5 Codes Podcast

In this OR Diary, I share a revision case that challenged something I say often: that having a procedure at a younger age does not limit your options for future procedures. My patient, now 53, had surgery at 51 with the mindset that she was early in the aging process, didn't need much done, and could get away with a less expensive option. What followed was a result that not only fell short bu...

In this episode, I sit down with Julianna Peña, a two-time UFC Women's Bantamweight Champion and the first mother to ever win a UFC title. We talk about what it actually takes to compete at the highest level of mixed martial arts, from the daily grind of driving across a city between gyms as a single mom to the mental and physical toll that every fight extracts. Julie opens up about motherhoo...

In this episode, I break down the new era of the deep plane facelift and neck lift, exploring what has changed, where the field is going, and why not all deep plane facelifts are created equal. This procedure has evolved more in the last four or five years than it did over the century before, and the gap between an average result and a truly exceptional one has never been wider. We dive into the e...

In this episode, I take you into the operating room for a revision facelift that turned into one of those "what are the odds" situations you couldn't script if you tried. My patient had a deep plane facelift eighteen months earlier on the other side of the country, and she came to me with a smile block and a visible line down her face that her original surgeon recognized but couldn&...

In this episode, I sit down with Rowena Gates to explore a key element of my optimized recovery protocol: the NanoVi, a device that uses specific wavelengths to create structured, ordered water that helps proteins fold and function the way the body intends. These protein functions sit at the foundation of nearly everything that matters after surgery, from cellular energy to immune response to how...

In this episode, I share a recent full facial rejuvenation case where a patient's unusual venous anatomy forced me to make a decision in the operating room that I had not made in fifteen years. Rather than sacrifice a spiderweb of veins to take my standard approach, I reached back to a lateral technique I had learned during my fellowship at UCLA, one that had been sitting dormant since my tra...

In this episode, I explore one of the most misunderstood molecules in medicine: creatine. Most people think of it purely as a muscle-building supplement, but its real power lies in something far broader. Creatine builds a reservoir of energy that any tissue in the body can draw on when demand spikes, whether that's the brain, the immune system, or the body healing from surgery. We dive into t...

In this episode, I share the story of the friend surgeon, a case involving a fellow physician who came to me for a complex revision after a procedure performed by a local plastic surgeon she knew and trusted. Her results included asymmetric brows and eyelids, hollowed upper lids, a bony growth on her forehead, and one of the most dreaded complications of all, lower eyelid retraction that required...

In this episode, I sit down with one of my best friends, my business partner, and my training partner, Tyler Alvarado. Tyler is a CPA turned serial entrepreneur who once led a next-level tech startup out of Coeur d'Alene, and he brought that same startup mindset into helping build our practice from the inside out. We trace how our relationship evolved from two dads crossing paths at a coffee...

In this episode, I take a deep focus on one of the most controversial topics in aesthetics: dermal filler, and specifically the hyaluronic acid gel fillers that have exploded in popularity over the past decade. These products were long sold on a set of assumptions that they were temporary, inert, stable, and easily reversible, but nearly all of those assumptions have turned out to need serious qua...

In this episode, I explore the counterintuitive ways certain treatments people turn to for anti-aging can actually accelerate the aging process. I use a real patient story, a woman in her early forties who ended up needing surgery earlier than expected, to walk through how filler, tightening devices like ultrasound and radiofrequency, liposuction, Kybella, and weight loss peptides can all leave la...

In this episode, I share a rare and revealing case: a patient I've followed for ten years, with over twenty sets of high-quality photos documenting her natural progression from filler to full surgical rejuvenation. Through her story, I break down what actually happens to hyaluronic acid filler over time - including uncomfortable truths that challenge some long-held assumptions in our field: t...

In this episode, I sit down with my wife, Aubree, for a candid and fun conversation answering your most requested questions. We share the story of how we met, what we've learned through marriage and parenthood, our perspectives on health, beauty, and family life, and the daily habits that help keep us connected and growing together. From relationship advice and parenting lessons to rapid-fire...

In this episode, I explore one of the most important and often overlooked factors in aesthetic surgery: the relationship between surgeon and patient. Through a personal story about a patient I initially declined to operate on, I break down how expectations, recovery readiness, trust, communication, and long-term alignment can ultimately determine the success of a facial rejuvenation journey. CONNE...

In this episode, I explore a little-known biological pathway that may have a major impact on surgical recovery: DAMPs, or damage-associated molecular patterns. These molecular signals help the body recognize injury and initiate healing, but they also influence inflammation, nervous system stress, recovery timelines, and overall resilience after surgery. We dive into how surgical technique, tissue...

In this episode, I explore a question that sits at the heart of aesthetic medicine: what makes someone look like themselves? Using a fascinating patient case involving a former model and actress, I break down why some features commonly labeled as "flaws" are actually defining characteristics that create identity, attractiveness, and recognition. We dive into facial aging, eye aesthetics,...

In this episode, Leah Streich, PA - Dr. Chesnut’s personal medical provider - breaks down the hidden drivers behind fatigue, hormone imbalance, poor recovery, metabolic dysfunction, and why so many people still struggle despite “normal” lab work. We explore GLP-1 medications, hormones, birth control, toxin exposure, advanced blood testing, genetics, methylation, supplementation, blood pressure, an...

In this episode, I explore the hidden psychology that can unfold around major decisions, especially when identity, appearance, and social dynamics collide. Using a real patient story, I break down the cognitive biases that shape how people justify choices, project insecurities, and subtly influence those around them during vulnerable moments. We dive into cognitive dissonance, choice-supportive bi...

What if surgery didn’t have to come at the cost of your brain, recovery, or long-term performance? In this episode, we break down an anesthesia and pain management protocol designed to protect neurocognition, minimize risk, and optimize recovery - without relying on opioids, benzodiazepines, or routine general anesthesia. You’ll learn how a more intentional, physiology-first approach can improve o...

In this episode, I share a powerful case from the operating room that highlights how chronic stress, trauma, and elevated cortisol can rapidly accelerate facial aging. I break down the physiology behind stress hormones, metabolic health, tissue quality, and why your face often reflects what’s happening internally long before labs do. You’ll learn why surgery alone isn’t always the answer, the impo...

In this episode, Dr. Ryan Kelm, Harvard-trained laser specialist and cosmetic surgeon, breaks down what actually works (and what doesn’t) when it comes to devices, longevity science, and modern facial rejuvenation. We explore cellular senescence, regenerative approaches like fat transfer, and how surgical thinking is evolving to integrate technology without compromising outcomes. If you want a cle...

In this episode, I break down what I’m actually seeing in the operating room when patients have had prior thread lifts. From persistent foreign material and linear fibrosis to biofilm-related inflammation that can flare after surgery. I explain why threads often fail to deliver meaningful lift, how they can complicate future procedures, and the long-term tissue changes they may leave behind. You’l...

In this episode, I break down the science of facial fat transfer, what it actually is, and how it differs from dermal fillers when it comes to restoring volume, structure, and long-term facial health. I explain who is (and isn’t) a good candidate, the regenerative role of fat in aging tissues, and how fat grafting works at the cellular level. You’ll also learn the most common misconceptions and mi...

In this episode, I address the real future of facelifting and break down one of the most misunderstood areas in aesthetic surgery: the buccal fat pad. I explain why simply tightening skin or relying on outdated techniques fails to correct the deeper structural descent of the face, and how modern deep plane approaches reposition muscle and fat for more natural, durable results. You’ll learn what ac...

In this episode, I’m joined by Chris Duffin to break down what it really means to become a “boardroom athlete” - building strength, resilience, and longevity without sacrificing performance in business or life. We dive into the science of BFR training, anabolic signaling, and how trauma - both physical and psychological - shapes adaptation and recovery. We also unpack foot health, functional stren...