Loose skin on the upper arms is super common, especially after weight loss, and it can really make people feel self-conscious.

The truth is, no amount of exercise can tighten loose skin. That’s where an arm lift comes in. Dr. Koehler, Dr. Gardner, and Kirstin explain how the procedure removes extra skin and reshapes the arms for a smoother, more toned look.

They clarify that while there are non-surgical skin tightening options, they’re best for mild cases. If there’s a lot of extra skin, surgery is the only way to truly see a big change.

Recovery takes a little patience—there’s swelling, and you’ll need to avoid lifting your arms too much at first—but results are long-lasting as long as your weight stays stable.

Most people say it’s totally worth it for the confidence boost, especially those who’ve worked hard to lose weight. It’s not a “shrink wrap” fix, and scars are part of the tradeoff, but for many, the payoff is life-changing.

Read more about arm lift surgery

Follow Dr. Gardner on Instagram @drvincentgardner and TikTok @drgardner

Alabama the Beautiful is the cosmetic surgery podcast co-hosted by Dr. James Koehler, a surgeon with over 2 decades of expertise in cosmetic surgery and his trusty co-host Kirstin, your best friend, confidante, and the snarky yet loveable “swiss army knife” of Eastern Shore Cosmetic Surgery.

Have a question for Dr. Koehler or Kirstin? Record your voicemail at alabamathebeautifulpodcast.com and we’ll answer it on the podcast.

Eastern Shore Cosmetic Surgery is located off Highway 98 at 7541 Cipriano Ct in Fairhope, Alabama.

To learn more about the practice or ask a question, go to easternshoreplasticsurgery.com 

Follow Dr. Koehler and the team on Instagram @easternshorecosmeticsurgery

And on TikTok @jameskoehlermd

Watch Dr. Koehler & Kirstin on YouTube @JamesKoehlerMD

Alabama The Beautiful is a production of The Axis: theaxis.io

Theme music: Never Need a Reason, Guy Trevino and Friends

Where your implants go—above or below the muscle—actually makes a big difference. It can change how your breasts look and feel, and how you recover.

Most people go under the muscle because it gives a more natural look and lowers the risk of capsular contracture.

Dr. Koehler, Dr. Gardner and Kirstin explain how your body type, fitness level, and goals all play into what’s best for you. Above the muscle can work great for some athletes or people with enough natural tissue, but for most, under the muscle just makes sense.

They also clear up a few myths, like needing new implants every 10 years, and talk honestly about complications like animation deformity and capsular contracture.

Bottom line: there’s no one “right” answer. Have an open chat with a surgeon you trust, listen to your body, and make the choice that fits your lifestyle.

Read more about breast augmentation

Follow Dr. Gardner on Instagram @drvincentgardner and TikTok @drgardner

Alabama the Beautiful is the cosmetic surgery podcast co-hosted by Dr. James Koehler, a surgeon with over 2 decades of expertise in cosmetic surgery and his trusty co-host Kirstin, your best friend, confidante, and the snarky yet loveable “swiss army knife” of Eastern Shore Cosmetic Surgery.

Have a question for Dr. Koehler or Kirstin? Record your voicemail at alabamathebeautifulpodcast.com and we’ll answer it on the podcast.

Eastern Shore Cosmetic Surgery is located off Highway 98 at 7541 Cipriano Ct in Fairhope, Alabama.

To learn more about the practice or ask a question, go to easternshoreplasticsurgery.com 

Follow Dr. Koehler and the team on Instagram @easternshorecosmeticsurgery

And on TikTok @jameskoehlermd

Watch Dr. Koehler & Kirstin on YouTube @JamesKoehlerMD

Alabama The Beautiful is a production of The Axis: theaxis.io

Theme music: Never Need a Reason, Guy Trevino and Friends

Not all med spas are created equal. Dr. James Koehler and Kirstin walk through how to spot a safe, physician-run med spa versus those “too good to be true” spots.

They explain the difference between traditional spas, medical spas, and those connected to surgical practices—where you benefit from having both non-surgical and surgical options under one roof. Dr. Koehler also shares what really goes on behind the scenes, from safety regulations to who should be doing your injections.

And when it comes to bargain Botox? He’s seen what can go wrong. His advice: if the price sounds too good to be true, it probably is.

Read more about the medical spa at Eastern Shore Cosmetic Surgery

Alabama the Beautiful is the cosmetic surgery podcast co-hosted by Dr. James Koehler, a surgeon with over 2 decades of expertise in cosmetic surgery and his trusty co-host Kirstin, your best friend, confidante, and the snarky yet loveable “swiss army knife” of Eastern Shore Cosmetic Surgery.

Have a question for Dr. Koehler or Kirstin? Record your voicemail at alabamathebeautifulpodcast.com and we’ll answer it on the podcast.

Eastern Shore Cosmetic Surgery is located off Highway 98 at 7541 Cipriano Ct in Fairhope, Alabama.

To learn more about the practice or ask a question, go to easternshoreplasticsurgery.com 

Follow Dr. Koehler and the team on Instagram @easternshorecosmeticsurgery

And on TikTok @jameskoehlermd

Watch Dr. Koehler & Kirstin on YouTube @JamesKoehlerMD

Alabama The Beautiful is a production of The Axis: theaxis.io

Theme music: Never Need a Reason, Guy Trevino and Friends

Rhinoplasty isn’t about picking a nose from Instagram—it’s about creating balance and preserving function unique to you. 

Dr. James Koehler explains that while many patients bring in celebrity photos for wish pics, real results depend on each person’s unique anatomy and structural limits.

He and Kirstin break down common misconceptions, surgical techniques, and what recovery looks like. 

From open and closed techniques to newer preservation approaches, Dr. Koehler explains how he keeps results looking natural while helping you breathe and heal better. He also touches on fillers for nose reshaping, sharing why they can be risky and why surgery is usually the safer, more lasting option.

Read more about rhinoplasty

Alabama the Beautiful is the cosmetic surgery podcast co-hosted by Dr. James Koehler, a surgeon with over 2 decades of expertise in cosmetic surgery and his trusty co-host Kirstin, your best friend, confidante, and the snarky yet loveable “swiss army knife” of Eastern Shore Cosmetic Surgery.

Have a question for Dr. Koehler or Kirstin? Record your voicemail at alabamathebeautifulpodcast.com and we’ll answer it on the podcast.

Eastern Shore Cosmetic Surgery is located off Highway 98 at 7541 Cipriano Ct in Fairhope, Alabama.

To learn more about the practice or ask a question, go to easternshoreplasticsurgery.com 

Follow Dr. Koehler and the team on Instagram @easternshorecosmeticsurgery

And on TikTok @jameskoehlermd

Watch Dr. Koehler & Kirstin on YouTube @JamesKoehlerMD

Alabama The Beautiful is a production of The Axis: theaxis.io

Theme music: Never Need a Reason, Guy Trevino and Friends

The more pregnancies you have—or the bigger the baby—the more likely you are to develop diastasis recti, when the “six-pack” muscles drift apart. Instead of snapping back together, those muscles can leave a gap that affects both strength and appearance.

A tummy tuck often includes repairing these muscles by bringing them back to the midline. This step is key to restoring strength, stability, and a flatter abdominal contour.

Dr. James Koehler and Dr. Vincent Gardner discuss what causes diastasis recti, why repair is important, and what recovery looks like after a tummy tuck. They also stress the importance of maintaining results with healthy weight management.

Follow Dr. Gardner on Instagram @drvincentgardner and TikTok @drgardner

Learn more about tummy tuck

Alabama the Beautiful is the cosmetic surgery podcast co-hosted by Dr. James Koehler, a surgeon with over 2 decades of expertise in cosmetic surgery and his trusty co-host Kirstin, your best friend, confidante, and the snarky yet loveable “swiss army knife” of Eastern Shore Cosmetic Surgery.

Have a question for Dr. Koehler or Kirstin? Record your voicemail at alabamathebeautifulpodcast.com and we’ll answer it on the podcast.

Eastern Shore Cosmetic Surgery is located off Highway 98 at 7541 Cipriano Ct in Fairhope, Alabama.

To learn more about the practice or ask a question, go to easternshoreplasticsurgery.com 

Follow Dr. Koehler and the team on Instagram @easternshorecosmeticsurgery

And on TikTok @jameskoehlermd

Watch Dr. Koehler & Kirstin on YouTube @JamesKoehlerMD

Alabama The Beautiful is a production of The Axis: theaxis.io

Theme music: Never Need a Reason, Guy Trevino and Friends

We’re excited to welcome Dr. Vincent Gardner to the Eastern Shore Cosmetic Surgery family. With more than 20 years of experience in both general and cosmetic surgery, he brings a unique blend of skill, compassion, and perspective to our team.

Earlier in his career, Dr. Gardner cared for many patients who had undergone bariatric surgery. Witnessing how excess skin often affected their confidence is what sparked his interest in cosmetic surgery. He’s passionate about helping people reach that “reveal moment” where they can finally see and feel the results of their hard work.

In addition to his cosmetic focus, Dr. Gardner has spent more than two decades treating venous disorders. His minimally invasive vein procedures restore comfort, energy, and confidence—helping patients feel like themselves again.

Faith also plays a meaningful role in his approach. Dr. Gardner often prays with patients, supporting healing in both body and spirit.

Follow Dr. Gardner on Instagram @drvincentgardner and TikTok @drgardner

Alabama the Beautiful is the cosmetic surgery podcast co-hosted by Dr. James Koehler, a surgeon with over 2 decades of expertise in cosmetic surgery and his trusty co-host Kirstin, your best friend, confidante, and the snarky yet loveable “swiss army knife” of Eastern Shore Cosmetic Surgery.

Have a question for Dr. Koehler or Kirstin? Record your voicemail at alabamathebeautifulpodcast.com and we’ll answer it on the podcast.

Eastern Shore Cosmetic Surgery is located off Highway 98 at 7541 Cipriano Ct in Fairhope, Alabama.

To learn more about the practice or ask a question, go to easternshoreplasticsurgery.com 

Follow Dr. Koehler and the team on Instagram @easternshorecosmeticsurgery

And on TikTok @jameskoehlermd

Watch Dr. Koehler & Kirstin on YouTube @JamesKoehlerMD

Alabama The Beautiful is a production of The Axis: theaxis.io

Theme music: Never Need a Reason, Guy Trevino and Friends

A little extra TLC can make all the difference after cosmetic surgery. Dr. Koehler swears by lymphatic drainage massage for speeding up recovery after procedures like liposuction and tummy tucks. 

By helping move excess fluid to the lymph nodes, this gentle technique can cut down swelling, ease discomfort, and get you back on your feet faster.

Find out when to start, how often to go, how to find a good specialist, and why DIY can sometimes do more harm than good. If you want the smoothest recovery and the best results, this just might be your secret weapon.

Read more about tummy tuck and liposuction

Alabama the Beautiful is the cosmetic surgery podcast co-hosted by Dr. James Koehler, a surgeon with over 2 decades of expertise in cosmetic surgery and his trusty co-host Kirstin, your best friend, confidante, and the snarky yet loveable “swiss army knife” of Eastern Shore Cosmetic Surgery.

Have a question for Dr. Koehler or Kirstin? Record your voicemail at alabamathebeautifulpodcast.com and we’ll answer it on the podcast.

Eastern Shore Cosmetic Surgery is located off Highway 98 at 7541 Cipriano Ct in Fairhope, Alabama.

To learn more about the practice or ask a question, go to easternshoreplasticsurgery.com 

Follow Dr. Koehler and the team on Instagram @easternshorecosmeticsurgery

And on TikTok @jameskoehlermd

Watch Dr. Koehler & Kirstin on YouTube @JamesKoehlerMD

Alabama The Beautiful is a production of The Axis: theaxis.io

Theme music: Never Need a Reason, Guy Trevino and Friends

Every year there’s a new “miracle” face lift with a catchy name. But a lot of these are just clever marketing spins on the same thing. 

Dr. Koehler and Kirstin sort through the alphabet soup of face lift techniques, from mini lifts that might work for a younger crowd to powerhouse options like the lateral SMASectomy and deep plane face lift.

They cover which buzzword procedures to be cautious about, why the surgeon’s skill matters way more than the trademarked name, and the extra know-how it takes to get great results for men versus women.
If you’re wondering what’s real and what’s just branding, this one’s worth a listen.

Read more about face lift surgery

Alabama the Beautiful is the cosmetic surgery podcast co-hosted by Dr. James Koehler, a surgeon with over 2 decades of expertise in cosmetic surgery and his trusty co-host Kirstin, your best friend, confidante, and the snarky yet loveable “swiss army knife” of Eastern Shore Cosmetic Surgery.

Have a question for Dr. Koehler or Kirstin? Record your voicemail at alabamathebeautifulpodcast.com and we’ll answer it on the podcast.

Eastern Shore Cosmetic Surgery is located off Highway 98 at 7541 Cipriano Ct in Fairhope, Alabama.

To learn more about the practice or ask a question, go to easternshoreplasticsurgery.com 

Follow Dr. Koehler and the team on Instagram @easternshorecosmeticsurgery

And on TikTok @jameskoehlermd

Watch Dr. Koehler & Kirstin on YouTube @JamesKoehlerMD

Alabama The Beautiful is a production of The Axis: theaxis.io

Theme music: Never Need a Reason, Guy Trevino and Friends

Even when your surgeon is amazing, your results depend on you doing your part too. Taking an active role in getting ready for surgery—and recovery—makes all the difference.

Reading through your pre-op instruction booklet may not be the most exciting thing, but it can really help you know what to expect and what to do. You’re in charge of your recovery, so speak up if something feels off. There’s no such thing as a silly question!

Dr. Koehler shares why he turns down smokers for surgery, why you’ll need to pause the tequila shots for a while, and why it’s so important to be honest about any supplements or medications you’re taking.

You’ll also learn what surgical drains actually do and how to take care of them, why your surgeon’s advice matters more than what you saw on Instagram, and how to set yourself up for a smoother surgery and a better recovery.

Alabama the Beautiful is the cosmetic surgery podcast co-hosted by Dr. James Koehler, a surgeon with over 2 decades of expertise in cosmetic surgery and his trusty co-host Kirstin, your best friend, confidante, and the snarky yet loveable “swiss army knife” of Eastern Shore Cosmetic Surgery.

Have a question for Dr. Koehler or Kirstin? Record your voicemail at alabamathebeautifulpodcast.com and we’ll answer it on the podcast.

Eastern Shore Cosmetic Surgery is located off Highway 98 at 7541 Cipriano Ct in Fairhope, Alabama.

To learn more about the practice or ask a question, go to easternshoreplasticsurgery.com 

Follow Dr. Koehler and the team on Instagram @easternshorecosmeticsurgery

And on TikTok @jameskoehlermd

Watch Dr. Koehler & Kirstin on YouTube @JamesKoehlerMD

Alabama The Beautiful is a production of The Axis: theaxis.io

Theme music: Never Need a Reason, Guy Trevino and Friends

Since age 15, Rebekah had tried—and failed—at nearly every diet. After yo-yoing through almost every clothing size and coming dangerously close to a serious health crisis, she chose to undergo gastric bypass surgery, ultimately losing an astonishing 205 pounds.

While she was left with significant excess skin—an issue she insists is much more than just a “vanity thing”—Rebekah found Dr. Koehler and underwent a breast lift along with a belt lipectomy to tighten her midsection.

Rebekah shares how she discovered Dr. Koehler and what her consultation, surgery day, and recovery entailed. Beyond the physical transformation and surgical process, she describes how her mindset has changed in her smaller body and offers crucial advice for anyone considering surgery after weight loss.

See Rebekah’s before and after photos

Learn more about cosmetic surgery after weight loss

Alabama the Beautiful is the cosmetic surgery podcast co-hosted by Dr. James Koehler, a surgeon with over 2 decades of expertise in cosmetic surgery and his trusty co-host Kirstin, your best friend, confidante, and the snarky yet loveable “swiss army knife” of Eastern Shore Cosmetic Surgery.

Have a question for Dr. Koehler or Kirstin? Record your voicemail at alabamathebeautifulpodcast.com and we’ll answer it on the podcast.

Eastern Shore Cosmetic Surgery is located off Highway 98 at 7541 Cipriano Ct in Fairhope, Alabama.

To learn more about the practice or ask a question, go to easternshoreplasticsurgery.com 

Follow Dr. Koehler and the team on Instagram @easternshorecosmeticsurgery

And on TikTok @jameskoehlermd

Watch Dr. Koehler & Kirstin on YouTube @JamesKoehlerMD

Alabama The Beautiful is a production of The Axis: theaxis.io

Theme music: Never Need a Reason, Guy Trevino and Friends