Nipped and Toxxed

In this episode of Nipped & Toxxed, Dr. Ashley Robey sits down with Nurse Practitioner Crystal Stutler to break down one of the biggest shifts in women’s health in decades: the FDA’s removal of the black box warning on hormone replacement therapy (HRT).

They unpack what a black box warning actually means, why the 2002 Women’s Health Initiative study created widespread fear around HRT, and what we now understand about the flaws in that research — including the use of synthetic hormones, oral formulations, and an older study population that didn’t reflect typical perimenopausal patients.

Dr. Robey and Crystal dive into the difference between synthetic and bioidentical hormones, oral versus transdermal versus pellet therapy, and why route of administration matters — especially when it comes to cardiovascular risk and inflammation. They also discuss testosterone for women (yes, women!), progesterone options, and why dosing should focus on symptom optimization — not just “normal” lab ranges.

The episode tackles common questions:

• Is HRT safe for postmenopausal women?

• How long can you stay on it?

• What about breast cancer history?

• Are birth control pills the same as hormone therapy?

• Are compounding pharmacies or regular retail pharmacies better?

They also emphasize the importance of individualized care, proper lab monitoring, and working with a knowledgeable provider — especially in an era of online hormone prescriptions.

Bottom line? You don’t have to suffer through menopause symptoms. With the right guidance and a personalized approach, hormone therapy can be bone-, brain-, and quality-of-life protective — helping women feel balanced, energized, and in control again.

Because midlife isn’t the end of vitality — it’s the start of optimizing it.

In this episode of 'Nipped & Toxxed,' Dr. Ashley Robey discusses fat transfer in detail, building on a previous discussion about liposuction. She explains that fat transfer involves taking fat from areas of excess and injecting it into areas of deficiency. The procedure offers a natural feel compared to implants or fillers and has the potential for long-term results. Dr. Robey outlines the steps involved in fat transfer, including harvesting, processing, and injecting the fat, and highlights the most common areas for the procedure: breasts, buttocks, face, and hands. She also discusses ideal candidates, precautions, techniques to maximize fat retention, and potential risks. The episode addresses myths and misconceptions and emphasizes the importance of choosing a board-certified plastic surgeon for the procedure. Lastly, Dr. Robey answers listener questions and shares some typical before and after results.

Dr. Ashley Robey, quadruple board certified plastic surgeon, delves into surgical procedures for arm contouring. Dr. Robey discusses various options for improving arm contours, especially for those who are unhappy with the appearance of their arms due to loose skin or disproportionately large arms. She describes traditional brachioplasty, liposuction, the minimally invasive Body Tite treatment using radio frequency energy, and limited brachioplasty incisions. Dr. Robey also reviews some other techniques and tools that surgeons utilize in the arm contouring world, such as laser liposuction, JPlasma and Cool Sculpting. Dr. Robey emphasizes that brachioplasty, typically an outpatient procedure lasting two to three hours, has a high satisfaction rate but carries theoretical post-operative challenges such as scarring and swelling. She also provides an overview of the costs involved and indicates that such procedures can be life-changing for the right candidates.

In this episode of 'Nipped and Toxxed,' Dr. Ashley Robey and Dr. Kelly Killeen discuss unusual and unique requests they receive as plastic surgeons. They delve into procedures not typically within the plastic surgery domain, such as limb lengthening and extreme waist training. They also highlight specific patient requests like body modifications to mimic celebrities or characters, colored iris implants, and dimpleplasty. The conversation further explores minimally invasive treatments for knee laxity, unusual facial procedures, and surgeries reflecting gender identity transitions. Both doctors share insights into the challenges of balancing patient expectations and ensuring safe, realistic outcomes.

In this episode of Nipped & Toxxed, Dr. Ashley Robey and Dr. Christopher Zarella discuss rhinoplasties. They explain the differences between aesthetic and functional rhinoplasties, emphasizing the importance of a balanced approach to achieve both cosmetic and functional improvements. They delve into the complexities of the procedure, including the meticulous planning it requires and the common challenges faced. The doctors also address misconceptions about the surgery, touch on minimally invasive liquid rhinoplasties, and underscore the importance of setting realistic patient expectations. Dr. Robey & Dr. Zarella advise prospective patients to consult with board-certified surgeons who specialize in rhinoplasty for optimal results.

Dr. Ashley Robey and Dr. Kelly Killeen discuss surgery for gynecomastia, or feminized male chests. When does it present, what are predisposing factors, what is the work up, and what are the surgical techniques that are utilized. All the questions and more are answered during this episode of Nipped and Toxxed.

Exploring the intricacies of handling challenging patients in surgical realms, Dr. Ashley Robey & Dr. Kelly Killeen delve into categorizing difficult patient types based on behaviors. Topics include managing deceitfulness, mental health issues, non-compliance, and setting realistic expectations for improved outcomes and professional relationships across plastic surgery and other medical scenarios.

Dr. Ashley Robey & Dr. Kelly Killeen discuss their recommendations for skin care. What are the essential products types? What specific products should you seek out?

1:40 Start with a good cleansing regimen

2:46 Nighttime double cleanse

7:08 Moisturizers 

7:30 Spend a little extra on your hyaluronic acid product

11:50 Peptide based rejuvenating products

15:29 Instant topical wrinkle removers don’t work

16:56 Exosomes in skin care

18:55 Hyperpigmentation and dark spot treatments: hydroquinone, tranexamic acids, kojic acid, niacin amide

24:14 Sunscreen

29:37 Antioxidants, vitamin C

30:43 Retinoids: retinols, Retin-A, tretinoin, isotretinoin, adapalene, tazorac

36:39 Eye creams

39:00 Popular Rx-strength skin care lines

41:08 Some price favorable alternatives

46:05 Acne options

Dr. Ashley Robey and Dr. Kelly Killeen tackle the challenges associated with the lack of regulations in the aesthetic and plastic surgery industry.

00:17 More demand for procedures leads to more supply of people performing them

01:50 Medical supervisor at most spas is usually not an expert nor is he/she on site

02:30 Inexperienced providers and bad outcomes: HIV transmission in Albuquerque medspa

7:00 Mixed experience levels of injectors

8:46 Unqualified medical providers doing medical procedures: 2 NPs in Indiana performing liposuction

9:47 PA in Vegas liposuctions independently

12:35 Bad Surgery Plan: 1)phone call with sales person 2) book surgery 3) make travel reservations

13:30 Lipo Chop Shops

19:37 Non plastic surgeons performing plastic surgery

24:17 Board Certified "Cosmetic" Surgeons do not have the same level of training of actual board certified Plastic Surgeons

32:22 Check certificationmatters.org

33:39 Med spa providers resorting to FB to help with medical disasters

35:14 Unregulated products: fillers, botulinum toxins, medications

40:56 Seeking providers that will treat patient as a whole and have the ability to say no

42:35 Some plastic surgeons bend the rules for celebrities and attention

47:22 A physician led team is important for patient safety & plastic surgeons are the expert physicians in the realm of aesthetics

Dr. Ashley Robey and Gavy Uppal, NP cover the latest and most popular peptide therapies that are utilized in anti-aging medicine.

1:04 What are peptides?!?!

4:22 Semaglutide - the uber-popular weight loss peptide

12:46 Mounjaro - newest weight loss peptide

14:57 How we determine what kind of body weight your losing

17:09 You are what you eat, so don't eat garbage

19:21 BPC-157

25:47 Growth hormone

27:36 CJC-1295 and Ipamorelin

29:04 Ghrelin and gremlins?

32:24 NAD+

33:42 What Dr. Kelley said

36:03 Epitalin "fountain of youth"

39:21 Not a peptide, but we still love Morpheus

39:56 Melanotan II, the Barbie peptide

46:22 Skin care peptides

48:12 PTD-DBM - the hair peptide