July 7, 2026
Perimenopause, Menopause, and Plastic Surgery: What Every Woman Should Know | Beauty and the Beasts
Perimenopause is finally getting the attention it deserves, and it has a bigger impact on cosmetic surgery results than most people realize. In this episode of Beauty and the Beasts, Dr. Sam Jejurikar of Dallas and Dr. Sal Pacella of San Diego break down how the hormonal shifts of perimenopause and menopause change the face, the breast, and the way patients heal.
Two board-certified plastic surgeons explain why estrogen and progesterone decline starting in the 40s, how that drives collagen loss, thinning skin, and facial deflation, and why women can lose one to two percent of their collagen every year leading up to menopause. They get into how low estrogen can undercut fat transfer results, why radiofrequency skin tightening loses its punch after menopause, the underrated roles of sleep, cortisol, and growth hormone in surgical recovery, and the emotional dip that so many patients hit a few days after surgery.
They also tackle the practical questions patients actually ask: should you stop hormone replacement therapy before surgery, how blood clot risk factors into that decision, how the Caprini score and procedure type guide their approach, and why breast tissue changes like lower pole thinning and the waterfall deformity matter for augmentation and lifts. The takeaway is honest and clear, including why your plastic surgeon is not the one who should be prescribing your hormones.
If you are navigating perimenopause or menopause and thinking about your skin, your breasts, or a future procedure, this is a grounded, judgment-free conversation worth your time.
Chapters:
0:00 The growing push for hormone support in your 40s
0:26 Welcome and today's topic
0:54 Why perimenopause is real and why surgeons should care
2:12 What perimenopause is and when it starts: estrogen, bone, soft tissue, sexual health
4:12 Collagen and elasticity loss in the face and breast
5:13 Should plastic surgeons screen for it? Biologic and psychologic factors
7:54 Men, andropause, and testosterone
8:30 Breast involution, skin changes, and why some non-surgical treatments stop working
9:52 Sleep, cortisol, growth hormone, and surgical recovery
11:46 The emotional side and post-op depression
13:01 Hormone therapy and blood clot risk around surgery
13:54 Tailoring the plan: Caprini score, oral vs transdermal, facelifts
16:04 What perimenopause does to the breast and the waterfall deformity
17:00 Breast lifts at 35 vs 55 and the need for internal support
17:24 Final thoughts: see your gynecologist or sexual medicine provider
Beauty and the Beasts is hosted by Dr. Sam Jejurikar and Dr. Salvatore Pacella, two board-certified plastic surgeons offering honest, behind-the-scenes conversations about aesthetic surgery, wellness, and the topics that matter most to their patients. New episodes drop regularly, so subscribe and hit the bell to follow along.
This podcast is for educational and informational purposes only and is not medical advice. It does not create a doctor-patient relationship. Always consult a qualified, board-certified physician about your individual situation.
#BeautyAndTheBeasts #SamJejurikar #SalPacella #Perimenopause #PlasticSurgery
Two board-certified plastic surgeons explain why estrogen and progesterone decline starting in the 40s, how that drives collagen loss, thinning skin, and facial deflation, and why women can lose one to two percent of their collagen every year leading up to menopause. They get into how low estrogen can undercut fat transfer results, why radiofrequency skin tightening loses its punch after menopause, the underrated roles of sleep, cortisol, and growth hormone in surgical recovery, and the emotional dip that so many patients hit a few days after surgery.
They also tackle the practical questions patients actually ask: should you stop hormone replacement therapy before surgery, how blood clot risk factors into that decision, how the Caprini score and procedure type guide their approach, and why breast tissue changes like lower pole thinning and the waterfall deformity matter for augmentation and lifts. The takeaway is honest and clear, including why your plastic surgeon is not the one who should be prescribing your hormones.
If you are navigating perimenopause or menopause and thinking about your skin, your breasts, or a future procedure, this is a grounded, judgment-free conversation worth your time.
Chapters:
0:00 The growing push for hormone support in your 40s
0:26 Welcome and today's topic
0:54 Why perimenopause is real and why surgeons should care
2:12 What perimenopause is and when it starts: estrogen, bone, soft tissue, sexual health
4:12 Collagen and elasticity loss in the face and breast
5:13 Should plastic surgeons screen for it? Biologic and psychologic factors
7:54 Men, andropause, and testosterone
8:30 Breast involution, skin changes, and why some non-surgical treatments stop working
9:52 Sleep, cortisol, growth hormone, and surgical recovery
11:46 The emotional side and post-op depression
13:01 Hormone therapy and blood clot risk around surgery
13:54 Tailoring the plan: Caprini score, oral vs transdermal, facelifts
16:04 What perimenopause does to the breast and the waterfall deformity
17:00 Breast lifts at 35 vs 55 and the need for internal support
17:24 Final thoughts: see your gynecologist or sexual medicine provider
Beauty and the Beasts is hosted by Dr. Sam Jejurikar and Dr. Salvatore Pacella, two board-certified plastic surgeons offering honest, behind-the-scenes conversations about aesthetic surgery, wellness, and the topics that matter most to their patients. New episodes drop regularly, so subscribe and hit the bell to follow along.
This podcast is for educational and informational purposes only and is not medical advice. It does not create a doctor-patient relationship. Always consult a qualified, board-certified physician about your individual situation.
#BeautyAndTheBeasts #SamJejurikar #SalPacella #Perimenopause #PlasticSurgery