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

01/23/2026

Starting recovery DURING the procedure via intraoperative metabolic optimization with red light photobiomodulation 🤯

This is the Next Level of surgical recovery 🔥

In surgery, we always use sequential compression devices. These squeeze venous blood through the legs to reduce clot risk and support healthy circulation while patients are under anesthesia.

I use the JetBoots Pro Plus, as they take that concept to the next level.

They deliver the same prophylactic compression we want intraoperatively, while simultaneously delivering red light therapy during the actual surgical procedure.

This is one of my methods to incorporate photobiomodulation in the operating room.

Patients are receiving the benefits of red and near-infrared light during their procedure - this is a critical time that I consider a purposeful metabolic stress. This is also all happening simultaneously with my my neurocognitively protective anesthesia protocol.

The red light has multiple benefits. It supports mitochondrial function, improves tissue oxygenation dynamics, and helps optimize the systemic metabolic environment during surgery itself.

Recovery does not have to wait until after the surgery. In this case the metabolic stress is addressed minute by minute during the procedure.

These are the kids of details that matter to me! My goals extend beyond just aesthetic improvement - I want better metabolic resilience, faster healing, and improved outcomes and long term results 🙌🏻

Thank you to Dr. Jason for your innovative spirit and Therabody for building tools that align with how I think about peak performance during surgery and optimized recovery for my patients 🤝🏻

More to come.

01/22/2026

Cory is 52 and traveled from the Midwest to see me 🙌🏻

Her story is very typical of my usual high performers - she did not come in looking for a shortcut. She eats well, trains consistently and pays attention to her sleep, recovery, and metabolic health. Her baseline is strong, which is so important, as the face unquestionably reflects our underlying metabolic health.

What Cory noticed over time is something many fit women experience with some facial hollowing and loss of gravitational support.

Looking back at her own photos, she realized that repeated filler and Sculptra had not solved the problem she was after. Her face felt puffy, and she didn’t feel like herself.

*This is a window into our own neuroanatomy of facial recognition and self identity that can be disrupted by filler.

None of her prior treatments were “wrong,” yet none of them fully addressed the root causes either.

This is the part of aging we cannot out-train, out sleep, or out work. Even when metabolic health improves tissue aging, gravity and structural descent still occur. With thinning fat pads and soft tissue qualitative changes, prior filler can also blur contours rather than restore them.

Our plan for Cory is intentionally minimal when looked at individually, yet comprehensive in the overall balance it will restore. Everything will be addressed without anything being overdone, utilizing my invisible access EnigmaLift®️ approach, meaning no incisions in front of the ears like a traditional facelift.

I hope is that this helps her look the way she feels! This is often my goal, and with all that hard work that she is putting in on her own, this is the reason Cory chose me 🤗

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

facelift, deep plane facelift, mini facelift, neck lift, face and neck lift, jawline surgery, facial rejuvenation surgery, anti-aging facial surgery, neck rejuvenation, lower face lift, jowl surgery, jawline contouring surgery, facial aging correction, facial tightening surgery, neck contouring surgery

01/21/2026

Not all beauty trends are created equal…👀👇🏻

What questions do you have? What should I rate next?

Send to someone who needs to see these!

Facial plastic surgeon, scarless surgery, beauty trends, facelift, plastic surgery, before and after, celebrity plastic surgery, rating, anti-aging

01/21/2026

Jessa (42) 1.5 years after my COMPLETELY SCARLESS 🤯 EnigmaLift®️ lower eyelid rejuvenation and SCARLESS ptosis repair!

Jessa has had lower eyelid bags almost her entire life, so this new look for her is incredible!

She had a strong genetic predisposition to these lower eyelid bags, as many patients do, and as I commonly see.

“I want my face to reflect what I feel like inside. My eyebags make me look tired, and I’m not tired. I’m actually really, really awake!”

I think we nailed it! 🙌🏼

This made her an incredible candidate for my COMPLETELY SCARLESS EnigmaLift®️ lower eyelid rejuvenation!

With this procedure, I was able to completely and three dimensionally reconstruct her midface fat pads, her lower eyelid bags, and use those to hide her eyesocket (orbital) rim and tear trough.

This one always blows my mind 🤯 with what is accomplished with zero visible access, zero scarring, zero evidence we were there.

I also focused on the qualitative aspects of Jessa’s aging utilizing the already mentioned regenerative medicine and her own stem cells!

She was out and about after one week and looked even better at two weeks. She took full advantage of my full optimized recovery protocol, including regenerative medicine, complete with her own stem cells! 🧬

Want to see more? Check out

What do you think of her results at the 1.5 year mark? Let me know below! 👇🏼

01/19/2026

“Scrotal” eyelids? 🤭- he told me this the first time we met, and I still laugh about it. He described them well… Our procedure together was the kick off for an overall metabolic health journey for him, which I LOVE being a part of.

This is a common situation for me, where this procedure with me is the demonstrative start to an overall health journey 🚀🚀

(I wish I could post his “before and after” lab values as well to reflect his metabolic health)

I’ve had many patients over the years where their entire health trajectory changed when viewing life through a long-term longevity and healthspan lens because of their procedure with me - he may be the greatest example.

His skin quality was EXTREMELY poor, as you can see here, due to a lifetime of smoking, sun damage, and metabolic stress.

His elastin fibers were completely destroyed.

There was some tough decision making to be done here, and I can imagine you’ll see that reflected in the comments.

If I did too much, I could completely change his look and the personality of his eyes, while creating a mismatch with the rest of his face.

And likely get 👉🏻 “He looks different.”

If I did too little, I would leave a bunch of improvement on the table.

“He still has _______ (fill in the blank), I would want more results than this.”

But… When we hit things just right, we provide a nice amount of rejuvenation while still maintaining his essence and character🙏🏼

There are still some things we could have done, but our chosen degree of correction helps maintain balance with the rest of his face.

This is the enigmatic part of his result: refreshed and rejuvenated compared to baseline, yet still looking like himself as though we were never there.

You tell me - how did we do?

I’m interested to hear your thoughts! Tell me in the comments 👇🏼

01/18/2026

Some of the most beautiful faces in the world are not perfect.

They are unique and memorable - sometimes even as a signature.

Take someone like Sydney Sweeney. Sydney is undoubtedly and universally beautiful.

She is instantly recognizable, primarily because her face exudes gravitas and carries a commanding presence on screen, as well as a distinct personality in real life.

This is actually rooted in our neurobiology, which you know I’m a nerd about.

Sydney does have a subtle eyelid asymmetry. One eyelid margin sits a little lower than the other, the apertures of her eyes are asymmetric. From a purely technical standpoint, this is something I can “improve” - brightening the eyes, balancing the apertures, and improving symmetry.

The real question is not whether it CAN be done.
The real question is whether it SHOULD be done.
Is that the right answer for everyone?

At what point does refinement start to erase identity. At what point does optimization turn into transformation.

I think about it all the time. That metaphorical line matters to me, especially for people who live on camera, where uniqueness is part of their currency.

I see patients like this all the time. The are beautiful at baseline, often young, and often successful. They come in asking for something small. Sometimes that request comes from aging, sometimes it comes from comparison, and sometimes it comes from pressure to look more like everyone else.

This is where judgement and restraint becomes just as important as skill.

The goal is not to make someone look different.
The goal is to help someone look like the best, most authentic version of themselves, even as time moves forward.

That balance is where great surgery lives.

What are your thoughts on preserving uniqueness versus pursuing symmetry in facial aesthetics?
Drop them below. 👇🏼

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

01/17/2026

Do you agree with these scores? Let me know below👇🏻

What trends should I rate next?

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?

Chesnut MD Cosmetics

01/23/2026

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