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.<br /><br />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. <br /><br />Have a question for Dr. Koehler, Dr. Gardner and Kirstin? Record your voicemail at<a href="https://alabamathebeautifulpodcast.com/" target="_blank" rel="noreferrer noopener"> alabamathebeautifulpodcast.com</a> and we’ll answer it on the podcast.<br /><br />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<a href="https://www.easternshoreplasticsurgery.com/" target="_blank" rel="noreferrer noopener"> easternshoreplasticsurgery.com.</a><br /><br /><b>Your Hosts</b><br /><br /><b>James Koehler, MD</b> - 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.<br /><br />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.<br /><br />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.<br /><br />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.<br /><br />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. <br /><br /><b>Dr. James Koehler</b><br /><ul><li>Board Certified by the American Board of Cosmetic Surgery in facial and body cosmetic surgery</li><li>Trustee for the American Board of Cosmetic Surgery</li><li>Served as the Chairman for fellowship training for the American Academy of Cosmetic Surgery and has trained numerous cosmetic surgeons</li><li>Served on the admissions committee at the Alabama School of Medicine, where he shared his knowledge and experience with residents and students</li><li>Served as a Board examiner for the American Board of Cosmetic Surgery and was the Committee Chairman responsible for formatting the maintenance of certification exam</li><li>Has been co-director for a number of live surgical workshops and has lectured on numerous topics on cosmetic surgery both nationally and internationally</li><li>Nominated in 2018 for the Stellar Patient Experience Award at the MyFaceMyBody Global Aesthetic Award in Beverly Hills, California</li><li>Active staff at Thomas Medical Center, Infirmary Health in Fairhope, Alabama and currently serves on the surgery steering committee</li></ul><b>Vincent Gardner, MD - </b>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.<br /><br />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.<br /><br />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.<br /><br />Faith also plays a meaningful role in his approach. Dr. Gardner often prays with patients, supporting healing in both body and spirit.<br /><br /><b>Kirstin Jarvis, Co-Host</b><br /><br />As 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.

Alabama The Beautiful
Claim This Podcastby Dr. James Koehler, Cosmetic Surgeon
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Podcast Overview
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.<br /><br />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. <br /><br />Have a question for Dr. Koehler, Dr. Gardner and Kirstin? Record your voicemail at<a href="https://alabamathebeautifulpodcast.com/" target="_blank" rel="noreferrer noopener"> alabamathebeautifulpodcast.com</a> and we’ll answer it on the podcast.<br /><br />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<a href="https://www.easternshoreplasticsurgery.com/" target="_blank" rel="noreferrer noopener"> easternshoreplasticsurgery.com.</a><br /><br /><b>Your Hosts</b><br /><br /><b>James Koehler, MD</b> - 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.<br /><br />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.<br /><br />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.<br /><br />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.<br /><br />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. <br /><br /><b>Dr. James Koehler</b><br /><ul><li>Board Certified by the American Board of Cosmetic Surgery in facial and body cosmetic surgery</li><li>Trustee for the American Board of Cosmetic Surgery</li><li>Served as the Chairman for fellowship training for the American Academy of Cosmetic Surgery and has trained numerous cosmetic surgeons</li><li>Served on the admissions committee at the Alabama School of Medicine, where he shared his knowledge and experience with residents and students</li><li>Served as a Board examiner for the American Board of Cosmetic Surgery and was the Committee Chairman responsible for formatting the maintenance of certification exam</li><li>Has been co-director for a number of live surgical workshops and has lectured on numerous topics on cosmetic surgery both nationally and internationally</li><li>Nominated in 2018 for the Stellar Patient Experience Award at the MyFaceMyBody Global Aesthetic Award in Beverly Hills, California</li><li>Active staff at Thomas Medical Center, Infirmary Health in Fairhope, Alabama and currently serves on the surgery steering committee</li></ul><b>Vincent Gardner, MD - </b>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.<br /><br />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.<br /><br />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.<br /><br />Faith also plays a meaningful role in his approach. Dr. Gardner often prays with patients, supporting healing in both body and spirit.<br /><br /><b>Kirstin Jarvis, Co-Host</b><br /><br />As 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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11/28/2023
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Recent Episodes

July 23, 2026
2026 Trends: What’s Real and What’s Hype?
Filler migration is all over TikTok, biostimulators get sold as a “natural” alternative, and people are choosing a surgeon by follower count. Dr. James Koehler and Dr. Vincent Gardner react to it all in real time.<br />Kirstin reads off the year’s biggest injectable and body claims and asks for gut reactions. The doctors sort what holds up from what doesn’t: why less filler is winning, why “natural” biostimulators are still just filler with a better publicist, and what a lip flip can and can’t actually do.<br />On the body side, Dr. Gardner explains why microdosing a GLP-1 is probably safer but won’t quiet your cravings, and why a vibrating plate only works if it gets you moving. Dr. Koehler makes the case against quick lunchtime thread lifts and lays out exactly when flying overseas for surgery ends up costing far more than it saves.<br />If a viral video has ever talked you into a treatment, this is the reality check to hear before you book.<b><br />Questions answered by this episode:</b><br /><ol><li>Is filler migration real or is the internet overreacting?</li><li>Why are so many people getting their filler dissolved?</li><li>Are biostimulators like Sculptra and Radiesse more natural than filler?</li><li>Is Sculptra reversible if I don’t like how it looks?</li><li>Does a lip flip actually work or is it just a few units of Botox?</li><li>Is microdosing Ozempic safe if I’m not overweight?</li><li>Do at-home body sculpting gadgets and vibrating plates really work?</li><li>Are lunchtime thread lifts a real alternative to a facelift?</li><li>What happens if I have a complication after surgery overseas?</li><li>Should I pick my surgeon based on their follower count?</li></ol>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.<br /><br />Have a question for Dr. Koehler, Dr. Gardner or Kirstin? Record your voicemail at <a href="https://alabamathebeautifulpodcast.com/" target="_blank" rel="noreferrer noopener">alabamathebeautifulpodcast.com</a> and we’ll answer it on the podcast.<br /><br />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 <a href="https://www.easternshoreplasticsurgery.com/" target="_blank" rel="noreferrer noopener">easternshoreplasticsurgery.com</a><br /><b><br /></b>Follow the team on Instagram <a href="https://www.instagram.com/easternshorecosmeticsurgery/" target="_blank" rel="noreferrer noopener">@easternshorecosmeticsurgery</a><br /><br />Watch Dr. Koehler, Dr. Gardner & Kirstin on YouTube <a href="https://www.youtube.com/channel/UCAq-MSbAPEfetsPcw6k_ovw" target="_blank" rel="noreferrer noopener">@JamesKoehlerMD</a><br /><br />Alabama The Beautiful is a production of The Axis: <a href="https://www.theaxis.io/" target="_blank" rel="noreferrer noopener">theaxis.io</a><br /><br />Theme music: Never Need a Reason, Guy Trevino and Friends

July 9, 2026
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. <br /><br />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.<br /><br />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.<br /><br />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.<br /><br />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.<br /><br /><b>Questions answered by this episode:</b><br /><ol><li>What is Ozempic face and is it actually caused by GLP-1 medications?</li><li>Why does losing weight make your face look older?</li><li>How much weight loss does it take before you see it in your face?</li><li>Does skin tighten on its own after major weight loss?</li><li>What is the difference between filler, fat grafting, and a facelift for facial volume loss?</li><li>How does facial fat grafting work and where does the fat come from?</li><li>Can someone in their 30s or early 40s be a facelift candidate?</li><li>Should you wait until you reach your goal weight before getting a facelift?</li><li>If you plan to stay on GLP-1s long-term, does that change what a surgeon recommends</li><li>When would a surgeon recommend cheek implants instead of fat grafting?</li></ol>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.<br /><br />Have a question for Dr. Koehler, Dr. Gardner or Kirstin? Record your voicemail at <a href="https://alabamathebeautifulpodcast.com/" target="_blank" rel="noreferrer noopener">alabamathebeautifulpodcast.com</a> and we’ll answer it on the podcast.<br /><br />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 <a href="https://www.easternshoreplasticsurgery.com/" target="_blank" rel="noreferrer noopener">easternshoreplasticsurgery.com</a><br /><br />Follow the team on Instagram <a href="https://www.instagram.com/easternshorecosmeticsurgery/" target="_blank" rel="noreferrer noopener">@easternshorecosmeticsurgery</a><br /><b><br /></b>Watch Dr. Koehler, Dr. Gardner & Kirstin on YouTube <a href="https://www.youtube.com/channel/UCAq-MSbAPEfetsPcw6k_ovw" target="_blank" rel="noreferrer noopener">@JamesKoehlerMD</a><br /><br />Alabama The Beautiful is a production of The Axis: <a href="https://www.theaxis.io/" target="_blank" rel="noreferrer noopener">theaxis.io</a><br /><br />Theme music: Never Need a Reason, Guy Trevino and Friends

June 25, 2026
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.<br /><br />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.<br /><br />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.<br /><br />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.<br /><br />Questions answered by this episode:<br /><ol><li>Can I have skin removal surgery while still on Ozempic or Wegovy?</li><li>How long do I have to stop GLP-1 medication before cosmetic surgery?</li><li>Is the skin different after GLP-1 weight loss versus gastric bypass?</li><li>Do I have to lose all my weight before booking a tummy tuck?</li><li>How much weight do I need to lose before plastic surgery after GLP-1s?</li><li>Will non-surgical skin tightening work for massive weight loss skin?</li><li>What happens to my surgical results if I gain weight back?</li><li>Why do people sometimes need a second surgery after GLP-1 weight loss?</li><li>Can liposuction take the place of a tummy tuck after weight loss?</li><li>Should I stay on a GLP-1 forever or wean off the dose?</li></ol><br />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.<br /><br />Have a question for Dr. Koehler, Dr. Gardner or Kirstin? Record your voicemail at <a href="https://alabamathebeautifulpodcast.com/" target="_blank" rel="noreferrer noopener">alabamathebeautifulpodcast.com</a> and we’ll answer it on the podcast.<br /><br />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 <a href="https://www.easternshoreplasticsurgery.com/" target="_blank" rel="noreferrer noopener">easternshoreplasticsurgery.com</a><br /><br />Follow the team on Instagram <a href="https://www.instagram.com/easternshorecosmeticsurgery/" target="_blank" rel="noreferrer noopener">@easternshorecosmeticsurgery</a><br /><br />Watch Dr. Koehler, Dr. Gardner & Kirstin on YouTube <a href="https://www.youtube.com/channel/UCAq-MSbAPEfetsPcw6k_ovw" target="_blank" rel="noreferrer noopener">@JamesKoehlerMD</a><br /><br />Alabama The Beautiful is a production of The Axis: <a href="https://www.theaxis.io/" target="_blank" rel="noreferrer noopener">theaxis.io</a><br /><br />Theme music: Never Need a Reason, Guy Trevino and Friends<br /><br />
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