← Biohacking Beauty: The Anti-Aging Skincare Podcast
Biohacking Beauty: The Anti-Aging Skincare Podcast
Dr. Cameron Chesnut: THIS is Why Most Plastic Surgery Goes Wrong…
01:07:49
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- [00:00]
Dr. Cameron Chestnut
Foreign.
- [00:06]
Amitaj Eshel
Hi everyone. Welcome to the Biohacking Beauty Podcast where we uncover the secrets to not just looking younger, but feeling more vibrant by embracing the science of beauty. I'm your host, Amitaj Eshel and this podcast is brought to you by Young Goose Skincare. And today we're diving deep into the world of dermatology and cosmetic surgery with our esteemed guest, Dr. Cameron Chestnut. Dr. Chestnut is a nationally recognized leader in dermatology and cosmetic surgery, specializing in innovative approaches to facial rejuvenation, laser surgery and skin health. So basically, not minimally invasive plastic surgery. With a passion for blending health and aesthetics, Dr. Chestnut has dedicated his career to not just enhancing beauty, but ensuring his methods promote overall skin health. And I really dub him the ultimate biohacking plastic surgeon. Today's conversation will cover the groundbreaking techniques of Dr. Chestnut that Dr. Chestnut is employing in his practice. From non invasive lasers to cutting edge minimally invasive surgery, to different injections that they do that are very, very unique, we learn how these technologies not only improve the appearance of the skin, but can significantly impact its health, functionality and the aging process. We're also going to look at Dr. Chestnut's holistic approach to patient care, discussing how lifestyle, nutrition and the biohacking strategies he applies in practice can complement the cosmetic surgery, cosmetic treatments and achieve the best, best results. This discussion will offer invaluable insights for anyone interested in how to really advance their skin health, how advanced dermatological practices can be integrated with biohacking, and optimal skin health strategies and rejuvenation. Before we get started, I want to highlight a review from one of our Biohacking Beauty listeners. So the review says, amazing podcast. Excited to see what you are continuing to develop. Love the products too, so thank you very much. Yeah, I mean, as I always say, reviews such, such as this, feedback such as the one we're getting is the reason we're continuing to do this podcast. We're not doing it for people to just hear all day how wonderful our products are. We're really doing it in order to make sure that people have listeners have the best habits around that facilitate healthy skin and a healthy overall body. Having said that, if you're enjoying the show and haven't yet left a review on Apple Podcasts or anywhere else you're listening to this, please consider doing so. Even a single review can make a huge difference in helping us grow and reach more people eager to learn about biohacking their beauty routines. But now, without further ado, let's welcome Dr. Cameron Chestnut to the Biohacking Beauty Podcast. All right, Cameron, welcome to the biohacking Beauty podcast.
- [03:37]
Dr. Cameron Chestnut
Well, thank you very much for having me.
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Amitaj Eshel
Yeah, it was. Listen, it was pretty funny how we got introduced because one day I get this, you know, super long email from Ben Greenfield, which normally Ben's emails are. You'd be exactly that. They are maybe a full sentence.
- [03:57]
Dr. Cameron Chestnut
Yep.
- [03:58]
Amitaj Eshel
And normally the word okay and sweet are the only words you're going to get from him. So it was obviously a really good introduction. We then he mentioned you do jiu jitsu. I'm like, I'm sold. And now we have you here. But. But it's pretty interesting. Your approach to plastic surgery echoes my approach to kind of facilitating your job. So how about we start by you detailing a little bit. What is your approach around getting a patient and providing them what they're looking for?
- [04:36]
Dr. Cameron Chestnut
Yeah, that's a, you know, that's a really interesting question overall, because it's different for every person depending on when I kind of catch them or when they find me and, you know, where they're at in their process and what their goals are, because it's a little bit different for everybody. You can get very into the aging process and what that breakdown looks like, but I'm seeing everybody as sort of a snapshot in time with a lot of things before and after. And I do a lot of revision work. So I end up seeing a lot of people who have gotten themselves sort of in a bad place, if you will. And we're working through that. But in general, I'm sort of thinking through qualitative and quantitative aspects of where people are aging. And that's a very much different paradigm. A lot of times you'll have a. I specifically do facial plastic surgery. So you'll have somebody who comes in and says, I want a fill in the blank, a facelift or an eyelid surgery. And most surgeons are like, great, let's do it without a lot of thought, maybe into what are the actual baseline needs. What's happening that's leading you to believe that. So I try to get really into that. Like, okay, what's, you know, if we were to nutshell it, you know, your question is, in a nutshell, I do as much as I can with as little as possible. Like, I want to get the most outcome with the least input. And so I'm looking at minimally invasive procedures for the most part to achieve those things. And I'm really, again, looking at that snapshot qualitatively. What's happening with your skin? What's happening with your fat pads underneath. Very importantly, what's happening with the ligaments, the whole things in place, that's the gravitational changes. And how can we sort of pick the low hanging fruit? That 8020 rule. What can we do to get 20% of input, 80% of the outcome and all of those little facets as opposed to just like beating one aspect to death, going way overboard in one area and leaving the other things alone. That's when you throw off facial harmony. Things don't quite look natural anymore. And so we want to really think about those and, and break it down. And again, what are your goals? How do we get to them with as little input as possible.
- [06:29]
Amitaj Eshel
Yeah, and it's very interesting because I think the plastics industry was kind of going in a different direction, in the opposite direction, you know, 10, 15, 20 years ago, where it was, I'm getting this, this, this patient only once or twice in their lifetime. Let's complete, get them completely sedated and go to town. So that your approach is, is, is very interesting. Why would we follow the 8020 rule? Why would we feel like we should not, you know, drive as many, you know, as many factors at the same time of recovery?
- [07:05]
Dr. Cameron Chestnut
Yeah, that's a great question. And it really gets into the multifaceted aspects of aging, right? If we, I like to use this analogy of low hanging fruit on a tree and you know, we, if we can pick the low hanging fruit first. It is my experience and belief that we need to pick all of the low hanging fruit before we move on to the next level in certain areas. And what you're describing is sort of that immediately taking one side of the tree and climbing to the top and leaving the other side completely alone. So it's not kind of looking at that360 sort of holistic view to it. And, and you know, you mentioned getting people more than, or only once or twice in their whole life. And that may have shifted a little bit now with some more easily accessible introductions and things into cosmetics, but that does carry over into even these minimally invasive procedures as well, where you may be getting one at a younger age than you would think of. For example, the average age for my patients who are getting like a small lifting procedure is like right around 50 years old, which is younger than most people think. Sometimes they're in their late 30s, sometimes they're in their 60s, but for the most part they're hovering around that like late 40s timeframe, early 50s. That's a little bit earlier than people think about. But they're Getting smaller procedures than they also associate with a traditional like facelift type of procedure. Yeah, so that's why you would adhere to this like 80, 20, you know, low hanging fruit principle. Early is you don't need to do as much to get to a better end place. So when people do procedures with that idea in mind, they look more natural afterwards, they last longer because they're tissue quality is stronger and better when they do get it done. It doesn't take as much to get there. So all of these things are great. You look better, it lasts longer, you didn't need as much to get there. It's a wonderful combination to really think.
- [08:51]
Amitaj Eshel
That way for sure. Look, I'm like a kid in the toy in the candy store. Like, I don't know what to ask you first, but let's maybe break it down. What do you mean by minimally invasive? Because you are grabbing a knife or that maybe it starts with a knife, but you're grabbing something and you're interacting with a layer that is lower than what we're seeing on the surface, Right?
- [09:13]
Dr. Cameron Chestnut
Absolutely, yeah, that's a great question. So, you know, there are things that I would classify as non invasive and that would be things like laser resurfacing, which I use with almost every surgical case that I'm doing. Because laser resurfacing is qualitative. It's addressing the quality of our skin. Stem cell rich fat transfer, something I use very, very often, I also classify as non invasive. Really, I'm not cutting and sewing to. But that's an important aspect of the layer below the skin. Now we're talking about the fat pad structure and the fat pad volume. So those are going to fall into those. You know, there is still a procedure happening, but not in the way we think of surgery when we're talking about minimally invasive surgery. Now we've crossed the line into an incision and cutting and things like that. I really like to use this analogy of laparoscopy that people think of for an appendectomy. It used to be, you know, cut your abdomen open, get to the appendix and take it out. But now through little pinpoint incisions, you can perform the same surgery in that deep structure. It's very similar to what I'm doing with a lot of my facial cosmetic procedures where a traditional facelift has an incision around the sideburn in front of the ear, back behind the ear. I'm able to do a lot of those same types of deep lifting work through a small incision hidden back in Your hairline, for example. And so that would fall into that sort of arthroscopic or laparoscopic thing that people think about with their shoulder, their knee surgery, or their appendectomy. Same types of ideas applied here. From a minimally invasive standpoint, something very.
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Amitaj Eshel
Very interesting that I want to. I want to kind of zero in on. You said the younger they come, the results can last longer and less. Can do more, basically.
- [10:55]
Dr. Cameron Chestnut
Right.
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Amitaj Eshel
So is that because our skin is just younger, it can perform things that an older skin is not going to do as well? What's going on there?
- [11:04]
Dr. Cameron Chestnut
Yeah, well, there's a few avenues that come into this sort of idea as just approaching things at a younger age. Earlier on, at a very baseline, you had mentioned sort of the old school paradigm around facial plastic surgery of just kind of go and get a bunch done. The angle that I'm coming from is very new. There's very few surgeons who can do what I do in these minimally invasive fashions. And that comes in a bunch of these facets of just having that priority, wanting that to happen, having the surgical skill set, the number of repetitions, all the things you need to be innovative and make those happen. So that opens up a world to the younger person in the first place, who it would have been overkill to do those other procedures in the first place. Now they exist. We can do these smaller procedures to achieve this. And when we make a little movement, when we make a little lifting motion, we need that soft tissue that we have moved to live in that place forever. So the younger it is, the more structural the fat pad is, the more resilience that they have in those soft tissues. So that skin or fat pad or ligaments, the longer it's going to stay. And so they need less surgery because, you know, at 50, you are closer to your ideal baseline or this sort of like unachievable perfection that we'll never get. But you're closer to that at 50 than you are at 65. So we don't need to move the needle as much. It doesn't take as much invasiveness. And then once you get to that place that you're going to be like you were just saying, the qualitative aspects of the elastin and the collagen in those tissues are going to make them stay there for longer. So it's, you know, it's generally less surgery, more bang for your buck, and you, you end up looking better. I can always make you look better at 50 than I could. When you're 65 so it's kind of a wonderful combination of all those things paired together to make that happen.
- [12:47]
Amitaj Eshel
Interesting. So what about if someone is 20, okay, and they're listening to this podcast right now? Are there things that they can do in order to preserve themselves in such a way that when they're 40, 50, 60, they come to you, they can be a better canvas as you as an artist?
- [13:08]
Dr. Cameron Chestnut
Sure, yeah. That's a great question. And that gets a little bit into sort of some of those more qualitative aspects. What are we doing that affects the aging process overall? So you get back into this is where I get very outside of the norm in the realm and my specialty, you know, I want you to be doing things that are affecting your internal wellness, you know, your psychological wellness, your physical wellness, all of those things. But by doing that, you're also going to slow your aging process, right? So we'll get into this idea of hormetically dosing things, right? Some things in small doses are good. You get too much of them, they're bad. Sunshine, prime example. In my world, the second my world that I say you should get a little bit of morning and late evening sunshine, that's blasphemy in my world, right? Like no sun, all that UV damage is bad for you. Well, there's, you know, there's. It's always a spectrum of truth in everything, right? So where do we actually lie? Like, a small amount of that at certain times is good. Oxidative stresses, you know, as I'm sitting here in a sauna, right, like in low doses, really, really good for you. Cold exercise, those are all oxidative stresses. You just want to mitigate how much you're getting, how you're dealing with them, keeping those things strong. So that's all going to keep you in a good place. So you should not be getting, and I'm going to speak in the northern hemisphere here, you should not be getting noon sun exposure on July 1st all day. You know, like that's too much oxidative damage, too much UV damage. You should be sort of thinking about these smaller doses at more specific times. That's going to keep you looking better. You should think about your oxidative stress internally. What kind of foods are you eating? I mean, you can get way into the weeds here. Like what oils are you eating and things like that, right? Those are all going to affect how your soft tissues age. And so if you're really focusing on those sort of more long term strategies in general, you're going to slow your aging process. To a point, both externally and internally and how you're doing that. And then I think the other one, this is going to open up a whole can of worms for us, is just being really careful with what your first and early interventions are as you kind of start dabbling in these like, you know, we'll get into this idea of volumizing with filler. Right. This has turned into this entire world that is so easily accessible, done on every corner. You can, you can get it everywhere. And it's problematic, it's distorting, quite literally distorting how the aging paradigm is happening where people are looking different, looking off, looking funny. And it's just, it's happening too fast, it's too new, and it's not being done well. So from my end, it's rare that I see a patient who hasn't had a lot of these prior things done, whether they were a tightening device that didn't work but disrupts their microvascular circulation, whether it is filler that is just now created this sort of like abnormal gel space in, you know, inhabiting their local tissue. So just being really thoughtful about, you know, what that is. If it sounds too good to be true, it usually is with those sort of non surgical, you know, things that are early anti aging.
- [16:05]
Amitaj Eshel
Yeah. And I think to your point, and you've mentioned some of the physical alterations that are happening, but there are also mental alterations that I really presume with your line of work, you're probably very, very aware of them. Such as if we are, you know, getting fillers done on a regular basis, the idea of what our facial structure should look like changes as opposed to what the environment deems natural. You know, I don't remember the comedian, but they come. There is a comedian that said about like I think, injectables and fillers, he said, no, you don't look younger, you just found the new age between 52 to 53. Right.
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Dr. Cameron Chestnut
Yeah.
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Amitaj Eshel
So that's number one. And number two obviously is the. And you did mention tightening devices that are providing a result that structurally is actually different in the paradigm of a result of the patient. Whereas let's say, you know, we're going to mention my nemesis, which to each his own. But radiofrequency. What you're thinking of, the client is thinking of as the result is actually the swelling and inflammation involved in the healing process. And the healed result is actually something that the person saying, oh, my results are out of my system, basically. In other words, I now need to do that again. So I bet for you as a. As a person that receives these people, you're getting a product that also physically, but also mentally has been altered.
- [17:36]
Dr. Cameron Chestnut
Right, Exactly. Yeah. You know, the. The first idea that you mentioned there is really well defined we call perception drift. That's that deviant. And filler in particular makes that really easy to do. And it's new, right? This idea of this perception drift is new because filler allows these small changes to accrue over time. And there's this idea with these fillers. And just to define what fillers is, you know, most of the time we're talking about this hyaluronic acid gel type of filler. There are bio stimulatory fillers that are a bit of a different category. They're less common, but this is the one that people think about getting in their lips or whatever, these hyaluronic acid fillers. And it creates these small changes over time, and they last decades. But the current thought paradigm behind them with most injectors is that they last six months or 18 months. We know that's very much not true. And surgeons like myself see them in tissue years and years and years and years and decades later. So that needs to change in the first place, because all of a sudden, someone's getting filler every six months or every year, and they get this abnormal change from their baseline. But they've been looking at it forever and they think this is. This is the new norm, right? This is where I'm supposed to be living. We see it in injectors all the time, too, because they're getting a double source of it happening, right? They're seeing it in themselves because they have very frequent access and they're doing it often. So they have these little micro alterations happening all the time. So they have that positive feedback coming in as this is their new normal. Plus they have the patients that they're creating that come in, so they're getting this double input of like, this is what normal looks like. So if you walk into an injector and they look off or funny or overfilled, that is where their perception has drifted to be norm. That's what they're trying to create. There's no. It's silly to think that they're trying to do anything different in you than what they've done in themselves, right? So this. And, you know, this gets way into the weeds a little bit into that. But yeah, this perception drift makes that very, very different, you know, as far as what the norm is. So I see people who've come in and their baseline has changed and we look at their before and after pictures as a snapshot in time and then, then maybe they can see like, oh, I do look quite different than when I started. Right. And this is another one of these. In my facial plastic world, before and after photos, they're everything. That's what my practice is built on. Right. Like look at, here's the. Objectively, this is what you get. It looks incredible.
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Amitaj Eshel
Yeah.
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Dr. Cameron Chestnut
But what I challenge most people look at with it before and after photo is it's different but is it better? Right, because this is what filler does. It makes things different over time and you assume that it's better because, well, you went to a reputable injector and you paid for it and you can tell that something happened. But then I questioned it. Really. Think critically. Yes, your lips are bigger, but are they better?
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Amitaj Eshel
Cameron, let me stop you. I have a small question about that. So now nowadays, you know, since the late 80s, early 90s, there are, within plastic surgery, aesthetic plastic surgery, there are measurements to which I forget the two names of the two people that, that, that started it, but there are measurements to which you aspire to imbue beauty, right, or symmetry. Is there, are there rules like that? So, so I'm talking about for example, the distance between the, the edge of your nose to the, to the top of your lip, et cetera. Is there anything like that when we talk about fillers nowadays or is it just, you know, non existent?
- [20:55]
Dr. Cameron Chestnut
Yeah, absolutely. And, and you, this is a really interesting topic because I believe that you're, you know, very into the mathematics of aging a little bit. Right. Like, yeah, so this gets into that, this goes way back to this idea, I would say the thought paradigm that a lot of injectors will use is this idea of a golden ratio, right, which is 1.618 to 1. Right. That gets used all over the face and ratios of lips and upper face to lower face. It truly does exist everywhere and it's really fun to talk about. And it's, you know, we have special like calipers that can measure golden ratio and things like that, but it's just not universally true across all races. And let's talk about lips in particular. It's not always 1 to 1.6, sometimes it's 1 to 1 and those are normal aberrations. But it kind of gives this almost a false credibility to things a little bit where it's like, well, I'm using the golden ratio. That doesn't mean it's right or better or normal. It means that you're using some mathematics in here. And so long answer to say, yes, there is some mathematics involved in what things look like, but you have to have much more of a discerning and artistic eye to things to really make it look natural.
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Amitaj Eshel
Yeah. Because the golden ratio is. Is someone's, I would say, well, first of all, taste, but it is someone's understanding of what symmetry and beauty is.
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Dr. Cameron Chestnut
Right.
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Amitaj Eshel
Propagated through mathematics. They didn't climb on to some mountain and found it, you know, that God didn't write it on some stone. Right. So I couldn't agree more.
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Dr. Cameron Chestnut
Yeah.
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Amitaj Eshel
Yeah, it's very interesting. Okay, going. Going to the second question about, you know, tissue that has been worked on to a. To an extent that it is now. You need to be the one dealing with it.
- [22:43]
Dr. Cameron Chestnut
Yeah. And, you know, I see this most commonly, most commonly with filler, because filler, the siluronic acid or the biostimulants, change the soft tissue, the fat pads and most of the muscle actually, where they integrate into it. Right. Any muscular tissue that has a gel integrated into it is going to change its movement patterns. It's got water in it. The vascularity is different. We call it hyalinizes, which means it kind of looks glassy. And so I see this surgically all the time. And all of the movement of your face then changes. Right. And we recognize that, you know, there's the static part of a face that part of our temporal lobe recognizes, and then there's the part that has to do more dynamically with motion. Those are actually two different parts of our temporal lobe, more of like the core and more of the, like, you know, more evolutionary part of us. But anyway, those, we, whether we can, like frontal cortex, pick it up and say, oh, that's different. We notice that things are off when our facial movement's off.
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Amitaj Eshel
It's.
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Dr. Cameron Chestnut
It's such an important part of our communication and recognition of age, beauty, all those things. Right. So they're very, very important to us, whether we know it or not. And I see those changes happen with filler or with radio frequency, as you mentioned, where you've now changed the way that that fibrotic muscle moves or that the blood supply to that feeds it. And there's those very simple changes there where it just looks different at rest and in motion normally. But then when I get in there surgically, it changes the way that I do my surgery. It changes the way that things recover after surgery, which will be an excellent segue into why I do A lot of the post operative recovery things that I do, it's out of necessity. My patients need often extra recovery because of these microvascular changes. Right. They have a higher risk after their surgery because their blood flow isn't normal. So I'm going to utilize hyperbaric oxygen very, you know, openly and aggressively for them because it's going to make them heal better anyway, but it's also going to help mitigate that risk. So if you've never had surgery, primary first time, you're going to have an incredible recovery with me because I'm utilizing all these things. But if we're doing a revision or if you've had some of these other prior procedures, they become especially important to your recovery to make sure that your results are optimal, but also so that we can get through with a really good safety profile.
- [24:57]
Amitaj Eshel
Yeah. I mean, and I think there are many other things that are a little more esoteric that we can talk about, like your feelings along the recovery, your mental state you know, along the recovery, how you come out of it. Because at the end of the day, you've paid to feel better. Right. And if you are, you know, suffering for a long time, that could affect that, you know, long term, even create some, some emotional trauma. So.
- [25:20]
Dr. Cameron Chestnut
Yep.
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Amitaj Eshel
I mean, I think it's. It is, yeah. So as a, as a, you know, really avant garde plastic surgeon, which is doing something that, you know, I've been trying to, you know, talk to surgeons for a very long time about, which is, you know, again, improving your canvas, not only working on yourself as an artist, do you want people to do specific things pre surgery before coming to you, or are you saying, you know what, that is too complicated? I just want them to get to me and we'll deal with it from afterwards.
- [25:52]
Dr. Cameron Chestnut
Yeah. I mean, if I had my choice, everybody would be that perfect canvas who had never had anything done prior. And we were kind of working through just sort of like what's sort of all natural, you know, as it is. And that's rare that that happens. And I'm. Either way, you know, I'm so adapted to managing some of these little complicated factors. But if I do get somebody who's really never done anything and that certainly happens. That's lovely. It's a wonderful situation. And we get into the things that I want them to do prior. Because even with that perfect canvas, we can still optimize. You know, you're talking about prehabilitating or prejuvenating. We can do that, you know, for our surgeries as well, with, you know, being in the best sort of, you know, psychological space or cognitive space, being optimized physically coming into it. You know, I, when I have three kids and every time we were going to get pregnant with my wife, it was like training for like the biggest event of your life. Right. You're going to make physical stress. And so if we can apply those types of things even to like these little surgeries, great. You're going to recover better afterwards. And that comes with things that people do on their own. It comes with like some pre surgical or pre procedural supplements and things that we'll do. We even start hyperbaric dives before procedures. We want people to be sort of ready to recover before we've ever even done anything. And it can be really important to do that.
- [27:10]
Amitaj Eshel
Yeah, for sure. Have you played around with using peptides within, within surgery? And then my question is, have you ever played around with using some peptides before? For, for example, you know, we know BPC157 has a loading period, so if we just, you know, give it to people after surgery, it could be incongruent. So, so have you, have you played around with that?
- [27:31]
Dr. Cameron Chestnut
Yeah, so we, that's part of our pre procedural supplement protocol is peptides, which for, you know, again in my world is very out there. It's sort of very frontline, cutting edge. People do not use peptides for their pre or post surgical situations. But BPC does have a loading dose to it. You know, we, and then we get into like oral versus sublingual versus injectable forms of all these too. Right. Depending on how many kilodals they are and things. And, and so that is part of our pre procedural protocol. And you know, for a lot of again, people in my world, patients who come in like my patients tend to be like very health conscious, very, you know, frontline in their fields. They've heard of peptides, they know a lot of these things. But for some that are, this is like mind blowing that, you know, we have all these options to sort of like get them rolling before we've ever done anything. And you know, it could be a little bit, you know, if they have heard of peptides, like, well, don't you have to inject those? And so there's some of these little hurdles that come over. But you know, GHC copper and, or GHK copper and you know, BPC157, some thymosin beta 4, these are like things that we'll very commonly use and try to customize leading into procedures. And then afterwards as well. When I say afterwards, it's for months, really, you know, which gets a little bit into your prior topic about having people sort of like in the right psychological space to recover afterwards. A big part of that is setting proper and realistic expectations as to what it is. That's a big part of the process. If somebody thinks that they're going to have any surgery and be better in two weeks, I don't care if it's your knee or your appendix or your face, that's not a realistic expectation. And then anything past two weeks, you're now psychologically in a bad place. But if we can realistically lay out what the recovery looks like and then expedite it even more, that's a recipe for sort of satisfaction, basically. You know, your happiness in life is equal to your expectations minus your reality. Right. So make the reality better. Let's make the expectations in line. And then everybody's happy 100%.
- [29:28]
Amitaj Eshel
I mean, it's a good analogy for like an ice bath for cold plunging. Because the hardest thing about cold plunging is not knowing how the journey looked like, because it's really, really difficult the first 30 seconds, it's then quite difficult the next 30 seconds. But really every 30 seconds until obviously a certain point, it becomes easier and easier and easier. So if you didn't know that, if you didn't know how the journey looks like, you didn't know it's going to be that hard in the beginning, you didn't know this, you know, you're going to feel exactly like that, you know, the second 30 seconds, and then how it feels onwards, you won't be able to get it. 3, 4, 5, 6 minutes, you're going to be jumping out of the water, which is the equivalent of, you know, having a breakdown or whatever.
- [30:09]
Dr. Cameron Chestnut
Right.
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Amitaj Eshel
I like that way beforehand.
- [30:11]
Dr. Cameron Chestnut
Yeah, I like that analogy. And if somebody tells you, oh, it's better, it's only like a minute of discomfort, and you're like, no, it's, it's not as bad maybe. I like that.
- [30:20]
Amitaj Eshel
Yeah, yeah, 100%. So speaking of ice baths and things like that, you. One of the things that I really like you using and saying is that you should approach, you know, rejuvenation or facial rejuvenation, plastic surgery, as a patient, like, you're basically an athlete. You're a rejuvenation athlete for that point. Now, obviously we've been kind of talking around that, but what is some of your belief systems around that? How do you equate the two?
- [30:50]
Dr. Cameron Chestnut
Yeah, so I Mean, I have kind of two parallels in this. Preparing like an athlete. There's what I do personally, which is very much in that line, and that's just sort of how I've been programmed my whole life. And then there's what I do for my patients within that. We talked about some of that, like pre training, pre habilitation, you know, an ice bath. If I've, you know, if I have a patient, honestly, who ice baths leading into their procedure, I know that they are resilient and tough and they're going to do great with their recovery. They're able to handle things that are challenging, right? So there's just that whole part of it, then there's the procedure itself. And then, you know, leading into the recovery. That's where I really am paralleling, you know, like an athlete's recovery. Like, even. Even in the athletic world, hyperbaric oxygen is quite progressive for people to be able to do, you know. But then we get into all the things that are targeted at, you know, we've created an injury, right? Just like an athlete who may be injured, we want to heal that injury as quickly as we can. So we're focused on the building blocks that they need. We're focused on the inflammatory cascades. Because everybody thinks inflammation is bad, but that's not necessarily true. When you're healing, we want certain types of inflammation. They're good. How we can use regenerative medicine, which, again, is very progressive in the athletic world, but has a strong tie into healing from a sports injury, just like it does to healing from a surgery. And so for me, there's multiple avenues intra procedurally, interoperatively after surgery in ways that I'm using regenerative medicine. But then you get into some of these more, you know, sort of, I would say, like, for example, rectal ozone after anesthesia can help recovery. But again, for some patients, that's like, you want to do what? You know, it's like, well, we're going to help you recover from your anesthesia here in a very odd way, but, you know, a very nice way to do it. And so it kind of like gets a little bit further down the line, depending. Sometimes depending on how into it somebody is or how aggressive they want to be with their recovery. But even at baselines, every single one of my patients is getting regenerative medicine, getting hyperbarics, getting pulsed electromagnetic frequencies to help their swelling and rebuild their extracellular matrix. They're getting IV nutrition after their procedures. Things that are, again, paralleling what an athlete's Doing quite a bit.
- [32:53]
Amitaj Eshel
Yeah, that's a great, great breakdown.
- [32:59]
Dr. Cameron Chestnut
Hey there.
- [33:00]
C
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- [35:06]
Amitaj Eshel
Well, we all know that there are a few types of athletes. Obviously there are the NFL. What's the average NFL playing times? Like three years or something like that? And, and then there's Tom Brady. Right. And, and the difference is, I think it's a few things. You mentioned resilience. I mean, you mentioned being able to sustain the recovery, sustain, you know, whatever that is, injuries, et cetera. But there's also, you know, optimal performance, which I would argue is in your, in your field is, is. Is literally like how well you recover right now.
- [35:41]
Dr. Cameron Chestnut
Right.
- [35:42]
Amitaj Eshel
And the third thing that I, I kind of want to parallel is longevity of an athlete. So how many of your allotted resources are you investing in the current moment and how many are you kind of saving on for later?
- [35:56]
Dr. Cameron Chestnut
Right.
- [35:56]
Amitaj Eshel
So how, how do you manage especially like the best recovery right now and you know, having their, their Skin, their, their body, their, their. The process that you've, that you've created last the longest amount of time.
- [36:11]
Dr. Cameron Chestnut
Right. Well, you know, there. This really gets into the, I think the surgical and the surgeon's preparation too, a little bit, you know, but, well, from a patient standpoint, you know, for. This is a, you know, if we're talking in an athlete, this is a big injury. This is like a season ender kind of thing where we really want to focus those resources heavily on the beginning and then get into, okay, now afterwards, now you've healed from your injury. Let's say you're a quarterback and you, you know, have a shoulder injury. Well, great. What are you doing now to maintain it afterwards? And a lot of that, interestingly, looks like what you'd be doing pre habilitating, right? Making sure that you're strong and, and all those things. And same afterwards, right. You want to be mitigating your oxidative stress to a certain point and you want to be taking care of your skin just because honestly, skin's the easiest of these to address externally. You don't need to do anything invasive to get to it. And so it parallels a lot of that as far as maintaining your result once you've got it. There's also this quality issue to the procedure that you got. Not all shoulder repairs are created equal. Just like not all certain, you know, facial plastic surgical procedures are created equal. You're going to have some longevity based off of just how good was your procedure? How good was that surgeon at it? And this gets very into like, you're not comparing apples to apples all the time. When you're like, well, this is this, you know, you have to really understand the longevity of what your surgeon can provide you. And then that gets into, okay, what's your surgeon doing? You know, this is where I get very internal with. This is, you know, I view myself as this sort of athlete with career longevity. And every surgery that I sit down for is the biggest event of my life to that point. I am prepared for that. Like it's my super bowl. You know, I had been for all the days prior leading into that, I've been getting ready what I'm eating, how, what my activity is, how I'm sleeping. I'm following those things and getting ready. But then the day of that procedure is pregame for me. I'm in my flow state. I'm doing all my little things to get ready for that moment where I sit down and start going, and I love it, right? Like I, there's Nowhere I'd rather be. That's. That's my place. And so for me, that's a lot of energy going into it. You have to be ready, you have to be primed. And I can't do that three times a day, every day. Right. And so this is where you get into that career longevity. If you're a pitcher or a quarterback or whatever it is, you have to, like, really look at each of these. Like, every time I do this, I'm giving part of me to this patient. Quite truly. It's a very intricate and dynamic and, like, loving relationship. Like, I'm only going to do so many of these in my life. And I just gave one to you, you know, like.
- [38:35]
Amitaj Eshel
Yeah.
- [38:35]
Dr. Cameron Chestnut
Which is a very special thing for me because this is my. My love, my gift, my masterpiece, my whatever. Each one I like to do. And so if that's not the normal paradigm of thought in any surgeons. Right. A lot of times the training to get to this point is so brutal that you get here and you are a super high performing person and you've been just sort of physically and cognitively beat into a shell of your former self, and you can go through the procedures, but it's not with the same sort of vigor that you could have prior. Right. And you're just sort of like an operator at that point. You're just doing it, you know, and that steals the joy for me. That leads to burnout, it leads to dissatisfaction. And then this is where it really comes to a head, is it leads to suboptimal outcomes. If you're not at your best, even individually, from surgeon to surgeon, if they're not at their best that day, they can't give their best result. It's, you know, there's a lot of decisions that go into every single procedure, even if you've done it a thousand times. So that's a long tangent on, you know, it's important as the surgeon to be optimized in that sort of mindset as well.
- [39:41]
Amitaj Eshel
Yeah, indeed. It's funny because you're related, not connected to this podcast at all. I asked you a Jiu Jitsu question, and to be completely honest, sometimes as you can tell, I ask questions which it seems like I'm the only one that's interested in them. Right. So I was asking you questions about specific Jiu Jitsu game plan, like a specific Jiu Jitsu way that long term you are building the things you're focusing on in this lifelong art that's called Jiu Jitsu. And I was asking you, how do you relate that to your fingers? And you and you. It's funny you said, you know, I think about it every time I jujitsu, which I believe is a very kind of Japanese traditional way of doing anything. It's like giving it full attention all the time, which really impressed me, to be completely honest.
- [40:31]
Dr. Cameron Chestnut
Well, thanks. Yeah, yeah.
- [40:33]
Amitaj Eshel
So let's talk a little bit about what surgeries you do do. You mentioned that they're minimally invasive. But as far as like scope of practice, who do you see? Do you see only people who I would say would succeed in a very certain, I would say, like scope of intervention. Do you do everything but that? But you know, but you're trying to adhere to those principles. Are there, as you said, you mentioned, like laser resurfacing. Are there things that you're doing even for people who don't need surgery? How does your practice look like?
- [41:10]
Dr. Cameron Chestnut
Yeah, so my practice is primarily surgical or procedural at this point. I do see patients who maybe just aren't like that 20 some year old comes in and, you know, part of my job is helping people understand, you know, sort of like, okay, well what's our best sort of like bang for your buck, Proverbially bang for your buck here. Like what's that sort of least thing you could do to get the most output? And at 20 that may be something really simple. Most of my patients are ready for something procedurally that's just sort of how it's evolved. Sometimes they are younger and may have genetic predisposition to something like let's say eye bags underneath their eyes. And it gets very easy for me in sort of a new school paradigm. What I'm comparing that to is in an old school procedure for, let's just say a lower eyelid bag, you'd have to cut through the skin and cut through the muscle and you create weakness in those soft tissue structures that become problematic down the road to make a 30 something year old with genetic predisposition to make them look better. Right. And so that gets a little bit into this, like are we actually doing maybe some harm, more harm than good with these types of things? With more of a new school approach, I can do that procedure completely scarlessly, without cutting through the skin, without it cutting through the muscle kind of approaching from the backside of the eyelid. And it makes that a lot easier to say, okay, well you're a little bit on the young end of the spectrum. But with an incredibly minimally invasive, completely non scarring surgery, we can make these little adjustments that you want, and then you can feel great, look and feel great. In my world, the most common thing I hear from my patients is I want to look the way I feel. Right. And that is a little bit of a sampling error for me. And just that my patients tend to be in that more wellness, high achieving type of thing. And they're just like doing great in life, but they feel like they're aging at a rate that doesn't match internally. And so I'm able to again, take these things. So my practice is very surgical. It's sort of like hairline to chest, I would say, is like my area that I work. And I'm usually having people come in and say, okay, what sort of, what do I need to do to get the best outcome? I don't want to look different, I don't want to do too much. And that's where I get to kind of work through. And when we talk about something like a facelift or a brow lift or an eyelid surgery or whatever, to me, when I hear that I'm down 150 different roads that I could go down with each person, it's not like a cookie cutter, oh, can I do this for you? It's like your nuance is so different than the next person. Thankfully, because I'm so specialized, I have that capacity to make these little micro adjustments for each person and again, like find that right balance of least input most output and then kind of like cut it off there. And most of my patients are very happy with that. They're like, I got a lot out of it. I didn't put too much into it. You know, maybe there's a couple little things I'd say left on the table that we could have chased, but those were the higher hanging fruit that we made a decision to leave behind. And that's okay because you still look like yourself.
- [43:57]
Amitaj Eshel
Yeah. Could you give me an example for one, for something that is left on the table? Because really the, you know, it's like in rock climbing, reaching to that would have risked significantly more than going a different route.
- [44:09]
Dr. Cameron Chestnut
Oh, absolutely. Yeah. With my. I teach two surgical fellows every year who are very far in their postgraduate training. It's their last step of training before they're done. They're super skilled surgeons and I'm just teaching them how to think basically at this point. But this, this lesson comes up a lot. In my experience, in my hands, most issues or complications or little things that you're unhappy with came when you were chasing that one last little reach, if you will. That one last bit, you're like, well, if I just push a little bit further, I might be able to make this 1% better. But you can get into complications quite easily because you're overreaching a little bit. So the place to think is to know when's it appropriate to do those and what that might look like is I would say most commonly things that I see are like over pulling or over tightening, over lifting and making it not balance somewhere else. And we've all seen that. That's like that windblown kind of tight lower face look where everything's still sinking on top. That's just sort of like not knowing when to. I'm going to tighten this to is the degree that it's going to let me quite easily that I'm going to leave it there. And there may still be a touch of laxity left in this person's neck. But they're 60 years old and that actually looks quite normal, natural and soft on them versus, you know, kind of overcooking it. And all of a sudden you create a complication quite quickly, whether, whether the patient knows it or not. You've created what is essentially a bad outcome. But they might be really happy that their neck's so tight, but that looks unnatural on them.
- [45:35]
Amitaj Eshel
You know, they might just be so tight they look happy.
- [45:39]
Dr. Cameron Chestnut
Exactly. Exactly. Right, Yep.
- [45:41]
Amitaj Eshel
So within the paradigm of those 80, 20 abilities that you have, is there anything that, like how does the future of plastic surgery look like? Because to be completely honest, this is a very hard question. You know, when I talk about the things that I'm interested, you know, a lot of people ask me about AI or quantum computing or whatever my friend and I, my friends and I are talking about. And there are literally a hundred million things that could take it to one or the other direction within plastic surgery. And I'm allowing you to say it's going to be very complicated, but how do you see the future of plastic surgery in that, you know, 10, 20, 30 years from now?
- [46:22]
Dr. Cameron Chestnut
Yeah, I think that we are going to continue to move towards a pendulum has been swinging from what you talked about before that like maximum input and then it swung all the way over to this like no input, but all non surgical fillers. And we realized, well, that doesn't work either. That looks really unnatural. It's going to, you know, like all things swing towards the midline of kind of balancing what is the most minimally invasive ways. This part over here, that's if you do it all by itself, it looks funny versus this other end, it's just too much surgery. We're going to find that, continue to find that midline. And what's driving a lot of that is some of these procedures that, you know, we're working on in pioneering or that, you know, my fellows and I are working through to, like, okay, well, how can we achieve this end, but with less input, more towards this, like, minimally invasive end? And as we continue to refine those and publish about them and teach them, that's really what's changing it. Because there's people coming up that are much smarter than I am, and they just need those basic thought paradigms and they need some surgical skills and experience, and then they'll start taking it and they'll run with it, too. And that's where the future is going to go. It's going to be customized. It's going to be minimally invasive, but. But it is going to involve some amount of procedures to make that happen, because we're talking about aging anatomy here, and we have to go touch parts of it. But it's figuring out, well, what are the key parts to touch and what are the key parts. So we don't really need to manage as much to make these outcomes happen, look nice, natural, and last a long time.
- [47:50]
Amitaj Eshel
Agreed. I mean, it's a complicated thing to conceptualize, but so 2022 in Copenhagen, there was the big conference about aging where five new hallmarks of aging were presented, and one of them was mechanical alterations. And I think it is very, very interesting because in your profession, you are holding in your hands, both you're holding in your hands the ability to correct mechanical alterations and now tap into one of the hallmarks of aging, like, literally rewind aging in a very physical level. But on the other hand, as you said, like, too much or, you know, the wrong approach doesn't even have to be too much altering mechanically, something to just appear better for a while, but perform older. I mean.
- [48:42]
Dr. Cameron Chestnut
Right.
- [48:43]
Amitaj Eshel
That might be. Yeah, that might be a big. A big shift. I hope it's going to be a big shift.
- [48:48]
Dr. Cameron Chestnut
Yeah. And some of that even gets in. I mentioned before, you know, before and after photos, right?
- [48:53]
Amitaj Eshel
Yeah.
- [48:53]
Dr. Cameron Chestnut
Like, they're so telling and they really are objective. But there's more to it. Sometimes it's like, well, let's see the before and after video of what the dynamism, what the function of this looks like. Because form and function following each other can be decoupled a little bit sometimes. And so we have to really think about that, too. So maybe that's a small part of that answer, but there's definitely this sort of like, okay, well, what's the function of this, this mechanical structure that you've created now? Yeah.
- [49:19]
Amitaj Eshel
Do you see a lot of people? I mean, you're a little bit, as you said, in the realm of people who are really interested in their health, and that is one brings another one, etc. But do you meet those people who are infatuated with an image they have online and come to you in order to match not to. Not the way they think about themselves because they have gotten older and they have a mental image of themselves, but their mental image is actually altered by a filter or altered by, you know, maybe them with makeup on tv, I don't know. But do you see things like that?
- [50:00]
Dr. Cameron Chestnut
Yeah, this is a really common thing in facial plastic surgeries. And this gets into all different realms. Sometimes it's an image of a completely different person. Right. And then that becomes more transformational. Right. And I don't really do transformational surgery, mostly just because it's not what I enjoy, it's not what I find fulfillment in. I like rejuvenative surgery. Right. So there's that aspect. And so I don't see as much of that just because I don't tend to, like, attract that or put that out as much. But in my opinion, somebody who has that same image of themselves, but sort of an unrealistic timeframe prior, it can be the same thing. At that point, we're rejuvenating to a point that's kind of overdoing, borderline transforming a little bit. And yeah, you know, filters can play a big role in that because who doesn't like to look at themselves through a filter better? It helps fix some of those things just sort of magically. And most often I look at that as a positive thing. It's like, okay, now we can understand a little bit of the things that bothered you that you really like to change for, because from a lot of filter standpoints, I can achieve things along those lines quite simply because it doesn't change everything. It doesn't make you look like a different person. It just takes some of these little minor 80, 20 things and makes them look a little bit better. And you like that look. That can be a positive thing to work with.
- [51:18]
Amitaj Eshel
Do you have conversations where you have to tell people your expectations are not only not realistic, but also. You really don't want me to try and aim to that?
- [51:28]
Dr. Cameron Chestnut
Right. Yeah. So I have a pretty, at this point in my career, pretty thorough screening process to get through a lot of that. And it's not always wrong. It's just that it may not. I may not be the right fit. So I say no to a lot of people partially because I don't need to anymore. And I love my career and my happiness and I love the people that I'm working with. So I'm just very selective on those relationships, basically. And sometimes it's unrealistic expectations that just lead me to say, listen, you know, I'm probably not the best person to shoot for that type of a result that you're after. And sometimes it's instead of, it's just me. It can be a harder conversation, which is. You shouldn't be pursuing that at all. But it's hard to tell somebody that, you know, that's a very unrealistic expectation that gets to borderline transformative. That's unachievable. Whatever it may be, those are harder, harder conversations to have. Definitely.
- [52:20]
Amitaj Eshel
Yeah. Yeah, definitely. Okay. I think I would like to not bring it to an end, but I want to, you know, focus a little bit on. On you and the way you take care of yourself. Drawing from the. All of that. All of that knowledge that you have. Because you did mention those injectors that you. You enter their office, and the injector that you're looking in front of you does not have the ratio that you would like to have in your face.
- [52:46]
Dr. Cameron Chestnut
Right.
- [52:46]
Amitaj Eshel
But I believe, you know, anyone who's watching this, because a lot of people are going to watch this, they think that your skin looks pretty good and that. That you're. You're doing a good job maintaining your youth. So I wonder what is important for you. We did touch a little bit about it. You are in an infrared sauna, per se, but what are some of the things that you're doing on a regular basis which you believe contribute to your youthful state?
- [53:10]
Dr. Cameron Chestnut
Yeah, so, I mean, I'm definitely more focused on my overall health than I am on, like, a particular facet of my especially facial aging. Like, I. To be fully honest, I don't do much to my face. You know, I'll do. I'm young, I'm 41. Right. So I'll do laser resurfacings and things like that periodically. I would say on average, every five years or something like that. And so those help some of those, like, actual aging aspects directly. But then I'm, you know, I'm a dad of three kids and I am a business owner, and I'm a, you know, a leader, and I'M a athlete and all the things that I want to be outside of that. And so I'm really taking that more holistic focus on my health, and then I'm applying to those little specific facets of, you know, what changes from there. So, I mean, I am focused on the type of water that I'm drinking, what I'm eating, and how much sun exposure I'm getting when all those things we talked about before, when I'm getting it.
- [54:04]
Amitaj Eshel
Hold on, hold on. What kind of water, for example?
- [54:07]
Dr. Cameron Chestnut
Oh, so, you know, this Ben would be so proud of me. Ben Greenfield. But I do love my structured water. Yeah, I love my structured water and my hydrogen water, you know, just hydrating thoughtfully about when I'm doing that. And I start every day with what I call an internal bath, you know, 40 ounces of water with hydrogen, and I use some Quinton trace minerals in there, and it's a. It's a slug to get it down, but it kind of kicks off my every day, you know, I love that.
- [54:34]
Amitaj Eshel
Great.
- [54:35]
Dr. Cameron Chestnut
And, yeah, so that'd be like, the types of water that I'm drinking, you know.
- [54:39]
Amitaj Eshel
Are you big into supplements? Do you take a lot of supplements?
- [54:42]
Dr. Cameron Chestnut
I am. I take some more focal supplements that I. So part of my practice is a functional medicine practice, too. Because of my recovery aspects from surgery, I have all the infrastructure, if you will, to have this sort of functional medicine part of my practice. And I personally love that, and I believe in it, and I want my patients to have access to it. And so through that more functional medicine part, which is another provider who knows way more about it than I do, she's my. My primary care provider, basically. And so through all the genetic testing and things, I've realized, like, oh, I don't methylate fully very well. And so, you know, all those classic things. And so my supplements are very tailored towards my genetics and my blood work and things like that. So I don't take a ton of supplements as a blanket. I take a very focal methylated folate, you know, multivitamin, which honestly changed my life and my cardiovascular risk forever by just methylating my folate. So simple. Dropping my homocysteine levels like, it just blows my mind.
- [55:42]
Amitaj Eshel
Yes.
- [55:43]
Dr. Cameron Chestnut
In that supplement world, how those things can do it without drugs.
- [55:46]
Amitaj Eshel
Indeed. Yeah. And then, you know, no one talks about the fact that everything. So you're mentioning about five genes that people we can have variations on, and these genes basically manage how you methylate your folic acid or folate, and people don't know that Everything that we consume has basically had a synthetic version of folate. It's called folic acid sprayed on it. Even if it's organic, anything and you're bombarded with that folic acid, if you're not methylating it, well, it could really, really, really tax burden your, your system. And by the way, you know, more and more research comes, is coming out about, you know, kids, behaviors, adults, older age. It's pretty crazy.
- [56:30]
Dr. Cameron Chestnut
All right. And there's a significant amount of people who have trouble methylating. And like you were saying, folic acid is enriched, it's everywhere. It seems like a good thing, but yeah, could be quite a whole. That's. We're way in the weeds of that now, but, yeah, absolutely.
- [56:43]
Amitaj Eshel
Do you have more people do genetic testing before you, before you go into that journey of operation again?
- [56:53]
Dr. Cameron Chestnut
This gets very into how sort of amenable somebody is to this because it's a significant investment of time, energy, effort, like all the things like, like, it's hard not to deep dive into it a little bit when you get it. And so I do like to offer it to my patients. 100% of my patients travel to see me. So we have a very solid infrastructure of people traveling where they stay, what their whole experience looks like. But a lot of those patients are traveling internationally as well. And so it can be challenging to, hey, can you come this early, you know, so that we can kind of run through this and. But it's available. And a lot of my patients do end up coming early, taking advantage of this sort of like pre surgical functional medicine journey, getting a bunch of information that they can utilize, moving forward forever after that, like what supplements they should be taking. But it does help us, like, guide their recovery a little bit too. Even in something as simple as, like, what their post operative IV looks like, you know, we can alter that, customize based off what their genetics are.
- [57:53]
Amitaj Eshel
Yeah, amazing. Definitely. What is your relationship, yourself in performance, youthfulness, your relationship with oxygen? Do you do? Well, first of all, you breathe it. But do you do any type of hyperbaric oxygen therapy or intermittent hypoxia training? Do you do any of those things?
- [58:12]
Dr. Cameron Chestnut
Yeah, so I spend a significant amount of time in the hyperbaric chamber. It's part of my flow state preparation, actually, for each procedure that I do. So every surgery that I go into, I spent at least an hour in the hyperbaric chamber that day leading into it. There gets to be some ritual to that in addition to just the physiologic benefits of it. Right. It's like a closed space. It's like mindful time. And my pre procedural flow state is very broken into like mindful time, academic time, input output, physical exertion, like kind of how I do that leading into it. But the hyperbaric chamber is part of that. And then even in like a subset of that question like a lot of times that output I'm using like blood flow restriction. So kind of a, you know, oxygen alteration in my muscles as I'm working because those are usually pretty short workouts the morning of. But I can get a little extra growth factor release and things like that by, you know, changing that oxygen profile to my muscles as I'm working out. So I guess I utilize oxygen very strategically and I, you know, the hyperbaric chamber has benefits well outside of surgical recovery, but man, it is wildly helpful to that. Hands down, the most dramatic of all of the modalities to the surgical recovery process is the hyperbaric chamber. Yeah.
- [59:28]
Amitaj Eshel
I think even if you go like pre Covid, it was kind of the secret weapon of plastic surgeons. Right. They were strategically looking for, you know, other. Obviously most of them didn't have a hyperbaric chamber. So looking for chambers to refer to because they knew at the end of the day it's going to refer to them as a surgeon, as a much better surgeon. Right, right.
- [59:49]
Dr. Cameron Chestnut
Yeah. And because it, you know, so I have two chambers in my practice, two hard studded ones that we're using them very, you know, all day, every day. And there is the recovery benefit. Right. Which is just nice for your patient. But then like I mentioned before, for my patients that may have some prior procedures, it helps them avoid complications. But then the one that's very, you know, under discussed is that it does improve your long term results of your procedure as well. And that's. Oh yeah, very much not adopted in the plastic surgery world. Like it's very rare that a surgeon embraces hyperbarics at all. To be honest. It's a small subset of us and I've been trying to grow that so aggressively. Possibly like I give lectures on this at our national meetings about like all how all these things can help. But one of those big topics that I think really hooks people is something really simple like fat transfer that we talked about. If you take that grafted fat that is now most the type that I use is almost purely stem cell. But I put these stem cells in a new place. They're trying to establish a blood supply, they're trying to grow, they're trying to change the native fat that they were put next to. If they have this nice little sort of comfortable home of oxygen for the week afterwards, their survival is much, much, much better. So a very objective improvement in your long term results just by employing this, you know, non invasive, simple thing.
- [61:06]
Amitaj Eshel
100%. Do you do red light therapy for that reason as well to try and you know, to improve the, the changes?
- [61:13]
Dr. Cameron Chestnut
Absolutely, yeah. Red light therapy comes a little bit temporally more down the line for me.
- [61:18]
Amitaj Eshel
Yes.
- [61:19]
Dr. Cameron Chestnut
Than right away. But yes, I do absolutely encourage and use red light therapy. You know, the sauna that I'm sitting in is the one actually at my office and we put our patients in here with red light therapy and things like that afterwards. But again, that's more, you know, like gets past a week down the road.
- [61:36]
Amitaj Eshel
From recovery usually because, because you want their capillaries to, to fully heal. Why is that right there?
- [61:41]
Dr. Cameron Chestnut
Oftentimes they've had that laser resurfacing as well and so that, you know, sort of barrier part of it and photo protection and all some aspects playing to that. And then sometimes they just have, have like a, you know, occlusive product on their skin for the afterwards.
- [61:54]
Amitaj Eshel
Okay, I have one last question. We're trying to keep it within an hour, which I fail miserably sometimes. But I have a question for you as far as again, those outcomes. Are you a proponent of hormone replacement therapy for people who come to you and get surgery? Is that a thing that you're trying to. I don't know how, how kind of, of openly or trying to insinuate that that's a good thing for them to be engaging in.
- [62:21]
Dr. Cameron Chestnut
Yeah. So this is a journey that I, I'm going to say in some capacity I punt this to my functional medicine provider because there's a lot more to this. So there's that overall I'm not encouraging every person to do it because there's a lot of personal factors that go into that. Right. But I know that you are a big proponent of this and I believe this very much too. When we start getting out of our reproductive age, when our sex hormones start changing, there is a wild change that happens in our facial soft tissues. That's my world. Right. So I'm just going to focus there. And a lot of times I'll see women who are perimenopausal or postmenopausal and they're telling me like I fell off my face, fell off a cliff in the past 18 months, which sounds like, oh, you know, a little dramatic. But oftentimes it Is true. Because our facial soft tissue, fat, the ligaments, whatever, are so wildly responsive to estrogen and progesterone specifically that there are these massive alterations qualitatively and quantitatively back to the very beginning, the things we talked about addressing. These massive, massive shifts happen right around that time very abruptly and some big changes happen that make things more challenging for me. Right. So as we get into what that recovery looks like afterwards and the longevity of it, it, if somebody is, again, this is where I'm trying not to like push it, but if somebody is on hormone replacement therapy or just if they're pre menopausal, just that, not on hormone replacement therapy, their procedure is going to last longer because of that.
- [63:53]
Amitaj Eshel
Yeah, yeah.
- [63:54]
Dr. Cameron Chestnut
So amazing. It's a complicated question. I don't, I don't necessarily push it or say, you know, but if it's the right fit for them, in addition to, you know, again, I'm focused on their overall health. Right. I want them to look how they feel. And so if it fits into their overall health journey, I'm all for it. As part of that process.
- [64:13]
Amitaj Eshel
Yeah. Amen. Again, obviously, I mean, it's very important to live within the narrative of the person's life. Right. At the end of the day, they need to. Again, my wife Anastasia, who's the hero of Young Goose, just gave birth a month ago and we were doing hypnobirth. First of all, we did three different courses, but we, we did a hypnobirthing course. And I think the most important thing that they're saying there is, like it's not necessarily that nothing bad is going to happen is that you're going to feel like it was congruent. Your decision making was congruent with who you are as a person. And I think that applies to every bottleneck, every focal point of your life. You know, that is what you're taking away from it. Again, ex military can tell you people who came back, you know, a little bit different than what they were before and people who aren't and you can actually, in hindsight, you can actually tell that that was part of the reason that that stayed with them. Yes or no?
- [65:08]
Dr. Cameron Chestnut
Yeah, absolutely.
- [65:10]
Amitaj Eshel
Absolutely. Anyway, listen, I feel like I can talk to you for hours and I believe that obviously you're the future, but you're the future that I want to support as well. Appreciate that. My question is, I'm sure you're extremely busy. I'm sure you're extremely sought after within those parameters. How does someone bring themselves to being operated by you how does this look like?
- [65:35]
Dr. Cameron Chestnut
Yeah, most of my patients follow me along on social media for quite a while to get familiar with a lot of things we talked about today. They kind of got a year's worth of content kind of today. But that's how a lot of people sort of get to know me. I'm very open on there about my life, my jiu jitsu, my family, all things on there. Right. But I talk about a lot of these, you know, aging things, filler things. I try to be very educational on there. So a lot of people find me that way. Lots of before, thousands of before and after photos. Right. That's like again the objective. Like look at those and then, you know, reaching out on there or through just like my clinic website. And then we kind of start this pre relationship dating process and then kind of select from there as we cook forward. But yeah, that it's a slow build, I guess, if you will, to kind of make sure that we're the right fit and we're doing the right things.
- [66:28]
Amitaj Eshel
And I assume men and women both.
- [66:30]
Dr. Cameron Chestnut
Oh, yeah, absolutely. I have probably a higher proportion of men than most facial plastic surgeons. Just I'm not 100% sure why. Maybe it just like that resonates a little bit better. But to get into that, they're completely different procedures. It's almost like two separate specialties to talk about women and men, like completely different. And so I almost have that sort of like double specialty of that.
- [66:53]
Amitaj Eshel
Interesting. Okay, we might need to do a podcast about that. Anyway, Cameron, I super appreciate the time that you, that you gave us here. We're obviously going to put all the, all the contact information, social media and everything in the show notes and yeah, I wish you continued success and you have our stamp of approval. I don't know if you need it, but you have have it.
- [67:18]
Dr. Cameron Chestnut
I love it. Well, I appreciate that and thanks for having me on.
- [67:21]
Amitaj Eshel
All right, bye everyone.