Scalpel and Skin

Can non-surgical devices really lift your face—or are the results being oversold? In this episode of Scalpel and Skin, Dr. Algie LaBrasca and Mistica welcome Andrew Liscio, aesthetic medical professional, clinical educator, consultant, and host of the Aesthetically Speaking podcast, for an honest conversation about energy-based aesthetic treatments.
They break down the difference between improving skin quality, creating a firmer appearance, and achieving the kind of lift that surgery can provide. From ultrasound and radiofrequency to RF microneedling and laser treatments, the conversation explores what these technologies are designed to do, who may be a good candidate, and why the device alone doesn’t determine the result.
They also discuss treatment risks, the importance of provider experience, how expectations can get out of hand, and whether expensive treatments deliver enough value for the money. Then it’s time for case studies and a rapid-fire “Is It Worth It?” round.
In this episode:
Can non-surgical treatments give you a facelift-like result?
Skin tightening vs. skin lifting: what’s the difference?
Ultherapy and microfocused ultrasound
Sofwave and ultrasound technology
Monopolar and bipolar radiofrequency
RF microneedling and the importance of safe treatment settings
Morpheus8, Genius, and newer RF microneedling devices
FaceTite, AccuTite, and Renuvion
Endolift: what we know and what still needs more evidence
Can lasers actually tighten skin?
Why patient selection and provider experience matter
What to consider before spending thousands on a treatment
Real-world patient scenarios: devices, combination treatments, or surgery?
The final “Is It Worth It?” verdicts
The biggest takeaway? A device can have a place without being right for every patient. Understanding its limitations, the evidence behind it, and the results you can realistically expect matters just as much as the technology itself.
Scalpel and Skin brings together plastic surgery, cosmetic dermatology, and honest conversations about what aesthetic treatments are actually worth your time and money.
Follow Andrew Liscio on Instagram and check out his Aesthetically Speaking podcast. Subscribe to Scalpel and Skin for more conversations about plastic surgery, skin health, aesthetic technology, and the trends worth questioning.
This episode is for educational purposes only and is not individualized medical advice. Treatment suitability, outcomes, risks, and recovery vary by patient and procedure.
#ScalpelAndSkin #NonSurgicalFacelift #SkinTightening #RFMicroneedling #AestheticMedicine
Follow Andrew: @andrewliscio
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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
Follow Melissa: @melissa.the.aesti
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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
Follow Melissa: @melissa.the.aesti
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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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