Chesnut MD Cosmetics

Chesnut MD Cosmetics Dr. Cameron Chesnut | 5C
Cosmetic surgery in Coeur d'Alene, Idaho. Preservation and restoration, never reinvention. Virtual consults👇🏼

https://hoo.be/chesnut.md

09/16/2026

Spoiler alert: we never found it.

Invisible access… Candid camera work here, caught in action looking for my own incision - access from a previous procedure that Lisa and I did together.

I quite literally laughed out loud when I saw this video that was captured. When I say invisible, I mean it so much that it even makes me look silly sometimes.

Lisa is 63 - and could easily pass for 20 years younger.

Some part of that is because we have taken a proactive, step wise surgical and regenerative approach with her over the past decade.

Lisa puts out a vibrant energy, and she feels that way inside. She has always wanted her appearance to match that! That is how she originally found me.

For us, that has meant a couple of procedures over the years that were very small, stealth, and focused on not only the exact position she was in at that time, but a mindset of decades down the road, which we can see working out in a very beautiful way for her here. 🥷🎯

Our journey originally started sometime back with revising some previous surgical procedures that she had had when she was much younger, and once we had fixed those and had her back with a solid and reset baseline, we have been very focused, responsible, and dialed in on a long-term and customized plan for her.

Lisa‘s path is not actually the norm. Most people wait until they are a little bit further along and tend to take care of everything at once. Lisa started earlier, which afforded her more ability to keep procedures smaller and focused, doing less each time and looking incredible in between.

Which path resonates with you the most?

More coming from Lisa, stay tuned…

Until then, enjoy me looking silly while hunting for my own incision. 🔎🧐

This is one of those realities where the internet’s filler fantasy version and the surgical real world are very differen...
09/14/2026

This is one of those realities where the internet’s filler fantasy version and the surgical real world are very different🙃

It feels to me as though we are finally entering an era where the long-term evidence is starting to catch up to what many of us have been observing for years in the operating room.

Most people are told filler is temporary, simple, and gone in 6–12 months.

This framing is incomplete, based on assumption alone, and has created a problematic real world orbit surrounding it.

MRI imaging, tissue biopsy, and direct visualization in surgery all show undeniable evidence that filler can persist for years, and in many cases for decades.

This fact completely disrupts the current paradigm of filler practice - something that stays in the face long-term is not just a quick or simple “tweak.” It becomes part of the tissue long term, thus part of the structure (like building on sand), and oftentimes is a key part of what people are reacting to when I hear them say, “I don’t feel like myself anymore.”

Filler also does not always stay where you put it.

Migration, or movement of filler, is real, especially in highly dynamic areas. It can also be seen happening on initial injection with ultrasound visualization. Even “well placed” filler can shift over time.

The face is not static - we do not want it to be static (think bad Botox or filler face) - these facial movements are key to the expressions the drive our nonverbal cues, a key element at the route of human communication.

When blunted movement meets inflammation and lymphatic drainage issues, we start seeing the long-term consequences show up in the mirror.

With filler moving and lasting longer than expected, we are now seeing what I often call the “mask” of filler… that subtle heaviness, puffiness, movement blunting, and static distortion that usually accumulate slowly enough that perception drift sets in.

This is a window into our neuroanatomy of facial recognition and self identity.

Make sure you send to a friend to read before they get filler 📲

09/14/2026

I did filler (yep 😉) 10 years ago for a beautiful patient’s tear troughs - she looked better for years - then yesterday we did surgery, and the process taught me some very important things.

IMO, this is the FUTURE of our discussions around filler - what happens to it as it ages, over decades? We just don’t know, and I’m starting to see it, be curious about it, and document it (like this).

I had known this patient for 10 years, and this continuity and consistency of photographs gave me something most surgeons never get: a real-time, year-by-year look at how filler actually behaves inside the face.

This was her first surgical procedure, she had the hyaluronic acid filler eight years ago that I injected myself (yep, I believed the same things that you do, but I was starting to get piqued that something wasn’t right and very curious right around this time).

I fully admit that she did look better after filler for several years…

In her case, the filler I placed eight years ago began “percolating” upward into the orbicularis oculi muscle - especially over the past few years.

It did NOT move because it was injected incorrectly.

It also did not move up (superficially) towards the skin surface into her orbicularis muscle for several years after the injection.

This is exactly why many people develop:
• Puffy lids
• A bluish hue
• Impaired lymphatic drainage
• New contour irregularities years after their injections, or years after their surgery

We removed what filler we could, restored her anatomy through scarless access surgery, reconnected her fat pads, corrected her ptosis and lower lid support, and finally addressed the underlying tear trough and eyebag issues that filler was trying to mask all those years.

If you want more deep dives on real filler behavior, let me know below.

Marie was NOT going to share her photos… then we got to SIX MONTHS and she loved her results so much that she changed he...
09/13/2026

Marie was NOT going to share her photos… then we got to SIX MONTHS and she loved her results so much that she changed her mind 🤗

*Read the first comment if you’re into the nerdy procedural details (like I am), and see an excerpt from my personal journal to myself after her surgery*

Meet Marie, 61, six months after her EnigmaLift®️, and I am incredibly grateful that she decided to let me share her journey, because I think her result illustrates something that gets lost in the way ‘we’ often talk about facial rejuvenation.

At 61, there wasn’t ONE thing making Marie look different from the version of herself she remembered, there were changes occurring across multiple layers and regions of her face at the same time, from brow position, eyelid aperture and ptosis, to facial volume, midface position, lower eyelids, jawline, neck, skin quality, and the relationship of her upper lip to the rest of her face 🧠

Prior hyaluronic acid filler, Sculptra, and facial scarring from some previous devices (including Ellacor micro-coring) were exacerbating this.

For Marie, I addressed her brow, upper and lower eyelids, ptosis and midface, removed prior filler, restored volume with her own stem cell-rich fat, performed my minimal access deep plane facelift with deep plane neck lift and contouring (both with extreme preservation using my EnigmaLift®), treated her skin with laser, and finished the balance of the lower face with my LoveLift® deep plane lip lift and corner lift. *see specific details in the first comment*

That sounds like a LOT when you list it out, yet our goal was not to make Marie look like she had a lot done 🎯

She simply looks like Marie.

Only now, she loves what she is seeing enough to decide these photos need to be shared with you (thank you for sharing Marie!) 🤗

And thank you for trusting me with your face 🙏🏼

If you want to understand how I think about facial aging, anatomy, and natural facial rejuvenation rather than simply chasing individual treatments, follow me! 🧠

09/10/2026

Should women fast? What about cold plunging? Training differently throughout their cycle? 🤔

There is SO much conflicting information around women’s health right now, so I wanted to go directly to someone who lives in this space.

Leah Streich PA-C joined me on 5 Codes Podcast to talk through the physiology, the nuance, and why the answer is rarely as simple as “women should” or “women shouldn’t.”
🧠

(If you’re a patient of mine , you probably know Leah well!😊)

Fasting, hormones, training, cold exposure, metabolic health - we got into ALL of it.

Leah knows this space incredibly well, and I learned a lot from this conversation 🙌🏼

This is especially important to me because in my practice I pay very close attention to and think often about the hormonal transition surrounding menopause (40s-60s) as a more important factor in facial aging that the actual chronologic age - I am particularly focused on what happens to skin, elastin/collagen, facial fat, muscle, facial bone structure, ligaments, hair, lymphatics, and even healing capacity.

Go listen to the full episode 5 Codes Podcast 🎧

A pretty epic couple of days in Coeur d’Alene with my friend DR. J 🙌🏼Dr. Jason is the founder of Therabody - a company t...
09/09/2026

A pretty epic couple of days in Coeur d’Alene with my friend DR. J 🙌🏼

Dr. Jason is the founder of Therabody - a company that makes truly athlete-driven products that I love and use personally.

I also use Therabody throughout my practice to help my patients in their recovery protocols.

Dr. Jason came up to visit both my practice and meet my team, and visit my home to hang with my family.

We recorded an awesome 5 Codes Podcast, got an underwater pool workout in 🤿 , played some golf CDA National Reserve ⛳️ with James Sprague and had a LOT of great conversations in between.

I already had tremendous respect for what Jason has built, but I loved getting to know him better as a human, dad, entrepreneur, and friend. We went deep on health, parenting, life, changing nervous system states, and plenty more 🧠

Jason spends a great deal of time with the most elite teams and the highest level athletes in the world. His conversations and integrations with these types of teams and athletes are what drive research and new product development - Therabody is 💯 creating their products for what their athletes need, whether a Premiere League soccer team or an NFL superstar.

Jason, THANK YOU for making the trip up and spending a couple days with me! I am grateful for the time and friendship, and I can’t wait to have you back in CDA 🤝🏻

Our conversation comes out NEXT MONTH 🎙️

Stay tuned… this is a good one 👀

Under eye dark circle correction, completely scarless!😯🤯 This is a beautiful follow up to our discussion from a few days...
09/07/2026

Under eye dark circle correction, completely scarless!😯🤯

This is a beautiful follow up to our discussion from a few days ago about the causes of dark under eye circles.

Under eye dark circles can have multiple causes:
🧬 genetic under eye coloration
🫀blood vessels showing through
☀️ sun damage and pigmentation on her skin
👜 bagging (fat herniation) creating shadow
💉purple discoloration from filler - this is common
🖤 post inflammatory discoloration (can also be related to filler)

In the situation we see here, her under eyes were strongly genetic with under eye bags, shadows, and blood vessel is showing through.

We utilized my signature EnigmaLift®️:

☝🏻 EnigmaLift®️ scarless lower eyebags
✌🏻 Stem Cell Rich Optimized Fat Transfer
🤟🏻 Customized Laser Cocktail

Lower eyelid bags have a strong genetic link, and this is the most common procedure that I perform in young patients.

Thankfully, we are able to achieve an anatomic change in the area that is long-term and durable - nothing temporary, and no shelf life as there is with injectable products (which could never achieve this result anyway).

This beautiful, young woman was bothered by her lower lid bags, and a close relative had just had her lower lids operated on by another surgeon. After digging and doing her research, she found me and wanted a long-term plan that would provide the best possible results that she could get.

We customized my scarless lower eye bag EnigmaLift®️ to address her bags - you have probably heard me say that even I am constantly amazed by the results that we are able achieve without having to create a scar!

We then fortified her result with some focal and strategic stem cell based optimized fat transfer to her mid face and cheeks for long-term, durable volume with a custom laser cocktail to the surface of her skin to cap it off.

What do you think of her results?

WELCOME TO THE NEXT LEVEL ®️

09/06/2026

Think you need upper eyelid surgery? PAUSE 😬 What if the problem isn’t actually your upper eyelid?

I see this all the time, and in my expert opinion, upper eyelid skin excision should be the fourth thing we are addressing in our thought paradigm about re-creating function (first) and beautiful form in the upper eyelid. Yet… skin excision is often the first, or better said the ONLY thing, that people (surgeons included) focus on.

Amelia is such a beautiful example of this. She had felt like she had heavy, hooded upper eyelids essentially her entire life, and she was seeking an upper eyelid surgery - yet a sinking brow and forehead or what actually made her eyes feel more closed and less lifted.

I corrected her beautifully and functionally with a focus on her brow.

This is one of the most misunderstood parts of “upper eyelid aging” 🧠

When somebody tells me, “I have extra upper eyelid skin,” my first thought is NOT how much skin can I remove?

That upper eyelid can simply be the fixation point where the forehead, scalp, and brow complex have gravitationally cascaded down and eventually come to rest - it is the downstream watershed, not the baseline issue.

If you cut away the skin without understanding WHY it is there, you are treating the endpoint rather than the actual problem.

For Amelia, the answer was scalp and forehead support 🎯

We repositioned and supported her forehead and brow, restoring them back toward where they naturally wanted to live.

Then look what happened to her upper eyelids 👀

Without removing upper eyelid skin, her eyes look more lifted, open, and awake, while still looking completely like Amelia.

This is exactly why I say the upper eyelid is not just the upper eyelid. You have to understand the entire forehead, temple, brow, and eyelid complex before deciding what actually needs to be treated.

Sometimes the best “eyelid surgery” is NOT touching the eyelid at all. 😉

What do you notice about Amelia’s eyes? Tell me below 👇🏼

09/04/2026

Nobody talks about this 😬 FILLER can actually lead you to seek surgery that you might not have otherwise gotten.

I think this is an incredibly important part of the filler conversation, mostly because the more common narrative from some injectors sounds something like this:

“My patients only ‘want’ filler because they are never going to have surgery.”

Hmm… are you sure about that? 🤔

I think there is a lot of misunderstanding buried in that statement, and sometimes a fair amount of projection from the injector about what their patients supposedly want.

“Surgery is invasive.”
“Surgery is scary.”
“You don’t want to do THAT.”

Paired with:

“Filler is simple and easy + it’s temporary + if you don’t like it, we can just dissolve it - it doesn’t last that long.”

These are the assumptions that filler has been sold under for YEARS, and we now have to start qualifying and clarifying them 🧠

We KNOW filler can persist far longer than we originally thought. We know it can move, change how tissues behave over time, create recognizable “filler signatures,” and sometimes leave somebody looking less and less like themselves.

Then what happens?

That patient who was supposedly “never going to have surgery” starts seeking surgery to address changes that may, in part, have been created by years of trying to avoid it with that filler.

That is a VERY different conversation 🎯

This does not mean filler is always bad, or that everybody should skip directly to surgery. It means we need to stop presenting the decision as “simple, temporary filler” versus “big, scary surgery” when the long-term reality is so much more nuanced.

We have to qualify those old, largely disproven assumptions, and we have to talk about what we actually know to be true NOW.

Long-term mindsets and thinking change everything.

Have you ever felt like years of filler actually pushed you closer to considering surgery? Tell me below 👇🏼

Watch the full episode on 5 Codes Podcast

Address

1831 N. Lakewood Drive Suite #1
Spokane, WA
83814

Opening Hours

Monday 8am - 4pm
Tuesday 8am - 4pm
Wednesday 8am - 4pm
Thursday 8am - 4pm
Friday 8am - 4pm

Telephone

+15092521299

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