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.

Every surgery leaves a scar. There is no such thing as scarless surgery. But there is a lot you and your surgeon can do to make a scar as imperceptible as possible.

Dr. Sam Jejurikar (Dallas) and Dr. Sal Pacella (San Diego) cut through the marketing and break down what the evidence actually supports for scar care: why every scar looks thick and red at three to four weeks (and why that's normal), how scars keep remodeling for one to two years, and why patience is half the battle.

They cover silicone sheets vs. gels and why total wear time matters more than anything, how to do scar massage correctly (firm pressure, not a spa day), the real difference between a keloid and a hypertrophic scar, and when microneedling, retinoids, lasers, or steroid and 5-FU injections make sense. Plus: when a scar revision is the right call, when it's too soon, and the one popular remedy the evidence says to skip. Sorry, vitamin E.

Two plastic surgeons. No filter.

Dr. Sam Jejurikar: https://www.drjplasticsurgeon.com
Dr. Sal Pacella: https://www.drpacella.com

This episode is for educational purposes only and is not medical advice. Always consult your own physician about your specific situation.

Dr. Sam Jejurikar and Dr. Sal Pacella cut through a two hundred billion dollar industry to answer a simple question: what actually works?

In this episode of Beauty and the Beasts, Dr. Sam Jejurikar explains why "medical grade" skincare is not a category the FDA recognizes, why a fifteen dollar sunscreen applied every day beats a two hundred dollar one applied occasionally, and how a genuinely effective regimen can be built for around a hundred dollars a month.

The two surgeons walk through the four pillars they recommend to patients: daily broad spectrum sunscreen at SPF 30 or higher, retinoids stepped down to retinols for maintenance, an antioxidant such as vitamin C, vitamin E, or niacinamide, and a moisturizer. Dr. Pacella makes the case for physical blockers containing zinc oxide and titanium dioxide, and argues that what you put in your body matters as much as what you put on it.

They also cover why the peeling and redness from tretinoin is a sign the product is working rather than an allergic reaction, why exosomes are heavily marketed and thinly supported by evidence, and how to think about laser resurfacing for sun damaged skin. Ablative versus non-ablative. Fractionated versus full field. CO2 versus erbium. Plus a blunt rule of thumb: the effectiveness of a laser treatment tends to track with its downtime.

The episode closes on the sun protection blind spots almost everyone misses. The eyelid margins. The light reflecting off pavement, right under the brim of that hat. The sunglasses that focus ambient sun back onto the skin. The ears. As Dr. Pacella puts it, it is the only skin you have.

Dr. Sam Jejurikar is a board certified plastic surgeon in Dallas, Texas. Dr. Sal Pacella is a board certified plastic surgeon in San Diego, California.

Beauty and the Beasts is available on Apple Podcasts, Spotify, YouTube, and everywhere you get your podcasts. New episodes every other Tuesday.

#SamJejurikar #DrJejurikar #BeautyAndTheBeasts #Skincare #PlasticSurgery

Lip filler has been responsible for some of the biggest aesthetic failures in cosmetic medicine. That is the bold claim that kicks off this episode, and both hosts agree it is true.

Board-certified plastic surgeons Dr. Sam Jejurikar (Dallas) and Dr. Sal Pacella (San Diego) dive into the most visible topic in plastic surgery: the lips. They trace the evolution of lip aesthetics from the thin lips of old Hollywood through the J.Lo gloss era to the overfilled Kylie Jenner years, and explain why the pendulum has finally swung back toward natural results.

Along the way they cover the permanent scarring that years of filler can leave behind, the silicone lip implant disaster that should have never happened, who is (and is not) a good candidate for a lip lift or corner lift, why fat grafting to the lips so often disappoints, and Dr. Pacella's preferred technique of using the patient's own SMAS tissue during a deep plane facelift for longer-lasting augmentation.

For anyone considering their first syringe of filler, the advice is simple: less is more. And for patients with years of built-up, scarred filler, the hosts walk through the "lip rehab" approach of dissolving old product over multiple sessions before starting fresh.

Plus, a cautionary tale about Botox around the mouth that involves one of the hosts, a missing front tooth, and nine months of talking funny.

New episodes every other Tuesday.

Dr. Sam Jejurikar and Dr. Sal Pacella dig into Preservé, the new breast augmentation technique built around the Motiva ergonomic implant, and ask the question dividing plastic surgery right now: is it a real breakthrough or just great marketing?

Dr. Jejurikar makes the case for why Preservé may be changing breast augmentation in a way the field has not seen before. Rather than cutting the tissue behind the breast, the technique uses fluid infiltration and a balloon dissector to gently separate the natural plane between the breast gland and the muscle, preserving the circumareolar ligament that locks the implant in place. The payoff is a smaller incision, no tissue cutting, and an implant that sits remarkably stable. He shares what he is seeing across more than 100 Motiva cases and why he has become a believer, while staying candid about what the data does and does not yet prove.

Dr. Pacella brings the skeptic's eye, drawing on the technique he has watched performed in Costa Rica and pressing on pocket tightness, capsular contracture, and whether the balloon dissector is truly necessary or whether this is simply a small implant through a small incision. Together they land on the points patients need to hear, including the local anesthesia marketing, the micro-texturing and capsular contracture debate, and the key caveat that Preservé is a retroglandular procedure without the long term track record we have for subfascial and subpectoral placement.

In this episode:
The embryology behind breast preservation surgery
How the Preservé balloon dissection actually works
Local versus general anesthesia for augmentation
Micro-texturing and the capsular contracture data
Why the implant may matter as much as the technique
Does Preservé just mean using a smaller implant?

Whether you are researching your own options or you work in the field, this is the honest, two sided breakdown the Beauty and the Beasts audience comes for.

Perimenopause is finally getting the attention it deserves, and it shapes cosmetic surgery results far more than most people realize. In this episode of Beauty and the Beasts, Dr. Sam Jejurikar of Dallas and Dr. Sal Pacella of San Diego break down how the hormonal shifts of perimenopause and menopause change the face, the breast, and the way patients heal.

Two board-certified plastic surgeons explain why estrogen and progesterone start declining in the 40s, how that drives collagen loss, thinning skin, and facial deflation, and why women can lose one to two percent of their collagen every year leading up to menopause. They dig into how low estrogen can undercut fat transfer results, why radiofrequency skin tightening loses its punch after menopause, and the underrated roles of sleep, cortisol, and growth hormone in surgical recovery, including the emotional dip so many patients feel a few days after surgery.

They also tackle the practical questions patients actually ask. Should you stop hormone replacement therapy before surgery? How does blood clot risk factor into that decision, and how do the Caprini score and the type of procedure guide their approach? And why do breast changes like lower pole thinning and the waterfall deformity matter so much for augmentation and lifts? The takeaway is honest and clear, including why your plastic surgeon is not the one who should be prescribing your hormones.

If you are navigating perimenopause or menopause and thinking about your skin, your breasts, or a future procedure, this is a grounded, judgment-free conversation worth your time.

In this episode:
Why perimenopause matters to plastic surgeons and not just gynecologists. The collagen and elasticity changes that accelerate after menopause. How hormones affect fat transfer, facelifts, and breast surgery results. Sleep, cortisol, and recovery. The blood clot conversation around hormone therapy and surgery. What to expect emotionally after a procedure.

Beauty and the Beasts is hosted by Dr. Sam Jejurikar and Dr. Salvatore Pacella, two board-certified plastic surgeons sharing honest, behind-the-scenes conversations about aesthetic surgery, wellness, and the topics that matter most to their patients.

This episode is for educational and informational purposes only and is not medical advice. It does not create a doctor-patient relationship. Always consult a qualified, board-certified physician about your individual situation.