Neck lifts are exploding in popularity, and it's one of the few areas of facial rejuvenation where men show up as often as women. In this episode, Dr. Sam Jejurikar and Dr. Sal Pacella break down the aging neck layer by layer: skin, fat, muscle, and glands, and get honest about which treatments actually deliver.

They dig into why radiofrequency devices like Morpheus8 and SoftWave impress at first but often disappoint later, and who's genuinely a good candidate. Dr. Jejurikar shares his own Kybella disaster story involving a transatlantic flight and a very swollen neck, and both surgeons explain why they've moved on from fat dissolvers. From there it's into the deep end: submandibular gland reduction, digastric muscles, and the real risk-reward conversation behind deep neck surgery.

Then the big one: is a "deep plane neck lift" a real operation or a marketing term? Two surgeons who actually do this work give it to you straight, along with why an isolated neck lift can be a great operation for men but almost never works for women, and the sleeper procedure Dr. Pacella loves for guys with short hair: the neck Z-plasty.

If you're researching a consultation or just tired of the buzzwords on social media, this one gives you the anatomy, the honest opinions, and the questions to ask.

What actually helps you recover faster after plastic surgery, and what's just hype? Board-certified plastic surgeons Dr. Sam Jejurikar (Dallas, TX) and Dr. Sal Pacella (San Diego, CA) separate the evidence from the wishful thinking, including their own self-experiments with the "Wolverine stack."

In this episode:

- ERAS protocols: staying ahead of pain and nausea before surgery even starts
- Aprepitant (Emend), the one-pill prescription that prevents postoperative nausea
- The truth about "clear liquids" and hydration before surgery
- Journavx, the first truly new class of pain medication in decades: how it works, the trial data, and why it's replacing opioids in our practices
- Nerve blocks, TXA, Exparel, and old-school pain pumps
- Peptides like BPC-157, TB-500, and sermorelin: what the evidence really says
- The Wolverine stack: our honest results after trying it ourselves
- Hyperbaric oxygen therapy (HBOT): faster healing or hopeful thinking?

Watch the video version on YouTube: https://www.youtube.com/@BeautyandtheBeastsPodcast
All episodes: https://www.beautyandthebeasts.com

DISCLAIMER: This podcast is for informational and entertainment purposes only and does not constitute medical advice. The discussion of any medication, peptide, or therapy is not an endorsement or recommendation. Always consult your own physician before starting, stopping, or changing any treatment.

One of the most common consults in breast surgery today isn't augmentation, it's downsizing. Dr. Sam Jejurikar (Dallas Plastic Surgery Institute) and Dr. Sal Pacella (San Diego / La Jolla) sit down for another candid, no-filter conversation, this time on why so many women who got bigger implants in their 20s and 30s come back 10, 20, even 30 years later wanting something smaller and more natural.

They cover:

• Why cup sizes (C, D, double D) mean something different from every implant manufacturer, and why that confuses the consult from day one
• The anatomy problem: what happens when a patient chooses an implant wider than her own breast base, and why that choice catches up with her later
• "Internal bra" mesh support: what it actually does, what it doesn't, and where Sam and Sal disagree on how well it holds up over time
• When downsizing requires a full breast lift versus a smaller scar option, and why patients often want to skip the lift they actually need
• The ethical question both surgeons wrestle with after two-plus decades in practice: how much responsibility does a surgeon carry for an implant choice made years ago

Whether you're considering your first augmentation or thinking about going smaller after years with implants, this episode lays out the physics, the anatomy, and the honest tradeoffs nobody tells you about upfront.

Hosted by:
Dr. Sam Jejurikar, MD, Dallas Plastic Surgery Institute
https://dallasplasticsurgery.pro/

Dr. Sal Pacella, MD, MBA, San Diego, CA
https://drpacella.com/

Beauty and the Beasts: two plastic surgeons, no filter.