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Craft MD Craft MD: Phoenix’s patient-centric practice led by Double Board-Certified Plastic Surgeon Dr.Craft

10/18/2026

Buying something for son

10/17/2026

Disclosure first. That’s Dr. Anderson, who does injectables in my practice, and this is the setup we charge for. Read the rest knowing that.

The patient came in with a Sculptra nodule she wanted broken up. Sculptra isn’t hyaluronic acid, so there is no enzyme that dissolves it. The tool is saline, injected into the nodule to disperse it. On the screen behind him is her face under ultrasound, in real time. The nodule is the dark shape. The pulsing line beside it is an artery.

They are closer than anyone injecting by feel would guess. That’s the whole video.

Every injection into a face is a bet about where the vessels are. Anatomy diagrams show the average. Nobody is the average. Ultrasound shows the actual artery, in the actual patient, while the needle is moving. That applies to placing filler, dissolving filler, and treating what filler leaves behind, even when the only thing in the syringe is salt water.

Here is what the evidence does and doesn’t say. For treating a vascular occlusion after it happens, ultrasound-guided hyaluronidase has a strong track record across dozens of published cases. For preventing one, nobody has run the trial comparing guided to blind injection. What ultrasound gives you is not a statistic. It’s the picture. If you can see the artery, you can go around it.

Ask your injector one question: how do you know where my vessels are? “Experience” is an answer. It’s not the best one available.

10/16/2026

Disclosure first: I do the alternative. Fat under the chin gets liposuction in my practice, under direct control, in one session. I make money when you choose that over a syringe. Read the rest knowing that.

I have never used Kybella for the one thing it’s approved for. Not because it can’t dissolve fat under a chin. It can. Because I’d rather decide exactly where fat comes out than inject a detergent and wait to see what else it reaches.

What I have seen is the other end: patients injected somewhere it was never approved to go, sent to me with the result.

That’s the FDA’s page behind me. Last month they added two things to the label.

One. Since 2015, 129 reported cases of adverse events from injection outside the under-chin area. Blurred or reduced vision when it went near the eyes. Nerve and muscle injury. Facial weakness. Numbness. The label now says don’t.

Two. 117 cases of nodules or masses that hadn’t gone away, present for an average of about five months when reported. Those happened with approved use too.

This is a label update, not a recall. Used where it’s approved, by someone who can manage what goes wrong, it’s a legitimate option. I’m not that someone, by choice. The patients I’ve met weren’t that patient.

Ask what’s being injected, where, and who handles it if it doesn’t go to plan.

That’s my hand and my b**r. Read the rest knowing which answer I wanted.A post says alcohol cuts muscle growth by up to ...
10/14/2026

That’s my hand and my b**r. Read the rest knowing which answer I wanted.

A post says alcohol cuts muscle growth by up to 37%. The study is real: eight men, one hard workout, then about 120 grams of alcohol in three hours. That’s eight and a half standard drinks, or ten of the light b**r in my hand. The authors picked that dose to match an athlete’s binge.

The 37% compares alcohol without protein to protein without alcohol. Two things changed. With protein in both, the drop was 24%. Every version still beat resting levels, and nobody measured size or strength.

One b**r? I couldn’t find a study of protein synthesis or next-day strength after one. In one lab, about three drinks did nothing measurable to strength recovery and about six made it worse. Other labs haven’t seen the six-drink effect. These are ten-man studies. They can miss small effects.

This is not a defense of drinking. Alcohol is a carcinogen. If you don’t drink, nothing here is a reason to start.

The recovery I answer for is surgical. Heavy drinkers put on an intensive quit program around surgery had 38% fewer complications in three small randomized trials. My pre-op instructions say no alcohol. For a light drinker that’s caution more than proof.

Next time a number scares you, ask: compared to what?

Muscle is medicine. I lift five days a week, so I wanted that to be true. I read the studies anyway.Proven, in randomize...
10/12/2026

Muscle is medicine. I lift five days a week, so I wanted that to be true. I read the studies anyway.

Proven, in randomized trials: lifting makes you stronger at any age. Nursing-home residents averaging 87 got 113% stronger in ten weeks. Their muscle barely grew.

Only observed: strong people live longer. In 139,691 people, grip strength predicted death better than blood pressure did. No trial of lifting has been big enough to count deaths, and that paper says nobody knows yet whether getting stronger changes the risk.

The part I didn’t want to read: when studies measure size and strength in the same people, strength tracks the risk and size mostly doesn’t. And more wasn’t better. Two large analyses put the sweet spot at 40 minutes a week and at 90 to 119. I do about 150.

What I tell patients: forty minutes to two hours a week. Legs and grip first. Add cardio. Any age.

The mirror is for my six-year-old. He has an excuse.

10/12/2026

I love him so much. But sometimes it’s Montreal versus Boston in here.

Offsetting majors. By dinner neither of us remembers the infraction. He started it.

For the record, nobody drops the gloves. I’m a plastic surgeon and I don’t generate my own referrals. He’s an anesthesiologist and could end any argument in about forty seconds. So far he’s shown restraint.

If you’ve seen Heated Rivalry, you know how these rivalries get settled. Same.

10/11/2026

To be clear: the b**r.

Being his dad is the best thing I’ve ever done. Somewhere along the way it also became the thing the rest of my life is organized around. Nobody warns you about that part. I wouldn’t change it.

I’m also good with one. He gets all of me, and I still run a practice, make it to the gym, and occasionally finish a sentence. Add a second and something has to go. Probably the sentence.

He’s a limited edition. The b**r is on tap.

10/10/2026

Youn Stitch Reel

10/09/2026

Gynecomastia. Same man, six months apart. Frontal, 45, lateral.

He'd done the work. Lean, training for years. The chest didn't move because it was never fat. It was gland, and gland doesn't answer to a deficit.

This is how I do it. Liposuction first, to take the fat around the gland and feather the edges. Then direct excision of the gland itself through a small incision at the lower edge of the ar**la. Then I stop early. I leave a disc of tissue under the ni**le on purpose, because taking all of it is how you get the crater: a ni**le sitting in a dent, which looks worse than what he walked in with and is much harder to fix. Then Renuvion under the skin. Helium plasma, subdermal, to tighten what lipo loosened. It's the one add-on I've kept.

It's common. Somewhere between a third and two thirds of adult men have palpable breast tissue depending on whose series you read. Most never mention it. The ones who do have usually spent years assuming it was their fault.

Photographs unretouched. Exposure and background matched between sessions. Face cropped by patient request, tattoo kept by patient consent.

I'm 50. That's me, my partner, and our boys in a gym mirror, which is where I've spent most of my adult life. I was an o...
10/07/2026

I'm 50. That's me, my partner, and our boys in a gym mirror, which is where I've spent most of my adult life. I was an obese kid; the weight room is where that stopped. I do almost no cardio I'd call hard.

A post told me scientists put 50-year-olds on a protocol for two years and their hearts looked 20 years younger. The post credits a podcaster and sells a book. The study is real: Howden and Levine, UT Southwestern, Circulation 2018. Sixty-one sedentary adults, mean age 53, randomized, two years.

The exercise group did four to five sessions a week, including one 4x4 interval session and strength work. VO2max went up 18 percent and the stiffness of the left ventricle dropped by about a third. The control group did yoga, balance, and strength three times a week. Nothing moved.

Read that again. The control group lifted. I lift. I have never done a 4x4. By this trial's design, I'm the control group.

Same lab tried it on 70-year-olds. Fitness improved, the heart didn't remodel. The window is middle age and it closes. I'm inside it.

So: one 4x4 a week, built up over six months, starting with one-minute intervals. Keep lifting. Get my VO2max measured now and in a year, and post both numbers, especially if they're bad. The boys are the reason.

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85018

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