Alabama The Beautiful: The Eastern Shore Cosmetic Surgery Podcast

Podcast de Dr. James Koehler, Cosmetic Surgeon

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Alabama the Beautiful is the cosmetic surgery podcast co-hosted by Dr. James Koehler and Dr. Vincent Gardner, surgeons with over 2 decades of expertise in cosmetic surgery and their trusty co-host Kirstin, your best friend, confidante, and the snarky yet loveable “swiss army knife” of Eastern Shore Cosmetic Surgery.With Dr. Koehler and Dr. Gardner's unique expertise in cosmetic surgery and medical aesthetics, each episode is a deep dive into a face, breast or body plastic surgery procedure or hot topic. From the first cosmetic surgery consultation to the days, months, and years beyond, no question goes unanswered. Have a question for Dr. Koehler, Dr. Gardner and Kirstin? Record your voicemail at alabamathebeautifulpodcast.com and we’ll answer it on the podcast.Located in Fairhope, Alabama on the beautiful Eastern Shore, cosmetic surgeon Dr. James Koehler and his team are dedicated to delivering the very best patient experiences and results. Learn why Eastern Shore Cosmetic Surgery Center one of the leading cosmetic surgery providers for men and women near Fairhope, Alabama and throughout the Mobile-Pensacola area at easternshoreplasticsurgery.com.Your HostsJames Koehler, MD - Dr. James Koehler is a board-certified cosmetic surgeon with an impressive list of academic and professional achievements. From breast augmentation and tummy tuck to face lift and eyelid surgery, women and men from all over the South and across the country seek Dr. Koehler for the aesthetic results he delivers and the stellar experience he and his team are known for.His patients love him for his charm and warm sense of humor, and when you meet him, it is abundantly clear how he has the best interests of each patient near his heart. Supporting him, Dr. Koehler’s staff goes above and beyond to create an exceptional experience for every patient, no matter how big or small the concern.Dr. Koehler first became interested in a surgical career during a general practice residency at the University of Washington in Seattle. During his training at Harborview Medical Center, he found he was armed with the skilled hands and keen eye for detail required for the technical demands of surgery.After completing a general surgery internship, Dr. Koehler further pursued his interests in maxillofacial surgery at the University of Alabama. He then completed a facial cosmetic surgery fellowship under the guidance of Dr. Peter Waite, a past president of the American Academy of Cosmetic Surgery.He later continued his training and completed two years of Fellowship in full body cosmetic surgery in Tulsa, Oklahoma. After caring for patients in Tulsa from 2006 to 2014, Dr. Koehler had the opportunity to take over the plastic surgery practice of a respected plastic surgeon in Fairhope, Alabama. Happy to return to his home state after decades away, he ventured forward to continue specializing in cosmetic surgery of the face, breast, and body. Dr. James KoehlerBoard Certified by the American Board of Cosmetic Surgery in facial and body cosmetic surgeryTrustee for the American Board of Cosmetic SurgeryServed as the Chairman for fellowship training for the American Academy of Cosmetic Surgery and has trained numerous cosmetic surgeonsServed on the admissions committee at the Alabama School of Medicine, where he shared his knowledge and experience with residents and studentsServed as a Board examiner for the American Board of Cosmetic Surgery and was the Committee Chairman responsible for formatting the maintenance of certification examHas been co-director for a number of live surgical workshops and has lectured on numerous topics on cosmetic surgery both nationally and internationallyNominated in 2018 for the Stellar Patient Experience Award at the MyFaceMyBody Global Aesthetic Award in Beverly Hills, CaliforniaActive staff at Thomas Medical Center, Infirmary Health in Fairhope, Alabama and currently serves on the surgery steering committeeVincent Gardner, MD - With more than 20 years of experience in both general and cosmetic surgery, Dr. Vincent Gardner 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.Kirstin Jarvis, Co-HostAs the practice manager at Eastern Shore Cosmetic Surgery, Kirstin ensures smooth office operations and provides excellent patient experiences. With a strong background in women’s health, she is passionate about helping people look and feel their best. She is dedicated to making sure every experience patients have at ESCS is a positive one.

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64 episodios

What GLP-1 Weight Loss Does to Your Face (And How to Fix It)

We hear about the weight loss, the body changes, the transformation. What almost nobody mentions is what that same transformation does above the collarbone. Significant weight loss, whether from medication or lifestyle, can pull volume out of your cheeks, jawline, and neck and leave a face that looks years — sometimes a decade — older than the body it's attached to. Dr. Koehler explains why a fuller face actually reads as younger, especially in people over 50, and why "Ozempic face" isn't really about the medication at all. The culprit is the scale of the weight loss. Lose five pounds and your face probably looks fine. Lose 40 or 50 and you may not recognize what's looking back at you. When it comes to solutions, the call is never one-size-fits-all. Dr. Koehler separates two distinct problems — volume loss and skin laxity — and explains why fixing one without addressing the other rarely gives a satisfying result. He walks through when filler makes sense, how facial fat grafting actually works (including the role of platelet rich plasma), and when a facelift is the only thing that will do the job — even in someone in their 30s or early 40s. There's also the timing question. Should you wait until you hit your goal weight before doing anything? What if you plan to stay on GLP-1s indefinitely? And what do you do if you're watching your face change month over month right now? Dr. Koehler has a clear framework for all of it. Questions answered by this episode: 1. What is Ozempic face and is it actually caused by GLP-1 medications? 2. Why does losing weight make your face look older? 3. How much weight loss does it take before you see it in your face? 4. Does skin tighten on its own after major weight loss? 5. What is the difference between filler, fat grafting, and a facelift for facial volume loss? 6. How does facial fat grafting work and where does the fat come from? 7. Can someone in their 30s or early 40s be a facelift candidate? 8. Should you wait until you reach your goal weight before getting a facelift? 9. If you plan to stay on GLP-1s long-term, does that change what a surgeon recommends 10. When would a surgeon recommend cheek implants instead of fat grafting? Alabama the Beautiful is the cosmetic surgery podcast co-hosted by Dr. James Koehler and Dr. Vincent Gardner, surgeons with over 2 decades of expertise in cosmetic surgery and their 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, Dr. Gardner or Kirstin? Record your voicemail at alabamathebeautifulpodcast.com [https://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 [https://www.easternshoreplasticsurgery.com/] Follow the team on Instagram @easternshorecosmeticsurgery [https://www.instagram.com/easternshorecosmeticsurgery/] Watch Dr. Koehler, Dr. Gardner & Kirstin on YouTube @JamesKoehlerMD [https://www.youtube.com/channel/UCAq-MSbAPEfetsPcw6k_ovw] Alabama The Beautiful is a production of The Axis: theaxis.io [https://www.theaxis.io/] Theme music: Never Need a Reason, Guy Trevino and Friends

9 de jul de 2026 - 14 min

What Happens to Your Skin After GLP-1 Weight Loss

Drug companies want you on these injections for life. Dr. Vincent Gardner sees it differently — and if you’re planning cosmetic surgery on the other side of a major transformation, that distinction matters. The combinations walking into our office at Eastern Shore are wild now. Someone had a Roux-en-Y a decade ago, regained, and dropped 50 more pounds on Wegovy. Someone else lost 160 pounds on Ozempic alone. Dr. Gardner explains why how you lost it matters as much as how much, and why medically supervised fasting hospitals in Europe show that gradual loss does something different for the dermis than a fast injection. The biggest myth he wants to bust: that GLP-1s will replace cosmetic surgery. The opposite is happening. Collagen and elastin don’t snap back when they’ve been stretched past their limit, and the people now booking arm lifts, buttock revisions, and abdominal pannus removals aren’t going anywhere. Plus: why he wants you 10 to 15 pounds from your goal before booking a tummy tuck, the two-week pre-op pause every weight loss medication user has to follow, and why a non-surgical skin tightening device is the wrong first move when you have stretch marks and a thin dermis. Questions answered by this episode: 1. Can I have skin removal surgery while still on Ozempic or Wegovy? 2. How long do I have to stop GLP-1 medication before cosmetic surgery? 3. Is the skin different after GLP-1 weight loss versus gastric bypass? 4. Do I have to lose all my weight before booking a tummy tuck? 5. How much weight do I need to lose before plastic surgery after GLP-1s? 6. Will non-surgical skin tightening work for massive weight loss skin? 7. What happens to my surgical results if I gain weight back? 8. Why do people sometimes need a second surgery after GLP-1 weight loss? 9. Can liposuction take the place of a tummy tuck after weight loss? 10. Should I stay on a GLP-1 forever or wean off the dose? Alabama the Beautiful is the cosmetic surgery podcast co-hosted by Dr. James Koehler and Dr. Vincent Gardner, surgeons with over 2 decades of expertise in cosmetic surgery and their 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, Dr. Gardner or Kirstin? Record your voicemail at alabamathebeautifulpodcast.com [https://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 [https://www.easternshoreplasticsurgery.com/] Follow the team on Instagram @easternshorecosmeticsurgery [https://www.instagram.com/easternshorecosmeticsurgery/] Watch Dr. Koehler, Dr. Gardner & Kirstin on YouTube @JamesKoehlerMD [https://www.youtube.com/channel/UCAq-MSbAPEfetsPcw6k_ovw] Alabama The Beautiful is a production of The Axis: theaxis.io [https://www.theaxis.io/] Theme music: Never Need a Reason, Guy Trevino and Friends

25 de jun de 2026 - 24 min

Unhappy After a Facelift? What a Revision Can (and Can't) Fix

The hardest consults in cosmetic surgery aren't the first-timers. They're the people sitting across from Dr. Koehler with someone else's incisions, someone else's result, and a question that's harder to answer than it sounds: did the surgery fail, or did the expectations? A lot of disappointment traces back to one misunderstanding. The word “facelift” doesn't mean “make me look younger.” It addresses the lower face and neck, with some improvement to the cheek. It doesn't lift the brow, fix the eyelids, or erase fine lines. People who came in wanting all of that and only got one of them weren't bad surgical cases — they got the wrong procedure. Dr. Koehler walks through what he checks for when he assesses someone else's facelift: incision design, whether other procedures should have been done at the same time, and whether skin quality is doing the result any favors. He also names the technical tells he can spot from across the room, like a pixie ear from over-tightening, which is the kind of thing that shows up in side-by-side photos of public figures and ignites Instagram conspiracy theories. Healing is its own beast in a revision. Slower dissection through scar tissue, longer operative time, and a higher risk of skin loss or nerve injury are all part of the trade. Bone structure and skin elasticity cap what any surgeon can deliver, and Dr. Koehler shares the line he uses on people whose expectations have outrun their anatomy: the enemy of good is better. Read more about facelift revision surgery: https://www.easternshoreplasticsurgery.com/when-should-i-consider-facelift-revision-surgery/ [https://www.easternshoreplasticsurgery.com/when-should-i-consider-facelift-revision-surgery/] Questions answered by this episode: 1. What is a revision facelift? 2. Why am I not happy with my facelift result? 3. How long does it take to see the final result of a facelift? 4. Does a facelift fix the eyelids and brow too? 5. What is a pixie ear deformity? 6. How long does swelling last after a facelift? 7. Can a facelift damage the facial nerve? 8. Is revision facelift surgery riskier than the first one? 9. Is there an age limit for getting a facelift? 10. How do I find a good surgeon for a revision facelift? Alabama the Beautiful is the cosmetic surgery podcast co-hosted by Dr. James Koehler and Dr. Vincent Gardner, surgeons with over 2 decades of expertise in cosmetic surgery and their 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, Dr. Gardner or Kirstin? Record your voicemail at alabamathebeautifulpodcast.com [https://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 [https://www.easternshoreplasticsurgery.com/] Follow the team on Instagram @easternshorecosmeticsurgery [https://www.instagram.com/easternshorecosmeticsurgery/] Watch Dr. Koehler, Dr. Gardner & Kirstin on YouTube @JamesKoehlerMD [https://www.youtube.com/channel/UCAq-MSbAPEfetsPcw6k_ovw] Alabama The Beautiful is a production of The Axis: theaxis.io [https://www.theaxis.io/] Theme music: Never Need a Reason, Guy Trevino and Friends

11 de jun de 2026 - 23 min

The Red Flags We Watch For in a Cosmetic Surgery Consultation

Picking the wrong provider for your procedure is a problem no one wants to fix. Before any of the technical details matter, cosmetic surgeon Dr. James Koehler and Dr. Vincent Gardner think the most important moment of your whole experience is the one most people rush through: sitting across from the surgeon for the first time and deciding whether to move forward. Surgeons are vetting you back. Dr. Koehler explains the questions running through his head: Is the decision yours, or is your spouse driving the conversation? Are your expectations grounded in your actual anatomy, or in someone else's before-and-after? Is something else going on — a recent loss, a sudden upheaval — that might mean this isn't the right time to make a permanent change? On your side, Dr. Gardner walks through what to vet for: real experience with the specific procedure you want, before-and-afters that look like you, post-op accessibility that doesn't drop off after the stitches come out, and an office-based facility that's accredited. Alabama's new rules now require accreditation for office-based surgery, but it's worth confirming. And if a quote comes back $10,000 below everyone else's, that's the kind of bargain that costs you later. The question nobody asks but everybody should: what's the revision policy? Every procedure carries a revision rate. Knowing in advance how your surgeon handles touch-ups, and what they cost, is the difference between an awkward conversation and a fair one. The doctors share what to ask, how to ask it, and what a good answer sounds like. Read more about choosing a cosmetic surgeon: https://www.easternshoreplasticsurgery.com/about/cosmetic-vs-plastic-surgery/ [https://www.easternshoreplasticsurgery.com/about/cosmetic-vs-plastic-surgery/] Questions answered by this episode: 1. How do I choose the right cosmetic surgeon? 2. What questions should I ask at a plastic surgery consultation? 3. What are the biggest red flags when picking a cosmetic surgeon? 4. Why is one surgeon thousands of dollars cheaper than the others? 5. What does it mean for a surgery facility to be accredited? 6. Does my cosmetic surgeon need hospital privileges? 7. What is a revision policy and how do I ask about it? 8. Is it offensive to ask my surgeon about complication rates? 9. How many before-and-after photos should my surgeon have? 10. What should I research before booking a consultation? Alabama the Beautiful is the cosmetic surgery podcast co-hosted by Dr. James Koehler and Dr. Vincent Gardner, surgeons with over 2 decades of expertise in cosmetic surgery and their 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, Dr. Gardner or Kirstin? Record your voicemail at alabamathebeautifulpodcast.com [https://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 [https://www.easternshoreplasticsurgery.com/] Follow the team on Instagram @easternshorecosmeticsurgery [https://www.instagram.com/easternshorecosmeticsurgery/] Watch Dr. Koehler, Dr. Gardner & Kirstin on YouTube @JamesKoehlerMD [https://www.youtube.com/channel/UCAq-MSbAPEfetsPcw6k_ovw] Alabama The Beautiful is a production of The Axis: theaxis.io [https://www.theaxis.io/] Theme music: Never Need a Reason, Guy Trevino and Friends

28 de may de 2026 - 26 min

What Chin Lipo Couldn’t Fix: Kirstin’s Deep Plane Neck Lift

Some kinds of fullness under the jaw don't budge no matter how much weight you lose. The reason isn't the layer most people are looking at — it's the one a few millimeters deeper, where the muscles, glands, and deeper fat actually live. Kirstin had been bothered by her neck for years. She finally booked the procedure that fixed it — a deep neck lift — and came back to talk through what it actually involves. Dr. James Koehler walks through the deeper anatomy: contouring the digastric muscles, trimming the deeper fat pads, and shaving down the submandibular glands when they're hanging too low. He also explains why a less experienced surgeon would have offered her liposuction, and why the wrong procedure can leave you with 20 percent of the result you'd get from the right one. Dr. Vincent Gardner joins to cover recovery — Kirstin was back at work three days after surgery, and her bruising was gone in four days with Dermacut. They also talk about why some "minimally invasive" alternatives — Kybella and Sculptra in particular — can quietly sabotage a future facelift by creating scarring that a surgeon later has to work around. If you've ever wondered why no amount of weight loss seems to change the shape of your neck, this one tells you why — and what to look for when you're choosing a surgeon to do something about it. Read more about neck lift surgery at Eastern Shore Cosmetic Surgery. [https://www.easternshoreplasticsurgery.com/face/neck-lift/] Questions answered by this episode: 1. What is a deep neck lift? 2. Deep neck lift vs. facelift — what's the difference? 3. Why doesn't liposuction work on every double chin? 4. How long is recovery from a deep neck lift? 5. When can you go back to work after a deep neck lift? 6. Does Kybella make a future facelift harder? 7. How do you choose the right surgeon for a neck lift? 8. Is it a red flag when a surgeon doesn't do facelifts? 9. Why do some people have a fuller neck even at a healthy weight? 10. How long until you see final results from a deep neck lift? Alabama the Beautiful is the cosmetic surgery podcast co-hosted by Dr. James Koehler and Dr. Vincent Gardner, surgeons with over 2 decades of expertise in cosmetic surgery and their 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, Dr. Gardner or Kirstin? Record your voicemail at alabamathebeautifulpodcast.com [https://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 [https://www.easternshoreplasticsurgery.com/] Follow the team on Instagram @easternshorecosmeticsurgery [https://www.instagram.com/easternshorecosmeticsurgery/] Watch Dr. Koehler, Dr. Gardner & Kirstin on YouTube @JamesKoehlerMD [https://www.youtube.com/channel/UCAq-MSbAPEfetsPcw6k_ovw] Alabama The Beautiful is a production of The Axis: theaxis.io [https://www.theaxis.io/] Theme music: Never Need a Reason, Guy Trevino and Friends

14 de may de 2026 - 19 min

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