Lipstick & Lipo: Your Unfiltered Guide to Plastic Surgery
Join us, two Board-Certified female Plastic Surgeons, as we discuss all things plastic surgery, beauty, and wellness. No topic is off-limits. Our mission is to provide you with accurate information and educate in a real, approachable, and relatable way.
Dr. Smita R. Ramanadham is a double-board certified plastic surgeon in private solo practice in NJ and Dr. Ashley Amalfi is a board certified plastic surgeon in private practice in Rochester, NY.
We share a love and passion for plastic surgery, mentorship, women in surgery, and, fashion (of course!)! Our friendship has been so natural and organic that it only made sense that we would start this adventure together. We hope you enjoy these episodes as much as we enjoyed making them!
Episodes

2 hours ago
2 hours ago
This is probably the most common question we get asked: How often do breast implants need to be replaced?
A lot of advice says 10-15 years, but that's not actually true.
There's no expiration date on breast implants.
We explain why the timeline is different for everyone, what signs to watch for that indicate replacement might be needed, and how to think about imaging for both your implants and your breast tissue.
We also discuss the important distinction between replacing implants because they failed versus changing them because your breast itself has changed over time through weight fluctuations, pregnancy, or natural aging.
What you'll learn:
Why the 10-15 year replacement timeline is a myth.
The car tire analogy that explains replacement timing perfectly.
How to know if your implant has failed or ruptured.
What capsular contracture looks and feels like.
FDA imaging recommendations for silicone implants.
The difference between imaging for implants versus breast tissue.
When ultrasound and MRI are needed for implant evaluation.
Have you been putting off your mammogram or breast imaging? This is your reminder to schedule it. Taking care of your breast health matters, whether you have implants or not.
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Thursday Feb 12, 2026
Thursday Feb 12, 2026
Male cosmetic procedures are booming, especially in two specific industries: tech and finance.
We're seeing a surge of men in their 50s and 60s feeling pressure to look younger as 20 and 30-year-old workers enter their offices.
From Botox and skincare to facelifts and body contouring, men are embracing procedures they once avoided. We discuss why this demographic shift is happening now, how we approach male procedures differently to maintain masculinity, and why many male patients start their journey after watching their wives' positive experiences.
Whether it's facial rejuvenation to look powerful in boardrooms or body contouring for a more athletic appearance, the stigma around male plastic surgery is finally fading.
What you'll learn:
The key differences in approaching male versus female facial surgery
Why maintaining masculinity is critical in male procedures
Common male procedures: Botox, facelifts, eyelid surgery, liposuction, gynecomastia
How male eyebrow and jaw structure differs from female anatomy
Why many men start their plastic surgery journey through their wives
Why starting small with skincare leads to better aging over time
If you found this episode interesting, share it with someone who might benefit from hearing that plastic surgery isn't just for women anymore. Real expert advice makes all the difference.
Dr. Smita Ramanadham
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Thursday Feb 05, 2026
Thursday Feb 05, 2026
Simone Biles has been incredibly transparent about her breast augmentation, sharing details about her surgery and her board certified female surgeon.
We applaud her openness and her choice of a qualified surgeon.
However, as board certified plastic surgeons who specialize in breast surgery, we have serious concerns about one specific aspect of her procedure: the placement of her implants under the muscle.
For an elite athlete with the strongest pec muscles you can imagine, cutting that muscle and placing implants underneath can possibly create long-term complications.
We explain why this placement may cause her implants to migrate laterally over time, what alternatives would have been better suited for her athletic lifestyle, and why customizing surgery to each patient's unique anatomy and goals matters so much.
What you'll learn:
Why Simone Biles' implant placement is problematic for elite athletes.
How pec muscle strength affects implant positioning over time.
When under-muscle placement makes sense versus when it doesn't.
The newer implant technology and techniques available today.
What alternatives exist for athletic patients.
Why there's no one-size-fits-all approach to breast augmentation.
The importance of matching surgical technique to lifestyle.
Are you loving these celebrity analysis episodes? Leave us a review on your podcast app it helps other people find evidence based plastic surgery information.
Connect with Dr. Smita
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Connect with Dr. Amalfi
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Thursday Jan 29, 2026
Thursday Jan 29, 2026
Viral beauty trends are everywhere on TikTok - from lip flips to buccal fat removal to slugging and face taping. We're discussing why chasing these trends is usually a waste of your time and money.
As board certified plastic surgeons, we discuss the good and bad of social media's impact on plastic surgery, how to spot BS advice from unqualified "experts," and why reading recovery horror stories online isn't giving you the full picture.
If something seems too cheap, too easy, or too good to be true it is. We explain how to invest your money wisely instead of wasting it on every new fad.
What you'll learn:
How to spot viral beauty BS on social media.
The difference between an expert and someone with an Amazon review.
Why recovery horror stories are usually extreme outliers.
How to read patient experiences with the right lens.
The good and bad impact of social media on plastic surgery.
Why trends like lip flips, buccal fat removal, and BBLs go viral.
How to invest vs. waste money on skincare and procedures.
What questions to ask board certified plastic surgeons.
We have amazing episodes coming up make sure you're subscribed so you never miss anything.
Connect with Dr. Smita
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Thursday Jan 22, 2026
Thursday Jan 22, 2026
Andy Cohen looked noticeably different during his New Year's special with Anderson Cooper on CNN, sparking rumors about a facelift. He came out and addressed what he actually had done.
He addressed the speculation, and we're looking at his before and after photos. We'll never truly know exactly what he's had done since we're not his doctors, but we discuss what weight loss, professional lighting, and makeup can do tools most people don't have access to. That's part of the challenge: celebrities can look amazing through a combination of resources the general population simply doesn't have.
This sparks a bigger conversation about what celebrities owe the public. There's a level of privacy everyone deserves, but when you have a massive platform, where's the line between privacy and setting unrealistic expectations? We also dive into male cosmetic procedures, why male anatomy requires different techniques, and why Botox in men needs to be done perfectly to avoid feminization.
What you'll learn:
Specific changes visible in Andy Cohen's appearance.
The anatomy differences that make male Botox more challenging.
What professional makeup, lighting, and contouring can actually achieve.
How facial volume changes naturally as we age.
Why a straight brow matters for masculine appearance.
The privacy versus transparency debate with real examples.
Why weight loss shows differently on camera versus in person.
We have some amazing episodes coming out over the next few months. Make sure you're subscribed so you never miss anythin
Connect with Dr. Smita
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Connect with Dr. Amalfi
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Thursday Jan 15, 2026
Thursday Jan 15, 2026
Kendall Jenner recently spoke out on a podcast, stating she's never had plastic surgery only baby Botox.
We're analyzing her before and after photos to educate our audience.
When celebrities with massive platforms lie about their procedures, young women develop false expectations about what's naturally achievable.
The transformation goes beyond what "baby Botox" alone can achieve.
She has great genetics and looked beautiful before, and she looks gorgeous now but if she was honest about the work, it would actually help people understand these results come from a combination of genetics and procedures, not just one or the other.
What you'll learn:
What "baby Botox" is versus regular maintenance.
How to spot the difference between minimal work and regular procedures.
The visible changes we see in before and after comparisons.
Why transparency matters from celebrities with large platforms.
Don't forget to subscribe which helps more people find the channel and also makes sure you don't miss an episode.
Dr. Smita Ramanadham
Connect with Dr. Smita
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Connect with Dr. Amalfi
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Thursday Dec 25, 2025
Thursday Dec 25, 2025
About a year ago, the FDA approved the Motiva implant and after using them in our practices, we're seeing why patients love them.
These implants have been proven in Europe and South America for over a decade, and the technology is a real step forward. The gel and shell improvements mean they move and feel more like natural breast tissue than any previous generation. We discuss what's actually different and why this matters.
What You'll Learn:
Why the Motiva implants are a game-changer for natural results.
How the FDA approval process works (and why the US gets technology last).
The difference between textured and smooth implants.
Why these new implants move and feel more like real breast tissue.
Who makes a good candidate for this technology.
Are you thinking about breast augmentation or upgrading to these newer implants? We practice in New Jersey and Rochester, NY, and we'd love to see you if you're in the area. You can come try them on and feel them in our office. Not local? Find a board-certified plastic surgeon near you and ask about 6th generation implants.
Connect with Dr. Smita
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Connect with Dr. Amalfi
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Thursday Dec 18, 2025
Thursday Dec 18, 2025
Medical spas are popping up on every corner, and while many are reputable and well-run, not all are created equal.
In this episode, we're giving you a reality check about what "medical" actually means when it comes to med spas.
We discuss why any doctor can be a medical director (even if they have zero aesthetic training), the critical questions you need to ask before getting injected, and the red flags to watch out for.
From supervision standards to pricing, we discuss how to find a truly qualified provider who can handle complications if they arise.
What You'll Learn:
Why "medical" spa doesn't always mean properly supervised.
How any doctor (cardiologist, pediatrician, gastroenterologist) can be a medical director.
The critical questions to ask: Who supervises you? Where are they? Can they handle complications?
Why having protocols and immediate access to a qualified physician matters.
Red flags: gimmicky marketing, shopping-like atmosphere, confusing answers.
How to identify if a med spa is truly medical or just using the name.
Dr. Smita Ramanadham
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Thursday Dec 11, 2025
Thursday Dec 11, 2025
We're living in the undetectable era where plastic surgery changes are subtle and hard to notice and that's exactly how it should be!
After years of preaching natural results, the world is finally on board with our aesthetic.
We discuss why good plastic surgery should look like you were born that way, how overdone procedures age poorly, and why less is always more.
From BBLs to breast augmentations to facelifts, we explain how staying natural minimizes long-term complications and why plastic surgery is a marathon, not a sprint.
What You'll Learn:
Why overdone results age terribly and create long-term problems.
How oversized implants and dramatic BBLs interfere with active lifestyles.
Why natural results minimize long-term risks and complications.
The importance of finding a surgeon whose aesthetic matches yours.
How to approach plastic surgery as a marathon, not a sprint.
Why establishing a long-term relationship with your plastic surgeon matters.
The progression from skincare to injectables to surgery over time.
How board certified plastic surgeons can guide you through every stage of aging.
Don't forget to subscribe which helps more people find the channel and also makes sure you don't miss an episode.
Connect with Dr. Smita
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Connect with Dr. Amalfi
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Thursday Dec 04, 2025
Thursday Dec 04, 2025
We're diving into one of the most exciting innovations in breast surgery breast preservation!
This revolutionary new technique for breast augmentation is changing everything by preserving your natural anatomy while delivering beautiful results with minimal downtime.
Instead of cutting through tissue, this method uses a specialized device to gently stretch a pocket for the implant.
We explain how it works, who it's for, why recovery is so much faster, and why you might not even need general anesthesia.
If you've been considering breast augmentation but hesitant about the invasiveness or recovery time, this episode is for you.
What You'll Learn:
-What breast preservation surgery is and how it differs from traditional breast augmentation.
-How the technique preserves natural ligaments, nerves, and breast tissue
-Why this is ideal for smaller breast augmentations.
-Recovery timeline: back to work the next day, gym within a week or two.
-How this can be done under local anesthesia or light sedation instead of general anesthesia.
-Why busy moms and working women are excited about this option.
-Who is a good candidate for breast preservation.
-Why 2026 will be a big year for this technique in the US. -How to find a surgeon who offers this procedure.
Don't forget to subscribe which helps more people find the channel and also makes sure you don't miss an episode. We have more exciting things coming your way in 2026!
Connect with Dr. Smita
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