Chesnut MD Cosmetics

Drama this week… Mental sabotage? Why would someone’s own support person undermine them during recovery?

I had a patient whose best friend came to help care for her after surgery. When I first met them, everything felt warm, supportive, and exactly what you would hope for. As the week unfolded, though, I started noticing subtle comments, small criticisms, tiny seeds of doubt, and individual remarks that seemed insignificant on their own, but together began changing how the patient interpreted an otherwise “perfect” recovery.

I learned throughout the week that the care person had had a facial rejuvenation surgery of her own with a local surgeon in their hometown.

My lightbulb went off. I thought to myself: “this is care person sabotage.”

This is not a psychological diagnosis. It’s simply a pattern I’ve observed (more subtly in the past) where the very person who is supposed to provide reassurance slowly introduces uncertainty instead.

The fascinating question is WHY?

In many cases, I don’t think it’s intentional. It is human psychology.

Once we’ve made a major decision, particularly one involving our face, identity, or appearance, our brains naturally become invested in believing we made the right choice.

If we’re then exposed to someone who chose a different surgeon, a different philosophy, or appears to be having an excellent experience, it can create subtle internal tension. This is known as cognitive dissonance.

One way the brain resolves that discomfort is by looking for flaws.

That process is often strengthened by confirmation bias, where we naturally notice information that supports what we already believe.

Sometimes there is also an element of social comparison. Watching someone else experience a beautiful recovery can create an unconscious need to minimize what we’re seeing in order to protect our own decision and sense of satisfaction.

These are remarkably common cognitive biases that affect all of us.

Have you ever watched someone’s confidence slowly erode because of the commentary from the very person who was supposed to support them? I’d be curious to hear your thoughts, as this is a new observation of mine

Many men are currently terrified… with good reason. Male facial surgery is inherently different - this is especially true around the eyes, and when that is not understood, not respected, you get what we see far too often today.

Anthony is a prime example of a masculine face at baseline, but as he aged that internal identity started to decouple from what he saw in the mirror. He wanted to look and see something that reflected the way he currently saw himself, and what he felt inside.

With all the things he was seeing about prominent men changing their look, he was nervous about changing his own baseline masculine look, not recognizing himself afterwards, or looking like he had something done.

That is how he found me - he saw that my results maintained the person’s essence and identity, yet they always look refreshed and more vital afterwards.

When he first saw these results, he said it looked like photos of him in his 20s.

Ironically, that’s not necessarily the exact goal - yet I thought it was interesting to see his neurobiology recognize his old self image.

As far as procedures performed: after extensive conversation, together we created a fully customized plan for him utilizing my invisible EnigmaLift®️ to rejuvenate his forehead and upper eyelids.

We paired this with my stem cell-rich optimized fat transfer (to improve his cheeks and lower face), and finished with my customized laser cocktail.

Maintaining his rugged masculinity was absolutely key, as we were focused on rejuvenating his brow and upper lids, which was very well accomplished.

🎯 My goal was to reveal the character of his eyes that was being concealed by his aging changes, so he just looks like a fresher version of himself!

All of these procedures were performed in a very minimally invasive, very durable fashion.

He had that VERY important wedding a couple of weeks after this, and we were able to get him recovered with plenty of time, thanks to my optimized recovery protocol!

What do you think of his results? 🤗

WELCOME TO THE NEXT LEVEL®️

The very last thing I do at the end of a procedure is one of the most important parts of my recovery protocol.

I perform very precise nerve blocks using a long-acting local anesthetic called liposomal bupivacaine. The nerves in the face are extremely reliable anatomical targets, and by placing the medication directly around them, we can significantly blunt the peripheral pain signals traveling back to the brain for up to three days! 🧠

This is very different from waiting until someone is in pain and then trying to cover it up with opioids, or just taking opioids to “get ahead of the pain.“ 🤦🏻‍♂️

My goal is to interrupt that pain pathway before the brain ever even feels any discomfort from the surgical signal (we call this “priming“).

In practical terms, we are significantly blunting the pain response for the first two or three days, which is the time period when most of the typical postoperative discomfort tends to be the strongest 🎯

I always explain to my patients that this is not perfect. It is not necessarily rainbows and puppy dogs after surgery, and I never want to create unrealistic expectations. You may still feel pressure, tightness, soreness, or awareness that something happened.

That being said, the sharp peripheral pain signals are dramatically reduced, which helps patients stay more comfortable, sleep better, move more normally, and avoid the downstream effects of opioids like brain fog, constipation, nausea, and neuroinflammation.

This is one of the reasons my patients are often surprised by how manageable their recovery feels. It is not an accident - it comes from understanding and controlling the pain pathway at its source - building the recovery plan into the procedure itself 💉

What questions do you have about nerve blocks, liposomal bupivacaine, or how I manage discomfort without opioids?

Drop them below 👇🏼