in, the faster your recovery and the your results are!

This is overall a very atypical mindset. My patients take a great deal of comfort knowing that I am thinking about them for weeks before their procedure.

In the six(ish) weeks leading into surgery, I’m also putting my patients on targeted supplement protocols, cleaning up the oils they’re cooking with, addressing inflammatory inputs, and optimizing their metabolic environment from the inside out 💊

Here I’m asking stem cell expert .md about whether that process also improves their stem cell quality.

I often tell my patients that I can control the quantity of these cells, but what I cannot do is determine the quality. The biology you walk in with is the biology we’re working with.

I asked Dr. Meadows whether this preoperative optimization actually changes stem cell function and he confirmed exactly what I’ve been doing.

Stem cells thrive in healthy environments and underperform in toxic ones. Every positive change you make to your overall health in the weeks before surgery directly improves the function of the stem cells already living inside you.

The protocol isn’t arbitrary, and every inflammatory oil eliminated, every supplement added, every metabolic lever pulled in those six weeks is reflected in what those cells are capable of doing inside your face after surgery.

If you want to watch or listen to the full conversation on with Dr. Meadows, use the link in my bio 🔗

04/01/2026

KEEP 3 CUT 3…for procedures on the face 👇🏻

I think you’ll be very surprised by the fate of at least one in here 👀

Do you agree with me?

What would you add to the list? Drop it in the comments!

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03/31/2026

Red light therapy was once called “BOGUS” by a key opinion leader in the light and laser space…

Man was he wrong, a bit behind this time, and that single label quietly stalled the entire field for years 🤐

Back in the early 2000s, a leading researcher presented red light findings at a major medical conference. The next speaker - one of the most influential figures in photomedicine - put up a slide calling it bogus science.

Just like that, high-quality studies stopped getting published (even though they certainly should have). The field went quiet for years.

It’s wild looking back on that today, where we now have thousands of studies on medical applications of red light and near infrared light, including Grade 1A (the highest) medical evidence for area is in the cosmetic wheelhouse, like skin and hair.

Red light isn’t bogus anymore, and it never truly was.

This is a prime example to me of the medical literature often taking a decade or two to catch up to what clinical practice is showing. It’s also a wild example of group thinkers behind a key opinion leader, were the critical thinkers lose sometimes, unfortunately.

Here’s how photobiomodulation works ⚙️

Red and near-infrared light pe*****te tissue, interacts with your mitochondria (via cytochrome C oxidation in the electron transport chain), and boost cellular energy (ATP). More energy available means better healing, faster recovery, and even improved performance.

This helps with muscle and joint recovery, skin health and collagen production, post-surgery healing and inflammatory modulation.

It’s an incredible example of how tuned our bodies are to react with light in various ways, from our eyes to our skin to our brain.

Sunlight is a key example of this too, and I definitely swim upstream in my field a bit talking about the benefits of strategically timed sunlight versus simply hiding from it.

This was one of my favorite topics to focus in on for the We covered the backstory, the science, the devices, and how I personally apply this in my own life and with my patients preparing for surgery.

Watch or listen to the full episode using the link in bio 🔗

03/29/2026

Neck lift? 0% chances of success with the treatments she’s had. Some situations just cannot be fixed with non-surgical devices, threads, or filler.

This is certainly the case for today’s patient who is 56, joining us from Southern California - and she’s a CHALLENGING surgical neck case that many surgeons would avoid 🙅🏻‍♂️

She has a small chin, a severely obtuse neck angle, and major soft tissue descent with a very low hyoid position (anatomically = 3 strikes).

To boot, her neck has been made worse by years of non-surgical attempts that were never going to work in the first place.

Back to that 0% chance… Kybella + Threads + Filler + Ultrasound Lifting + RF Microneedling = She’s tried it all.

She really needed true muscular support and proper soft tissue repositioning the whole time, otherwise her lower face and neck would just keep falling 📉

She serves as a perfect example of how certain patients become more challenging surgical candidates because of repeated non-surgical interventions that disrupt tissue planes and impair vascularity during healing.

*My optimized recovery protocol becomes especially useful in these types of situations, helping to offset the microvascular insufficiency*

Now we’re going to do what those approaches never could:

Restore structure + Rebuild anatomy + Reposition the entire substructure of the neck through true deep plane elevation.

This will give her what I would argue is the most “natural“ result possible, while also being quite stunning, because this is what her anatomy ACTUALLY needed all along.

I cannot wait to show you her results! 🙌🏼

Hint: they are already 🔥🔥🔥

What questions do you have about her procedure? Ask me below!👇🏼

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03/27/2026

The sandbox of plastic surgery when it comes to the face: Multiple specialty areas practice in this landscape, all with different core backgrounds and training routes, and some with their own thought biases.

It certainly hasn’t traditionally been a friendly environment with specialties seeking to understand one another (typical behavior for a sandbox). The history of the relatively recent battles in the space are fascinating, still felt, and ongoing at the low levels.

The good news is, results are starting to outweigh titles, and the best in the field have created a spirit of collaboration and innovation amongst all of the different training backgrounds!

I call this “cross pollinating,” a term I borrowed from our chief of plastic surgery at UCLA when I was training with him.

It is an exciting time in the history and evolution of facial surgery. Because of this spirit of collaboration at the top, the field is advancing faster than ever, no doubt about it. I explain all about how facelifting and eyelid surgery have benefited from that cross pollination in here!

In this video I also break down:
• the landscape of the “core four” and the training necessities for each
• fellowship training, quality, and quantity via case volume
• how different specialties have helped shape the modern practices of plastic surgery on the face
• my training pathway as an integrated alloy of the core four
• the key facets to 12 years of building my practice focused exclusively on the face (hint: it’s built solely on results)
• the evolution (and battle story) of facial plastic surgery and oculoplastic surgery
• how both surgeons and patients often reveal their identity structures, bias, and insecurities by what they choose to value and prioritize - training pathways vs outcomes

At a certain point, results become self-evident, and that mindset is taking the lead amongst the most thoughtful and progressive surgeons in the field.

I am so grateful for my colleagues at the top, for their support, for my patients, for the core four collaboration, and for this beautiful specialty and craft that I have gotten to obsess over for the past 12 years!

(Continued i

03/26/2026

2.5 and 3 month (swipe 👉🏻 to see both) sent from
Canada 🇨🇦 after a full upper and lower eyelid EnigmaLift®️ rejuvenation for Anna (59).

Our key to helping Anna look the way that she feels was restoring symmetry and structure to her eyelids.

She’s looking vibrant and energetic after; we nailed matching that to her bubbly personality.

For the technical details:
🔹 Her left eye was slightly smaller due to mild eyelid and brow ptosis, which made her look more tired. We beautifully corrected that for a brighter, more symmetric and awake look.

🔹 The outside corners of her brows had descended slightly over time due to fat pad shifting (the ROOF fat pad). We also addressed that for a subtle, natural refresh.

For Anna’s lower lids and midface, our key focus was long term improvement and stability of her lower lids as she moves through the aging process 👇🏼

🔹 Recognizing the location of prior filler and managing it. That meant we removed some of her previous filler and replaced it with her own stem cell rich fat.

🔹 I evened the symmetry, positioning, and structural stability of her lower eyelid margins.

This is what my eyelid and brow rejuvenation are all about: making sure the results are balanced, symmetric, bright, energetic, and true to YOU.

I want what you to interface with the world in a way that matches how you feel on the inside!

How did I do? Let me know in the comments below 👇🏻

Follow along for her journey and drop any questions below!

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03/25/2026

Japanese ski lunch with a very specific purpose 🇯🇵🎿🍱

This is natto, a traditional fermented soybean dish made with a very specific bacillus bacteria, and those little spider web strings you see are actually a perfect example of a biofilm in action.

It also contains an enzyme called nattokinase, which is part of the supplements I have my patients eat before and after surgery as part of my regenerative medicine protocol🧠

Before surgery it helps with stem cell mobilization via the microvascular circulation, essentially getting those stem cells delivered exactly where they need to go. After surgery it helps those tiny blood vessels repair and recover more efficiently.

This is an ancient fermented food meeting a very modern clinical application.

Nattokinase is very interesting and challenging to eat! Worth it 😂

Do you incorporate any fermented foods into your routine?

Tell me in the comments!

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03/24/2026

The strong historical and emerging data behind red light therapy serve as such a perfect example of this idea - the medical literature often takes decades to catch up to what is happening in clinical practice.

We now know that red light therapy is directly influencing how your brain functions 🧠

I have known this on some level for years as I’ve used it in preparing for every surgery I’ve done, and it’s incredible to see a cross pollination of literature for multiple medical specialties pooling together to define what is happening.

Something as simple as sitting in front of a red light (and near infrared light) can impact neurocognition, mood, and overall mental performance.

From increased nitric oxide production to improved mitochondrial activity (cytochrome c oxidase), the effects go far beyond what most people expect.

There’s also growing evidence that red light can pe*****te through the skull and interact with brain tissue itself, helping explain improvements in focus, anxiety, and depressive symptoms. You can listen to this podcast to see how this is even being used in neonates.

If you’ve only thought about red light in the context of recovery or aesthetics, this conversation will add a significant amount of depth and change how you understand and use it.

Watch or listen to the full episode using the link in my bio! 🔗

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03/24/2026

Two month 🤯 Cory (52) checking in from home after traveling from the Midwest for her invisible access EnigmaLift®️.

At this stage, what matters most is not a dramatic reveal. It is creating alignment. She is already looking in the mirror and seeing a face that matches her energy, presence, and the way she moves through the world.

Our plan for Cory was intentionally minimal when viewed piece by piece, yet comprehensive in the balance it restores. Everything was addressed without anything being overdone, utilizing my invisible access EnigmaLift®️ approach, meaning no incisions in front of the ears like a traditional facelift and no surface-level pulling to chase short-term change.

Her story is very typical of the high-performing women I work with. She did not come in looking for a shortcut. She trains consistently, eats well, protects her sleep, and pays attention to recovery and metabolic health. Her baseline is strong, which matters, because the face always reflects the underlying physiology and the way someone lives.

What she began to notice over time is something many fit women experience: gradual hollowing, subtle descent, and a mismatch between how vital they feel internally and what they see externally.

Looking back at photos, she realized that repeated filler and Sculptra had not solved the problem she was trying to solve. Her face felt puffy. She did not quite feel like herself. This is often a window into the neuroanatomy of facial recognition and identity, where small distortions in contour and light reflection can disrupt the way we recognize our own baseline. None of her prior treatments were “wrong,” yet none of them addressed the deeper structural changes that occur with time.

My goal is always simple: help patients look the way they feel, especially when they are already doing everything right.

This is why Cory chose me, and this is why I am so intentional with every step of her plan.

More to come on her journey. Follow along here 👉🏻

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