Scalpel and Skin

Is medical-grade skincare really worth the money, or is it just marketing? In this episode of Scalpel and Skin, Mistica is joined by Skin Lab esthetician and fan-favorite co-host Melissa Janoski to break down what medical-grade skincare means, how to think about product claims, and which skincare products may be worth prioritizing.

They discuss vitamin C, retinol, ingredient formulations, clinical studies, and the difference between building a skincare routine around your goals versus buying every product trending on social media. They also get into Sephora skincare culture, why teens don’t need complicated anti-aging routines, and how at-home skincare supports—but doesn’t replace—in-office treatments.

Then it’s time for rapid fire: vitamin C, hyaluronic acid, pimple patches, pore strips, peptides, double cleansing, sheet masks, eye creams, collagen creams, expensive moisturizers, and the skincare trends they’d love to see disappear.

In this episode:

• What does “medical-grade skincare” actually mean?
• Medical-grade skincare vs. drugstore and Sephora products
• Vitamin C and retinol: what are they used for?
• How to prioritize skincare when you’re on a budget
• Skincare for tweens and teens
• Can skincare replace lasers and other in-office procedures?
• Why skin preparation matters before certain treatments
• Double cleansing, eye cream, sheet masks, and more: worth it or skip it?
• Salmon sperm skincare and the importance of looking at the evidence

As always, Mistica and Melissa bring their honest opinions, professional perspectives, and plenty of sibling-style teasing to the conversation.

Scalpel and Skin is all about talking honestly about aesthetic treatments, skincare, and what may actually be worth your time and money.

Subscribe for more conversations about skincare, cosmetic treatments, and the science behind the beauty trends.

This episode is for educational purposes and is not a substitute for individualized medical advice. Skincare needs and treatment suitability vary from person to person.

#ScalpelAndSkin #MedicalGradeSkincare #SkincareRoutine #VitaminC #Retinol

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Are esthetician treatments actually worth it? Which facials and skin treatments are worth your money—and which ones aren't?

In this special episode of Scalpel and Skin, Mistica Lebraska is joined by Melissa Janoski, the first official guest and co-host of the podcast. Melissa has worked alongside Mistica for years and brings 16 years of experience in the aesthetics industry to the conversation. 

Together, they break down traditional esthetician treatments and newer aesthetic procedures, giving their honest take on what actually delivers results and what may not be worth the investment.

They talk about facials, dermaplaning, microdermabrasion, chemical peels, Hydrafacials, skincare treatments, and newer esthetician procedures—and put them all through the Scalpel and Skin “Is It Worth It?” test.

And yes… some of their opinions might make a few estheticians very unhappy.

In this episode:

• Are traditional facials worth it?
 • What does a facial actually do?
 • Dermaplaning
 • Microdermabrasion
 • Chemical peels
 • Hydrafacials
 • Newer esthetician treatments
 • Which treatments actually improve the skin?
 • Which treatments are more about relaxation?
 • What treatments are worth the money?
 • What treatments aren't worth it?
 • Esthetician treatments vs. medical aesthetic treatments
 • Mistica and Melissa's honest “Is It Worth It?” ratings

Plus, plenty of sibling-style chaos—even though Dr. Algie is nowhere to be found.

Because when it comes to aesthetic treatments, the question isn't just what can you do to your skin.

Is it actually worth doing?

#ScalpelAndSkin #Esthetician #Skincare #Facials #ChemicalPeels

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Are tummy tucks actually worth it? What’s the difference between a mini and full tummy tuck? And when is liposuction—not a tummy tuck—the right choice?

In Episode 9 of Scalpel and Skin, Dr. Algie Lebraska, a board-certified plastic surgeon, and Mystica Lebraska, a dermatology PA of 16 years, break down abdominal contouring and tummy tuck surgery from a surgeon’s and patient-care perspective. 

They explain what actually happens during a tummy tuck, including muscle repair, excess skin removal, belly button reconstruction, liposuction, and abdominal contouring. They also discuss the differences between mini, full, extended, fleur-de-lis, and circumferential tummy tucks, plus what recovery can really be like.   

The conversation also gets into lipo 360, CoolSculpting, RF microneedling, muscle-sculpting devices, diastasis recti, drains, and common misconceptions about body contouring—including whether these treatments are actually appropriate for the patient in front of you.  

And, of course, they put abdominal contouring through the Scalpel and Skin “Is It Worth It?” test.

In this episode:

• What a tummy tuck actually does
 • Tummy tuck vs. liposuction
 • Mini vs. full tummy tuck
 • Extended tummy tuck
 • Fleur-de-lis tummy tuck
 • Circumferential tummy tuck
 • Muscle repair and diastasis recti
 • Belly button reconstruction
 • Tummy tuck recovery
 • Lipo 360 and abdominal contouring
 • CoolSculpting for the abdomen
 • RF microneedling for loose abdominal skin
 • Muscle-sculpting devices
 • Tummy tuck drains
 • Common tummy tuck misconceptions
 • Choosing the right procedure for the right patient
 • Is abdominal contouring worth it?

Because when it comes to aesthetic procedures, it's not just about what you can do.

It's about doing the right procedure for the right patient at the right time. 

#ScalpelAndSkin #TummyTuck #AbdominalContouring #Lipo360 #PlasticSurgery 

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In Episode 8 of Scalpel and Skin, Dr. Algie LaBrasca, a board-certified plastic surgeon, and his sister Mistica LaBrasca, a cosmetic dermatology Physician Assistant, break down one of their favorite collagen-stimulating treatments: Sculptra.

Unlike traditional hyaluronic acid filler, Sculptra is a biostimulator designed to gradually stimulate collagen and elastin over time. That means the results aren't instant—and according to Mistica and Algie, this is definitely a treatment for people willing to play the long game.

They look back at the history of Sculptra, including its early use for HIV-associated facial lipoatrophy, and explain how the treatment has evolved into a popular option for facial rejuvenation. They also get into where Sculptra works well, where it absolutely should not be injected, how long results may last, and why the final outcome can vary from patient to patient.

They also talk about:

• What is Sculptra and how does it work?
• Is Sculptra a filler or a biostimulator?
• Sculptra vs. hyaluronic acid filler
• How long does it take to see Sculptra results?
• How long does Sculptra last?
• Where can Sculptra be injected?
• Can you use Sculptra in the lips or under the eyes?
• Can Sculptra cause lumps, nodules, or granulomas?
• Why provider experience matters with Sculptra
• Why Sculptra isn't a quick fix
• Who may not be a good candidate for Sculptra
• Can Sculptra tighten or lift the face?
• Can Sculptra replace a facelift?
• Can you still have a facelift after Sculptra?
• How much Sculptra do you actually need?
• How often should Sculptra be maintained?
• Is Sculptra better for patients worried about looking overfilled?
• And ultimately… is Sculptra actually worth it?

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Do you always look tired—even when you’re not? 👀

In Episode 7 of Scalpel and Skin, Dr. Algier Lebraska, a board-certified plastic surgeon, and his sister Mystica Lebraska, a dermatology PA, break down eyelid rejuvenation and the different treatments that can change the way your upper and lower face looks.

From upper and lower blepharoplasty to brow lifts, tear trough filler, PRF, bio filler, Botox, laser treatments, and fat grafting, they explain why there isn't always one procedure that fixes the way your eyes age.

They talk about what causes a tired-looking appearance, including skin changes, pigmentation, fat loss, fat pad herniation, brow descent, muscle movement, and changes to the bone around the eyes.

They also get into some of the biggest questions surrounding eyelid rejuvenation:

• What is an upper blepharoplasty?
• What happens during an eyelid lift?
• When should you consider upper eyelid surgery?
• What causes under-eye bags?
• What's the difference between upper and lower blepharoplasty?
• Can lower eyelid fat be removed or repositioned?
• What is a tear trough?
• When can under-eye filler make things worse?
• Why does filler selection matter under the eyes?
• What is PRF and bio filler?
• Can PRF replace traditional filler?
• When should you use Botox around the eyes?
• Is laser good for creepy eyelid skin and crow's feet?
• What about fat grafting?
• What are Fox Eye and Cat Eye procedures?
• How much downtime does blepharoplasty require?
• Is eyelid rejuvenation actually worth it?

And, of course, they put the treatments through the Scalpel and Skin “Is It Worth It?” test.

Because sometimes the answer is surgery.

Sometimes it's filler.

Sometimes it's laser.

And sometimes… it's absolutely not worth it. 👀

Scalpel and Skin is hosted by siblings who combine plastic surgery and cosmetic dermatology to break down aesthetic treatments, trends, and procedures—with plenty of sibling arguments along the way.

#ScalpelAndSkin #Blepharoplasty #EyelidRejuvenation #UnderEyeTreatment #FacialRejuvenation

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Are hair loss treatments actually worth it? Which ones work—and which ones are just a waste of money?

In Episode 6 of Scalpel and Skin, Dr. Algie LaBrasca, a board-certified plastic surgeon, and Mistica LaBrasca, a cosmetic dermatology physician assistant, break down the most common hair loss treatments and hair restoration options for men and women.

From minoxidil and finasteride to PRP, PRF, PDGF, exosomes, red light caps, and hair transplants, they talk about what each treatment does, who may benefit, and whether they think it's actually worth doing.

They also discuss why genetics, hormones, stress, medications, diet, and other factors can contribute to hair loss—and why starting treatment earlier may help preserve the hair you have.

You'll hear about:

• Minoxidil and Rogaine for hair loss
 • Finasteride and male pattern hair loss
 • Hair loss supplements and biotin
 • PRP vs. PRF for hair restoration
 • PDGF and microneedling
 • Exosomes for hair loss
 • Red light therapy and hair growth caps
 • Hair transplant surgery
 • FUE (follicular unit extraction)
 • Hair transplant recovery and costs
 • Why donor hair matters
 • Hair loss in men vs. women
 • Genetics and hormonal hair loss
 • When to start treating thinning hair
 • Which hair loss treatments are actually worth it

And, of course, they put everything through the Scalpel and Skin “Is It Worth It?” test.

Because when it comes to aesthetic treatments, the question isn't just what can you do?

Is it actually worth doing?

#ScalpelAndSkin #HairLoss #HairRestoration #Minoxidil #HairTransplant

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Are facelifts actually worth it? And what is the difference between a deep plane facelift, a SMAS facelift, and a mini facelift?

In Episode 5 of Scalpel and Skin, Dr. Algie LaBrasca, a board-certified plastic surgeon, and Mystica LaBrasca, a cosmetic dermatology Physician Assistant, talk about one of the most misunderstood procedures in plastic surgery: the facelift.

They get into the facelift techniques patients hear about online, including deep plane and SMAS facelifts, and explain why the “best” facelift isn't necessarily the newest or most popular one. The right procedure depends on the patient, their anatomy, their goals, and their surgeon. 

They also break down what a facelift actually treats, why a facelift often includes the neck, how it differs from a brow lift or blepharoplasty, and why filler can't simply replace a facelift when there is significant skin laxity. 

And because this is Scalpel and Skin, they don't stop at the procedure itself.

They talk about:

• Deep plane vs. SMAS facelift
 • Mini facelifts and when they make sense
 • Facelift recovery and downtime
 • Skin laxity and what happens after surgery
 • Why facelifts don't treat every sign of aging
 • When lasers can complement a facelift
 • Whether filler can replace a facelift
 • Facelifts in younger patients
 • Celebrity plastic surgery and unrealistic expectations
 • What patients should look for in a plastic surgeon
 • Why you should find the surgeon, not just the procedure

They also get into some of the celebrities people love to speculate about, including Chris Jenner, JLo, Lindsay Lohan, Anne Hathaway, Brad Pitt, and Bradley Cooper—and what their aesthetic changes can (and can't) teach us about plastic surgery.  

The biggest takeaway?

Right patient. Right procedure. Right time. Right surgeon.

That's the philosophy behind Scalpel and Skin.

And at the end, Algie and Mystica give the facelift the official “Is It Worth It?” treatment.

#ScalpelAndSkin #Facelift #DeepPlaneFacelift #SMASFacelift #PlasticSurgery

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Are cosmetic lasers actually worth it?

Cosmetic lasers can improve skin texture, wrinkles, pigmentation, sun damage, redness, rosacea, scars, and overall skin quality—but not every laser is designed to do the same thing, and not every treatment is right for every patient.

In Episode 4 of Scalpel and Skin, Dr. Algie LaBrasca, a board-certified plastic surgeon, and Mystica LaBrasca, a cosmetic dermatology Physician Assistant, break down cosmetic lasers, laser skin resurfacing, energy-based treatments, and what patients should actually know before getting treated.

They explain the difference between non-ablative and ablative lasers, why CO2 laser resurfacing has more downtime, how RF microneedling fits into the conversation, and why some patients may benefit from several lighter treatments instead of one major resurfacing treatment. 

They also discuss treating:

• Skin texture and wrinkles
 • Pores
 • Sun damage and pigmentation
 • Redness and rosacea
 • Broken blood vessels
 • Scars
 • Skin laxity
 • Unwanted hair

And they answer some of the questions patients actually ask:

Can you get laser treatment with a tan?
Can lasers erase scars?
Can lasers shrink pores?
How much downtime will I have?
When is a laser enough—and when do you need surgery?
Are at-home laser devices worth it?

The conversation also gets into laser complications, including burns, pigment changes, infection, and why proper patient assessment and choosing an experienced provider matter. 

Because at the end of the day, the question isn't just:

“Does this laser work?”

It's:

“Is this the right treatment for me—and is it worth it?”

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Is filler actually worth it?

Filler is one of the most talked-about aesthetic treatments of the last 20 years, but it is also one of the most misunderstood.

In Episode 3 of Scalpel and Skin, Dr. Algie LaBrasca, a board-certified plastic surgeon, and Mystica LaBrasca, a cosmetic dermatology Physician Assistant, break down hyaluronic acid filler, how dermal fillers evolved, why filler became so popular, and why it developed such a bad reputation.

They discuss the history of filler, from early options like collagen and silicone to the rise of hyaluronic acid filler, and how today's fillers are designed differently depending on where they are used—from softer fillers for the lips to firmer fillers for the cheeks. 

They also get into overfilling, the changing aesthetic around lips and cheeks, the influence of social media, and what they call the “Maleficent cheeks” look.

Most importantly, they talk about what good filler should actually do: restore volume, structure, and balance without making it obvious that you had filler.

The conversation also covers:

• Who is actually a good candidate for filler
 • Why being a candidate doesn't always mean you should get filler
 • Why skin health should come first
 • When lasers, skincare, or surgery may be better options
 • Why patients should avoid bouncing between multiple injectors
 • Common filler myths
 • What happens when you stop getting filler
 • Whether filler stretches your skin
 • What happens when filler is dissolved
 • Why overfilling happens
 • What “Instagram Face” means
 • Whether hyaluronic acid filler is actually worth the investment

And at the end, Algie and Mystica give their Scalpel and Skin “Is It Worth It?” rating for hyaluronic acid filler.

So... is filler actually worth it?

Listen to the full episode and find out.

#ScalpelAndSkin #HyaluronicAcidFiller #DermalFiller #CosmeticDermatology #AestheticTreatments

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Why are there so many med spas—and with more aesthetic providers, treatments, and trends than ever before, how can patients know who to trust?

The aesthetic industry has exploded in popularity, but with more med spas, social media trends, injectables, lasers, and cosmetic treatments than ever before, it has also become harder for patients to know who to trust.

In Episode 2 of Scalpel and Skin, Dr. Algie LaBrasca, a board-certified plastic surgeon, and Mistica LaBrasca, a cosmetic dermatology Physician Assistant, talk about what worries them most about the current state of aesthetics, how social media has changed patient expectations, and why not every trending treatment is worth your time, money, or face.

They break down what makes a great aesthetic provider, from understanding anatomy and knowing when to say no, to thinking long-term and putting patient goals ahead of trends.

This conversation is for anyone considering Botox, filler, lasers, skin treatments, plastic surgery, or med spa services and wondering how to make safer, smarter aesthetic decisions.

In this episode:

• Why med spas are suddenly everywhere
 • How social media changed the aesthetic industry
 • Why it is hard to know who to trust
 • Red flags when choosing an aesthetic provider
 • Green flags patients should look for
 • Why good providers should be able to say no
 • The importance of anatomy, safety, and long-term thinking
 • What aesthetics may look like in the next 10 years
 • How to decide if a treatment is actually worth it

#ScalpelAndSkin #AestheticIndustry #MedSpa #AestheticProvider #PlasticSurgery #CosmeticDermatology #AestheticTreatments

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