The Plastic Surgery Consultation What Patients Should Expect

In this episode of Beauty and the Beasts, plastic surgeons Dr. Sam Jejurikar and Dr. Salvatore Pacella focus on one of the most important parts of plastic surgery that often gets overlooked: the consultation.

For many patients, the first visit with a plastic surgeon can feel intimidating. Most people arrive having done extensive online research and often come in asking for a specific procedure. Dr. Jejurikar and Dr. Pacella explain why the best consultations are not about requesting an operation, but about clearly explaining concerns, goals, and what truly bothers the patient.

The conversation explores how experienced surgeons structure a consultation, beginning with open ended questions and careful listening. The hosts emphasize the importance of rapport and trust, noting that plastic surgery is often a concierge style relationship that requires strong communication before, during, and after surgery.

A major focus of the episode is the physical examination and why it remains essential in plastic surgery. Dr. Pacella discusses the value of face to face interaction, hands on examination, and tissue evaluation, and why these elements cannot be replaced by electronic medical records or imaging alone.

The episode also covers the questions patients should expect to have answered during a consultation, including safety, recovery, and implant related concerns. The surgeons discuss how they address breast implant associated conditions, including lymphoma and breast implant associated illness, and why transparency about what is known and unknown is critical.

Financial considerations are addressed as well, including third party financing and how patients can prepare in advance to understand costs and options. The role of three dimensional imaging is discussed, with insight into how modern tools are best used for communication and assessment rather than exact prediction of results.

The episode concludes with a discussion on board certification and recovery planning, explaining why training, qualifications, and a clear understanding of postoperative recovery are essential before moving forward with surgery.

This episode is ideal for anyone considering plastic surgery, preparing for a first consultation, or wanting a clearer understanding of how to choose a surgeon and get the most out of the consultation process.

Revision Breast Surgery Why Secondary Breast Operations Are So Common

In this episode of Beauty and the Beasts, plastic surgeons Dr. Sam Jejurikar and Dr. Salvatore Pacella discuss secondary and revision breast surgery and explain why it is one of the most common procedures in modern breast surgery.

Many patients are surprised to learn that breast implants are not lifetime devices. Over time, changes in breast tissue, aging, pregnancy, weight fluctuation, implant wear, and personal preferences often lead patients to require revision surgery. In many practices, secondary breast operations are performed as frequently as primary breast augmentation.

The conversation covers the most common reasons patients seek breast revision, including capsular contracture, implant rupture, malposition, bottoming out, asymmetry, and changes in desired implant size. Dr. Jejurikar and Dr. Pacella explain what capsular contracture is, why it occurs, and how it can affect both comfort and appearance.

The episode highlights why revision breast surgery is significantly more complex than primary breast augmentation. Unlike first time surgery, revision cases often require pocket reconstruction, correction of the breast fold, reinforcement of tissue support, and frequently a breast lift to restore proper shape and nipple position.

Dr. Pacella explains the role of internal support systems, often referred to as internal bras, and why tissue that has supported implants for many years is often unreliable on its own. The surgeons clarify that internal support does not replace the need for a breast lift and discuss how physical exam findings determine the surgical plan.

Implant technology and capsular contracture prevention are discussed, including Motiva implants, acellular dermal matrices, and bioresorbable meshes. The surgeons explain what the current medical literature supports and where data is still lacking.

The episode also addresses ruptured breast implants, how they are diagnosed using ultrasound or MRI, whether ruptures pose health risks, and why addressing them sooner rather than later can simplify revision surgery.

This episode is ideal for patients with breast implants, those considering revision breast surgery, and anyone who wants a realistic understanding of why secondary breast operations are common and how they are approached safely and effectively.

Rhinoplasty - Form, Function, and Natural Results

In this episode of Beauty and the Beasts, plastic surgeons Dr. Sam Jejurikar and Dr. Salvatore Pacella explore rhinoplasty, one of the most technically demanding and misunderstood procedures in plastic surgery.

Rhinoplasty is often thought of as cosmetic nose reshaping, but the surgeons explain why it is just as much about structure and breathing as it is about appearance. The discussion highlights why rhinoplasty requires a unique skill set, why experience matters, and how small changes can have a major impact on both aesthetics and airflow.

Dr. Jejurikar and Dr. Pacella compare open and closed rhinoplasty techniques and explain why the choice depends on surgical goals rather than patient requests. They discuss cartilage support, tip shaping, and why the small scar associated with open rhinoplasty is usually insignificant.

The episode addresses common patient misconceptions, including the desire to copy celebrity noses. The surgeons explain why nasal skin quality, facial proportions, and individual anatomy make this unrealistic and why the goal should always be for the nose to fit the face while preserving identity and character.

Male and female rhinoplasty differences are discussed, with a focus on subtlety in male patients and the risks of over reduction. The surgeons explain how masculine nasal features differ from feminine ones and why preserving these differences is critical.

A significant portion of the conversation focuses on functional rhinoplasty and breathing. Dr. Pacella explains how airway evaluation, septal alignment, and internal nasal valve support are essential parts of planning surgery. Dr. Jejurikar discusses how cosmetic maneuvers can unintentionally affect breathing if not carefully managed.

Recovery is covered in detail, including what patients can expect in the first few weeks, why swelling resolves gradually, and why final results continue to refine over a full year. Dr. Pacella also shares his personal experience undergoing rhinoplasty for breathing issues and how it shaped his approach to patient care.

This episode is ideal for patients considering rhinoplasty, those researching cosmetic or functional nose surgery, and clinicians interested in the intersection of aesthetics and airway preservation.