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

11/13/2025

EnigmaLift®️ SCARLESS lower eyebag removal 🤯

I am constantly innovating to improve the results I deliver, and my triple fat pad fixation technique has been a perfect example of that.

This is part of my EnigmaLift®️ approach that involves repositioning the fat of the lower eyelid bag, repositioning the fat pads of the cheek + mid face, optimizing the fat pad volume and structure with stem cell rich fat transfer, and optimizing the skin quality with my my laser cocktail⚡️

All of this - quite literally - without one visible incision.

I love this combination as it does an incredible job of addressing both the quantitative (the anatomic soft tissue changes) and the qualitative aspects that lead to some of the surface changes, such as dark or purple bags.

Look at the lateral views to get a nice sense of what the midface lift accomplishes, and its importance to the interaction of the cheek and the lower eyelid.

The proprietary triple fat pad fixation technique is an example of my continuous innovation within my craft.

These innovations are integral parts of my EnigmaLift®️, helping me continually deliver better and better results.

The end product is an EnigmaLift®️ procedure that is performed in a way that significantly differs from traditional surgical methods.

Looking at this through a scarless lens, the initiation hurdle, the relative “cost“ of the procedure, and the value proposition of what you put in versus what you get out becomes so positively skewed by this beautiful and durable result.

This mindset aligns perfectly to my own personal mission, goals, and values. Constantly thinking, constantly improving, constantly innovating in micro evolutions.

What do you think of her results?

WELCOME TO THE NEXT LEVEL®️

Dr. Chesnut, EnigmaLift®️, Eyebags, dark circles

11/11/2025

I came to realize that nearly everything in the operating room was plastic, and my brain immediately went to microplastics and the burden that they can have on our cellular function.

The IV bags.
The tubing.
The drapes.
All soft plastic.

Every one of them also filled with phthalates and compounds designed for price and convenience, not compatible with human biology.

One of those phthalates, DHEP, is known to be present in these IV supplies, known to be harmful when kids get exposed to it over long periods of time, and it’s not legal for use in Europe…

The roughest realization, was that all of these would be entering my patients at their most vulnerable moment… while they are actively healing.

I asked myself the question I always come back to:

Would I want that running into my own veins?
The answer was no.

I did a deep dive into what we were using, I found the key spots, and we immediately started removing. Not using the supplies we had until they were gone, no delay, we did it immediately.

I started changing it, piece by piece.
Removing the specific plastics, the coatings, the disposables.

I found better alternatives, even when they were harder to source and more expensive to use.

I am so hyper focused on healing, I couldn’t ignore what we were putting in the body while it heals.

Micro plastics are detrimental to all types of cellular function, and all areas of our body, and I knew that it could affect healing.

The environment matters. The materials matter. The details matter.

For me, the commitment to my patients is simple:

Take the toxins out, even in the operating room, optimize cellular function and healing! This is what I would want, just like my benzodiazepine free, opioid free anesthesia protocol that minimizes neuroinflammation.

It was labor intensive, it was expensive, it was a deep dive into that rabbit hole, but in the end it was very much worth it!

Check out my full conversation with on Spotify or YouTube!

11/10/2025

Controversies in biostimulators…

Here is a summary from the panel of experts that we compiled at the American Academy of Facial Plastic and Reconstructive Surgery Annual Meeting ( ) with some of my favorite colleagues.

🚨Important note - not all bios stimulators are “bad.” I say that in here several times. There are controversies around them because people misunderstand them.

Also important - here I’m reflecting the ideas of an expert panel, sharing that important information, these are not all my own, and I did not agree with everything that was said on this expert panel.

To this group’s credit, it did gather to tackle one of the most controversial topics in aesthetics - biostimulators - this includes things like poly-L-lactic acid (Sculptra) and Calcium Hydroxyapatite (Radiesse).

Here were the takeaways:

Biostimulators do affect future surgery. That doesn’t mean they’re “bad” or that you cannot have surgery later - but it’s naïve to believe they leave no trace and do not affect results. This is coming from some of the best facelift surgeons in the world.

Some companies definitely do not want physicians saying it, and they take aggressive tactics to prevent it - multiple panelists had received legal threats via unfounded cease-and-desist letters from one particular company.

This panel was directed from surgeons to other surgical colleagues - not to scare anyone, but to educate the surgeons and injectors on what is actually happening in real life in the the face when these products are injected, with a direct link to what we are seeing in the operating room.

The truth, as always, lives somewhere in the middle with me - and it’s our job to find that balance, which was the goal of this panel!

Have you heard any of these claims about biostimulators before? Have you experienced it first-hand?

Please contribute to the conversation 👇🏻

11/09/2025

“I don’t want to look like [Celebrity Name].”

Bad plastic surgery? I have seen an absolutely undeniable and interesting trend in my practice over the last decade.

10+ years ago, when people said this, it was actually bad plastic surgery.

When people point to celebrities (or friends) and say, “I don’t want to look like that” NOW - they most often are referencing (at least in part) the effects of FILLER, not surgery.

The celebrity you’re thinking of… yep, them too.

This nicely parallels the rise in use of fillers during that same time frame. *Interestingly, this meteoric rise appears to be flattening.

Here is why the role of filler is under appreciated in these results that people are trying to avoid:

Filler can last decades, even the “temporary” kinds that providers (and patients) are being taught last 6–12 months, or even 24+ months, some may never go away.

Through years in the OR, I’ve seen it firsthand innumerable times, and I’ve seen it evolve over time.

I see filler that’s been dissolved multiple times, but is still very much present in the tissue.

I see filler that disrupts the lymphatic system - with evidence to unquestionably confirm this.

I see filler that has been bioactive, has caused inflammation, sometimes with the creation of a capsule around the filler (think breast implants). This idea is also supported by the fact that filler can become inflamed when someone gets a cold, dental work, or even a vaccination - even years later, the filler is recognized by the immune system.

These are not “rare” situations. They’re weekly occurrences in my world.

Back to the main idea here - the biggest issue is not just physical - it is perceptual and neuroanatomical 🧠.

This “bad plastic surgery” mixup shows the powerful effect that something like filler can have on our facial perception!

The solution is NOT to panic, fear and avoid intervention.

It’s to first understand, and second evolve how we approach the face.

What questions do you have? Ask me below!

11/07/2025

Upper eyelid results require contour, balance, and proportion - these are key aspect of youthful upper eyelids.

Recognizing this is hardwired into our neuroanatomy 🧠 yet it is very underappreciated and under addressed.

I often lecture about aspects of this exact topic - including this week at and recently at our national Facial Plastics meeting

There are numerous ways to optimize upper eyelid volume both with surgery and sometimes with non-surgical options.

Leveraging a knowledge of neuroanatomy, we were aiming to improve symmetry, soften with a youthful contour.

This type of a mindset significantly increases the longevity and long-term results of upper eyelid surgery.

Historically, this has been ignored, which hollowed out the upper eyelids and contributed to a more aged look in the years after an upper eyelid surgery.

Surgical options are broad and require a deep understanding of root cause - with ptosis repair to even up the symmetry and open the aperture, flowing to volume restoration with vascularized fat pad repositioning, free fat grafts, fat transfer, and even my own proprietary mechanism of utilizing temporal fascia - choosing the right combination and the right amount is key to creating upper eyelid results like this! 🙌🏼🙌🏼

What do you think of her results?

How does she resonate with your neuroanatomic circuitry? 🧠

WELCOME TO THE NEXT LEVEL ®

Dr. Cameron Chesnut, scarless eyelid surgery, eyelid volume, endoscopic facelift, Clinic 5C

11/05/2025

Most people think of creatine as a muscle supplement…

Interestingly creatine is a key part of our metabolic currency, being present naturally in many animal based products (fun fact, the richest natural source is herring 🐟).

Creatine is quite literally one of the varied fuel sources our bodies can utilize - making it a key part of our metabolic flexibility (think glucose and ketones also).

+ It increases ATP production: energy for your cells, not just your muscles.

+ It supports neuroprotection: reducing postoperative brain fog and improving cognitive recovery.

+ It protects against postoperative cognitive dysfunction (POCD) and speeds wake-up times.

+ It preserves muscle mass during the postoperative downtime when you can’t train.

+ It even enhances skin and soft-tissue healing by energizing fibroblasts for collagen and elastin repair.

I start my patients on creatine in the preoperative phase and keep them on it through recovery - just like I do for myself.

This has been an interesting phenomenon over the past 10+ years, where I used to see only about 10% of my patients (especially female) on creatine.

Recently (even over the past 18 months) that’s changed to be closer to 90% of my patients on creatine before I ever meet them - which allows us to focus on optimizing their dose.

Surgery is both a physical stress and a metabolic event, and creatine fuels brain, muscle, and facial soft tissues to recover.

WELCOME TO THE NEXT LEVEL®️

Dr. Chesnut, creatine, creatine before surgery, EnigmaLift®️, scarless surgery, endoscopic surgery

11/04/2025

2.5 year bright and beautiful results for Denise (42) from Chicago after my minimally invasive EnigmaLift®️.

As is my signature - there’s quite literally not a single scar you can see on her to attain this result.

We focused on the interface of her upper eyelids and brow to correct her ptosis and asymmetry, brightening the aperture of her eyes and bringing more life and vitality back to them. This was a strongly genetic predisposition for her.

The way her upper lids reflect light has quite literally now changed, resulting in that sparkle that we automatically associate with energy, youth, and being well rested.

We also corrected her lower eyelid bags and tear trough hollows by repositioning and re-structuring her fat pads using a scarless approach and regenerative medicine. This was also strongly genetic.

You can hear the entire explanation in our pre-operative discussion

In the end, her outcome is beautiful, her procedures were incredibly minimally invasive, and she will have a very natural and incredibly long-term result from this new baseline!

What do you think of her results?

Facial plastic surgeon, upper bleph, lower bleph, Dr. Cameron Chesnut, scarless eyelid surgery

11/02/2025

“People always give me compliments on how I look, but they don’t realize what I’ve done.“

Her results just keep getting better, and better!

18 month follow up from my EnigmaLift®️ facial rejuvenation finished with my stem cell rich
optimized fat transfer and a customized laser cocktail.

This result is most impressive to me because of the striking improvements in her eye and brow symmetry that give her a beautiful, natural look, where nobody would ever know that she had something done.

I think the beautiful nuance of this result is that on one side of her face, the forehead and brow fat pad position is slightly elevated creating a little bit more show of her upper eyelid (tarsal show) - while on the other side, the overall complex is actually relaxed a little bit to restore a natural position, volume, and contour (pay special attention to that part).

Can you tell which side is which when I say that?

I also corrected the subtle and asymmetric ptosis (drooping) that she had, which interestingly was one of the main drivers of the asymmetry that she had in her forehead.

She had been told by multiple others that in their opinion she did not have ptosis that needed to be corrected - in my opinion this was an absolute key component for her.

Here’s what the next level looks like.

This overall eyelid rejuvenation and symmetry correction were her main goals, and I think that we nailed it, as she looks incredibly refreshed and rejuvenated, but nobody knows!

Special note: ❤️ I love a long follow up, as most of my before and after photos are taken at 3-6 months for logistic reasons ✈️ as all of my patients travel.

We often follow up around the 3-6 month time point to comment and discuss the final stages of healing, and they are usually ready for after photos at that time.

Truth is: I’d much rather see everyone later, towards when final results are settling in, so I always am grateful when we get to do that in a situation like this!

What do you think of her results?

WELCOME TO THE NEXT LEVEL ®️

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

11/02/2025

Dear mama, thank you for making me a critical thinker. What 1970s nutrition and filler have in common…

I grew up with my mom as a registered dietitian/nutritionist, formally in scientifically trained in the 1970s. As I look back on it now, I realize she was very much a counterculture, critical thinker, way ahead of time.

At that time margarine was the thing, butter was terrible for you, and there was no question about it - my mom wasn’t buying that then, telling me that hydrogenated vegetable oils were not something we would be putting in our bodies.

That made her crazy, radical - not listening to what the “science“ was showing, not listening to her professional organizations, and certainly not listening to the food industries driving the products available (and in hindsight controlling the policies that were enabling them).

Turns out… The “science” from the industry, the professional organizations, and the pervasive thinking were NOT EVEN CLOSE.

When I really reflect on it, this feels a lot like where I live in my world with filler (and maybe even devices).

Echo chambers are everywhere. The science is driven by the industry, the industry drives pervasive thinking, and there’s a lack of critical thinking, even when abnormal outcomes, and filler are right in front of everybody’s eyes (literally).

My mom carried the same thinking with seed oils, how “big food“ was prioritizing profits over public health, teaching me about deceptive marketing practices, and all the conflicts of interest that she saw.

Some of these are still controversial nutrition topics today (seed oils). I certainly resonate with this, and I feel some of these controversies and small shifts happening in my world, but I also have no delusions, and I understand that some of these will be very well defined, as is already happening, while some of them will remain controversial topics for likely decades to come.

Thanks again Mom for teaching me to be a critical thinker early on, and showing me what it looks like to be observant, see what’s happening around you, and explore the reasons why.

10/31/2025

EnigmaLift®️ scarless eyelid rejuvenation 🙌🏼🤩 all about re-creating contours in a subtle fashion.

With a current trend of eyelid surgeries looking conspicuously overdone - including in men, women, and high-profile individuals - our objective was the opposite. We aimed to deliberately and meticulously avoid any sign of having had surgery.

This woman is a creative genius in her own right, and she was after a subtle, simple and minimally invasive way to improve what she felt were tired upper lids and lower eye bags.

I was focused on keeping things symmetrical, open, bright and smooth without changing the character of her eyes while using my minimally invasive and scarless techniques.

How do you think we did?

Curious about pricing or learning more about this procedure? Click the start your journey link in my bio!

Dr. Cameron Chesnut, Clinic 5C, Lower eye bags, eyebags treatment, dark circles treatment, scarless eyelid surgery

Chesnut MD Cosmetics

11/13/2025

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