Perimenopause is finally getting the attention it deserves, and it shapes cosmetic surgery results far more 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 start declining 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 dig into how low estrogen can undercut fat transfer results, why radiofrequency skin tightening loses its punch after menopause, and the underrated roles of sleep, cortisol, and growth hormone in surgical recovery, including the emotional dip so many patients feel a few days after surgery.
They also tackle the practical questions patients actually ask. Should you stop hormone replacement therapy before surgery? How does blood clot risk factor into that decision, and how do the Caprini score and the type of procedure guide their approach? And why do breast changes like lower pole thinning and the waterfall deformity matter so much 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.
In this episode:
Why perimenopause matters to plastic surgeons and not just gynecologists. The collagen and elasticity changes that accelerate after menopause. How hormones affect fat transfer, facelifts, and breast surgery results. Sleep, cortisol, and recovery. The blood clot conversation around hormone therapy and surgery. What to expect emotionally after a procedure.
Beauty and the Beasts is hosted by Dr. Sam Jejurikar and Dr. Salvatore Pacella, two board-certified plastic surgeons sharing honest, behind-the-scenes conversations about aesthetic surgery, wellness, and the topics that matter most to their patients.
This episode 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.
