Dr. Scott Miller: Plastic Surgery, Natural Aging & The Art of Knowing When Not to Operate When it comes to aesthetic medicine, knowing what not to do can be just as important as knowing what to do. In this episode of Vitality Unfiltered, host David J. Bauder, PA-C, founder of Weight Loss & Vitality, sits down with Dr. Scott R. Miller, fellowship-trained, board-certified aesthetic plastic surgeon and author of Authentic Beauty, for a thoughtful conversation about plastic surgery, natural aging, patient expectations, and what truly creates a great aesthetic outcome. Dr. Miller has spent nearly three decades in aesthetic plastic surgery and built a highly regarded practice in La Jolla, California, around an individualized, patient-first philosophy and natural-looking results. Certified by the American Board of Plastic Surgery, Dr. Miller completed advanced aesthetic fellowship training under Dr. Bruce F. Connell, widely regarded as the “Father of the Modern Facelift.” He has been included on Castle Connolly’s Top Doctors® list for more than 20 years and was recognized by Newsweek among America’s Best Plastic Surgeons for facelift procedures in both 2024 and 2025. He also serves as an attending surgeon at Scripps Memorial Hospital in La Jolla and a Clinical Instructor for UC San Diego plastic surgery residents. During the conversation, Dr. Miller explains why successful plastic surgery requires more than technical skill. It takes what he describes as “head, hands, and heart”—the vision to understand what will genuinely benefit a patient, the technical ability to achieve it, and the judgment and empathy to sometimes recommend doing nothing at all. David and Dr. Miller explore how facial aging should be evaluated, why imperfections can contribute to beauty, and why patients shouldn't chase someone else's definition of the perfect face or body. They also discuss the growing movement toward more natural aging, including public figures who have challenged conventional expectations surrounding cosmetic treatments and aging. The conversation then moves beyond surgery to examine the relationship between aesthetics and overall health. David and Dr. Miller discuss nutrition, exercise, sleep, hydration, body composition, skin health, and hormonal health, along with the effects that significant weight loss and GLP-1 medications can have on facial and body aesthetics. You'll also hear their perspectives on Botox, fillers, lasers, radiofrequency treatments, Sofwave, facelifts, and how to recognize when continued non-surgical treatments may no longer be the best approach. Most importantly, Dr. Miller explains how patients can choose the right plastic surgeon, establish realistic expectations, and make aesthetic decisions based on their own anatomy and goals—not trends, advertising, social media, or someone else's definition of beauty. In This Episode • When a plastic surgeon should say no • Dr. Miller's “five-foot rule” • Why perfectly imperfect features can enhance beauty • The psychology behind aesthetic surgery • GLP-1 weight loss and aesthetic procedures • Why weight stability matters before surgery • Healthy aging from the inside out • Botox, fillers, lasers, RF treatments and Sofwave • When non-surgical treatments stop making sense • Red flags surgeons evaluate before operating • Social media's influence on aesthetic expectations • Facelifts and modern facial rejuvenation • The movement toward natural aging • How to choose the right plastic surgeon • What to start doing today to look and feel better decades from now About Dr. Scott R. Miller Dr. Scott R. Miller is a fellowship-trained, board-certified aesthetic plastic surgeon based in La Jolla, California. His individualized approach emphasizes surgical precision, artistic judgment, and preserving each patient's unique characteristics. He is also the author of Authentic Beauty. Dr. Scott Miller | Miller Cosmetic Surgery Center Authentic Beauty by Dr. Scott Miller About David J. Bauder, PA-C David J. Bauder, PA-C is the founder of Weight Loss & Vitality and host of Vitality Unfiltered. Vitality Unfiltered explores longevity, hormone optimization, medical weight loss, exercise, nutrition, aesthetics, precision medicine, and the science of living healthier for longer. Weight Loss & Vitality Blog Weight Loss & Vitality 📞 571-550-9000 Subscribe wherever you listen to podcasts, and until next time—stay healthy, and more importantly, stay curious. ⚠️ Disclaimer This podcast is for educational purposes only and does not constitute medical advice. Listening to this episode does not establish a provider-patient relationship. Always consult your qualified healthcare professional regarding medical concerns, diagnosis, or treatment.