In this episode of The Beauty Equation Podcast, Dr. Christelle Oliver-Dussault, Dr. Harpreet Lotay, and Amanda Manholt dive into the hesitations many women feel about aesthetic treatments. They debunk common myths and fears—especially around Botox and injectables—while emphasizing the importance of skin health and the proven safety of these procedures. The hosts also discuss the pressures women face about appearance, the need for informed choices, and the value of working with qualified providers to achieve natural, confident results.

About the Hosts:

Dr. Harpreet Lotay is a family physician specializing in aesthetic medicine. She is the founder of Sona MD in Kamloops, BC, and serves as Chief Medical Officer at Bios Wellness Clinics. Known for her artistic approach and comprehensive non-surgical treatments, Dr. Lotay combines medical expertise with an eye for natural results. She is also an educator, a national trainer and holds academic appointments where she shares her knowledge in clinical dermatology and aesthetics. You can get in touch with her on Instagram @hlotaymd

Dr. Christelle Oliver-Dussault is a family physician specializing in aesthetic medicine, women’s health, and psycho-education. She brings a holistic, whole-person perspective to her clinical work, blending science with a deep understanding of the mind-body connection.

She is also the founder of Reclaim The Pink Within, a movement that empowers women to rediscover themselves during life’s most transformative stages. In addition, she is passionate about medical education and mentors the next generation of family physicians through her work with the department of Family Medicine at the University of British Columbia.

You can connect with her on Instagram @drchristellemd

Amanda Manholt is a clinic manager, patient consultant, and co-host of The Beauty Equation Podcast. With over 30 years of experience in beauty, aesthetics, and leadership, she has guided patients and teams alike toward confidence, growth, and empowerment. Known for her ability to connect with people and simplify the often-overwhelming world of aesthetics, Amanda brings a warm, practical, and relatable perspective to every conversation. You can find her on Instagram @crowsfeetandconfidence.

Websites

https://sonamd.ca/

https://www.getyourpinkbackproject.com/

Disclaimer: The Beauty Equation is for informational purposes only and not medical advice. This podcast does not create a doctor–patient relationship. Always consult a qualified healthcare provider before making medical or aesthetic decisions. Information may change as the field evolves.

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Well, skin health is foundational, so it's. And it's a. It's a

friendly, approachable way to get them to start to understand

that this is a very holistic thing. That one thing ties into the next, ties

into the next. So I love it when I can review what they're using for

their skin and give them some education and understanding about, you know,

things that will actually make a difference to their skin. I would say

neuromodulators like Botox and Dysport, that's probably one of the first.

First treatments. I don't know if you'd agree with that too, Harpreet, where it's,

you know, it's not a huge investment in terms of money per se.

And at the end of the day, if they don't like the results, guess what,

it goes away, and it's like you never had it. So I feel like that's

a real. I call it the gateway drug. Welcome back to the beauty equation.

I'm Dr. Christelle Oliver Dusseau. And I'm Dr. Harpreet

Lotade. And I'm Amanda Manholt. So today

we're talking about the. A specific group of women, women

who haven't really had any treatments done before, who are a bit

hesitant and are wondering, is this

the right space for them? Are they behind what's

available to them? And anyone who's feeling a little bit intimidated or

overwhelmed by the variety of options that we

have to offer or. Ashamed, I think that's the big one.

Yeah. Yeah, we see a lot of that too. So let's start with you,

Amanda. Since you do so many consults and you get a lot of these

con. You have lot of these conversations on a day to day basis, what

are some of the biggest myths or fears that you would like to

dispel? So many. But the number one myth

or the number one fear is that they're gonna look

fake. Today I had a lovely gallon for a consult,

and she was concerned that her forehead would look shiny and

plastic. So it's that feeling

like they look odd, like someone can point them out in a room and say,

I know what you did. Mm. And

I feel like that the underlying current for that is shame.

It is right. You know, and it depends. And I see it with,

you know, boomers and Gen X people like me, and

even sometimes with the millennials, but the, like, the younger ones I find are sort

of less averse. I feel like it's really these boomers and

millennial or Generation X and. And some of the

Older millennials. Yeah. The younger ones, I think, grew up

with more of a social media presence that

they don't seem as intimidated or bothered. Not at

all. It's like getting your nails done. You know, it's something that they do for

prevention. But their moms come in and it's.

Let me tell you, it's a whole other con, you know, a whole other

conversation. And I think the thing that's so frustrating and challenging about

aging is if you do nothing. Oh, God, she's let

herself go. Look at her. And if you do

too much, who does she think she is? Oh,

she's one of those people. Oh, she must be vain. Why would. Who would

do that? Right. So there's so much judgment or

perception of judgment. So what are some of the

treatments that you'll often introduce to women who are

coming into the clinic who would like to

have something done but are very hesitant and concern?

What are the most common things you'll usually find that they're

open to or feel comfortable trying? Well,

skin health is foundational, so it's. And it's a. It's a

friendly, approachable way to get them to start to understand

that this is a very holistic thing. That one thing ties into the next, ties

into the next. So I love it when I can review what they're using for

their skin and give them some education and understanding about,

you know, things that will actually make a difference to their skin.

I would say neuromodulators like Botox and Dysport, that's probably

one of the first treatments. I don't know if you'd agree with that, too, Harpreet,

where it's, you know, it's not a huge investment in terms

of money per se. And at the end of the day, if they don't like

the results, guess what, it goes away. And it's like you never had it.

So I feel like that's a real. I call it the gateway drug.

Yeah, right. I think the fear. It's interesting that

Botox, yes, definitely one of the first aesthetic

treatments that will be introduced to women. And from a medical perspective,

it's super, super safe. It's been around for

decades, and it's been used in for treating medical

conditions, you know, migraines, spasticity in stroke

victims, even so. But there's such a. Yes.

Overactive blood. So, so many aspects in medicine. We use

Botox, and yet it's, you know, considered the

boogeyman. And you'll find all kinds of misinformation out there

about how it's gonna, you know, change your

brain. It's going to travel all over the place

and give you botulinum. And,

you know, it's a toxin, which technically it is, but it's

extremely, extremely safe. So I feel very comfortable as a

physician recomm injecting that. And it is,

to Amanda's point, temporary. So that's very

nice because if people aren't loving the results,

they don't have to worry everything about it is going to go away.

So I love that. And like, those who are new to

Botox, because there's a lot of confusion around

the different injectables that we use. And I'm saying Botox not

just for the brand. It's just people commonly refer to.

How does it work? Well, it

basically stops your muscles from receiving the

impulse from the nerves that tell the muscles to contract. So it

stops contraction. That's all it does. And then

your body's clearing mechanisms will go in and break

down that protein and stop it from binding that receptor,

will open up again and contraction will start again.

You know, so a lot of people will say it magically erases

wrinkles. All it does is it stops muscle

activity and it lets your skin repair itself from the

micro trauma, from that repetitive creasing that you're creating that

you are not able to repair quickly anymore as you age.

So just stops muscle movement. Yeah, I totally

blame Tim Allen. And what was that Christmas movie? He goes

to the mall and he goes and apparently

gets a Botox treatment and then comes back and meets his family in the food

fair. And his face, like, is all. Yeah,

twisted up who are on the podcast. She's

making a very funny face. Oh, yeah. His face is all

contorted and. And it's like, looks ridiculous. And he's like, I just got a

Botox treatment. And I'm like, okay, come on. Like, first of

all, it's probably the most anticlimactic thing you could ever do. It's

literally a couple of pokes and you're on your way, and you don't really see

a whole lot until it starts to take effect somewhere between,

you know, depending on what you guys are using, four days to a week

or so later. Yeah, but it's, you know, this

myth that's been perpetuated that, you know, you're going to look crazy or

unnatural. And I have to say to people, I'm the winner in the clinic for

number of units. Like, what am I at? 100. Where am I using you guys?

121. Hundred and nineteen, baby. And,

and I, you know, that was the comment with when I did the consult today.

And she's like, I just, I really, I said, well, tell me what you're worried

about. Tell me what bought, like what is, what does it bad look

like for you in terms of an outcome? And she said, I don't want a

shiny forehead. I said, totally fine. I

said, but just so you know, I'm the, you know, the winner in the

clinic and is my

forehead shiny? Things still move, right? So yeah, unfortunately there's

just been a lot of misinformation and it feels like fear mongering

and, and it just feels like putting us in our place. I'm sorry,

I'm just gonna say it. That's what it feels like to me.

Like, how dare you want to show up and be

vibrant and still and be relevant. Right. Well, I mean the

interesting thing is is women worry about whether or

not they're vain. I don't think I've ever, I mean in

any context, I don't think I've ever had a man say,

am I being vain? They own

that. They're like, yeah, I care.

But that was a commercial media and commented on our appearance constantly.

Of course we're going to then reflect on the way we look and appear if

that's all we see. Yes. And popular

media. Well, and I think in our culture, you know, it's, a woman can never

be too beautiful and a man can never be too strong.

Yeah, I've heard, I've heard it said. Do you, do you remember there was a

commercial years and years ago and I want to say it was for Special

K or some sort of cereal and it was this guy sitting at

a bar with like, you know, a bit of a beer belly and

crying into his beer about looking fat. And it was just,

it was such a great commercial because it was just

so you're like, well that's just ridiculous.

Why was it ridiculous? Because it was a guy in a bar with a

beer and a belly. I don't know. So going

back to our hesitant listeners,

dipping your toe in often looks like a conversation

around skin health. How it ages and what

is suited to your skin type, what will

help, what will cause harm, and then introducing some

neuromodulators. And that's a really lovely combination because as

Harpreet said, once it kicks in and your skin isn't moving as much or

wrinkling or creasing like a piece of paper would, then those actives

that we're using on Your skin are starting to work, and it's a really nice

symbiotic relationship. And absolutely.

Usually, if you're going to be doing regular treatments, you should

probably think about your daily skincare. The other thing I really love about

Botox, too, it's not just the effects that it has on the overlying

skin, but it almost lets us play a little puppet game with

people's faces, particularly. I know last time, Harper, you talked about how I don't

want my face to droop. The effects of gravity and

on the lower face. That's where I've really enjoyed exploring the

use of neuromodulators, because you can get a real

lifting effect and definition of the jawline there, which a lot of people aren't

usually familiar with. So that's something that,

if you were thinking it's just for your forehead, your frown, or the

11s, as people say. No, we have lots of uses that go way beyond just

the upper third of your face that we can use. Yeah, absolutely.

In term. Oh, go ahead, Amanda. I was gonna say, I think another thing that

holds women back in particular is

their spouse. Oh, yeah. And I'm sure you guys

can both talk about this, but it's like, my partner can't know. It's

kind of funny. I think a lot of times it's grocery cash that comes in.

Again, it's just either they

don't want to have to talk to their partner about it, or they don't

want to feel guilty or the shame or. But that definitely comes in.

That conversation is, you know, had many times.

Well, at the end of the day, I think what sometimes

happens in those situations is that whatever the person in our

chair is noticing does not impact the spouse.

And what I mean by that is when the person looks in the mirror and

they see that line and it makes them feel like they're old or

they look angry, that affects that person, that woman

that's looking. And so she's seeking help for that

feeling. And that look, that has nothing to do with her

spouse or whether her spouse finds her attractive or not.

Because more often than not, the comment is,

you know, he thinks I look fine, but that's not the point. Right.

So, yeah. And I think, too, I mean,

we've been. I've been married for, gosh, 25 years now, and,

you know, obviously we're both aging. But when I look at my husband, I.

I don't tend to see a lot of that.

He's just who he is because we've been together so

long. I remember going to, I think it was my 30 year high school reunion.

Now that's a trip. And talking to a fellow that I literally did

not recognize. I had to read his name tag. And then once I figured

out who I was talking to, I was like, oh my gosh, Kelly. And

the weird thing that happened is as I was talking to him,

his beard sort of melted away, his weight sort of melted away.

And as I heard his voice, he was like the 17

year old person that I remembered. I just, that was

just an odd experience. So then I wonder, like with your spouse

again, to your point, I don't. It shouldn't be about. It

should never be for your partner, it should always be for you. And

I think from my experience, most people aren't coming in

to do this for somebody else, they're coming in to do it for themselves.

Yeah. And they just want to feel more

confident and they're coming into us to have a

conversation because they don't know where to go and what is

available and what can be done. We, you

talked, we kind of touched on a little bit about the skin

care, some of the injectables which are neuromodulators.

There's a few other injectables that we use and I think a lot of people

get confused with what that is. Harpreet, you want to give a quick

overview of what's available and when we might use it.

Neuromodulators come in different flavors, as Christel

mentioned. So those are those injectables that stop your

muscles from moving. So those are great for addressing

lines that are caused by movement or creasing. But there are other

things that we can inject as well to address other aspects of

aging. So one of the things that happens when we age is we lose

volume. Our fat pads start to sort of get smaller

in all the wrong places, like our cheeks, like our temples.

And we start to get some jowling and softening of the jawline.

So we can replace that volume with fillers that

are made out of sugars. And we have these natural

substances in our skin as well. It's called hyaluronic acid.

But when we want to use them to create volume, they're sort of

created in a way that gives them a little bit more substance. So we can

use them to create a structure like effect. We

can use them in thinner forms to

soften certain lines so they can be used in various

ways. So fillers are. And those are what is

injected into lips as well. And then we have

yet other injectables that will address the loss of collagen

that happens when as we age, we lose about 1% of our

collagen after the age of 20. And it just is this compounding

thing, snowballing thing that happens and decreases

elasticity in our skin. And we can inject things like

Sculptra, which is an injectable that will stimulate your

fibroblast to make its own collagen. We have

Radiesse, which also can be injected to do similar

things as well as create a scaffolding for volume.

So there are so many different injectables that we

use presently and other injectables coming

down the road, like harvested adipose tissue that's

sterilized and can be used. Down in the States they use that.

So yeah. Have you too. You may. You probably

don't get it as often as I do, but when you're doing an initial consult

with someone and they're just like, oh no, no

injectables for me for sure. Which is

totally fine. If that happens,

what. Where do you tend to go? Christelle, why don't you

take that one? Yeah. So oftentimes when people come into me,

the conversation is usually around what they're noticing and

what they want to address. And then if I

notice any hesitancy, particularly with regard to like fillers, I'll dig it in

to ask a little bit about like, what are those fears? What worries you? And

some are valid fears because there's been, it's

still a very unregulated industry in certain parts

of the world and sometimes even we've noticed issues here too.

And there can be complications if not

injected properly. If so,

I usually address those head on with them and

tell them what the degree of risk is and what to expect and

also tell them, well, if this complications arises, this is

how we manage it. So for example, with fillers, one of the

biggest, the most worrisome, although very rare,

is a vascular occlusion. So that's when the blood supply to the

area near where you injected gets blocked. And that can either happen

because the product has ended up in the blood vessel, if there's a big bruise

pressing on that blood vessel.

And we in our practice always give post care sheets to

our procedures with emergency contact numbers. Because if that

happens, that is the one emergency we have to deal with. And we have

a protocol on how to address that and break down and

return blood flow to the area. So that's something that you should

have a discussion with your provider. If you're somewhere else and you

want to, you're concerned. It's important to be aware about

what the potential risk and complications are. And then if they arise, how's

your provider going to manage those? Because if they know how

to manage them, then you know, or they have a protocol in

place, then you know you're in safe hands, that they're aware of the risk of

what they're doing and they also know how to address those issues. So I

break down those fears and sometimes it's still something that they're not

interested in and then we go to other tools. So

injectables aren't our only tools. And I have patients who have medical conditions that

prevent them from using filler type injectables. And then

we might go to more medical devices. So we have

microneedling, radio frequency microneedling, we have various light

based therapies like BPL or lasers. So,

Amanda, you'll often talk to our patients about that and link them in with

our medical esthetician, Alyssa John, and

maybe say a few words on those types of treatment and what people might expect

to see with those. Yeah, well, I think going back to the fact that great

skin looks good, it looks amazing on everybody, right. So I think there

was a study done. We should find that picture and use it.

But I know it's a twin study where one worse, the one that wore sunscreen,

the one that didn't wear sunscreen. And you know,

or I think of some of our patients where we've done things like my

favorite, which is the BBL halo combination where

you've got somebody that, you know, they lived a life of, they've had fun, they

lived in the sun. And I mean, gosh, when I was a kid, there was

no sunscreen. So just improving the overall tone and

texture of their skin with a, with a treatment like that,

I don't know, it makes them look less tired, it makes them look more

approachable, it makes them look more vibrant. So it doesn't

always have to be injectables. No, no. And I think

that's again, why skin health is just so

impactful and foundational. And going back

to the physiology of why wrinkles happen, right, it's because

our skin loses the reparative capacity over

time. So Botox, all we're doing is buying your skin time.

So the other aspect of that equation is up

regulating the skin's ability to repair itself using

actives that we know are

medically effective. You know, whether it be retinol or

antioxidants et cetera. Yeah,

yeah. I think, you know, so in terms of is it safe? I think,

as you know, you said her pre Botox is

pretty darn safe. And I think, you know, how do you determine if it's safe?

And I love, you know, hearing you both talk

and we'll parrot you, really, to say, you know, it's

been around. I think it's gotta be close to 40 years now,

Botox, because I think I've been saying it's been over, you know, over so many

years, and I've been saying that for the last 10 years. So as physicians,

I would assume that that's one thing that helps you feel

safe and comfortable using a product. If there's been umpteen million

treatments. So many studies on Botox and studies.

It was actually Dr. Jean Carruthers, who's based in Vancouver,

who first discovered it with her husband when they were treating someone for

blepharospasm, which is the spasm. Of your low eyelid. And she noticed, huh,

their wrinkles are getting better on their eyes. Yeah. See, it just needed another. I

just needed a smart lady. Exactly. So it has been

tried and tested and used, and the bigger numbers we have

and the more information you have in terms of potential side effects, the more comfortable

we feel because then we know how to deal with something if it goes

wrong. And I think too, Christelle, with you having

worked in the uk, there are some real challenges there. It's

different to the uk. Sorry. Right. Just for all the Irish

listeners out there who are about to get riled up. Sorry,

thank you for watching. I did training in the uk, though, so it is confusing.

I did training in London, but I. My aesthetic practice

was in Ireland, so. In Ireland, because I. Because I am

aware that there are some real challenges in

the UK with. Is it the same in Ireland where things like

dermal filler have been categorized as a device? Is that

how you say? Yeah, it was a similar issue and there's been huge talks. They

actually RT is the main news station and they recently did

a series on this and the safety. And there's now a new aesthetic board in

Ireland who is overseeing and try to establish guidelines around

safety. Last year, there were some products that had been brought

in through the north that

we don't really know what they were, dear. Yeah, so there's been issues.

And I think that's not just the UK and Ireland. There's been a few areas.

So in terms of safety for the public,

go to someone who's licensed. So we have a licensing body,

myself and Dr. Lotte, where we are registered. We have to

show that we have. Continuing medical education for this special interest

area that we've developed. We have to publish our

licensing authority in our clinic and it's there. If you're

at a clinic and you want to know who's injecting you and you don't see

a sign, just ask the front desk. They'll be more than happy to show you.

So that's a good little safety nugget that you can put in place.

And my advice is, if you have a consultation

with someone who is there to inject your face and you

think they look really weird,

run, don't walk as fast as you

can out the door, because

everybody's perception of beauty is

a little bit different. And there is a lot of dysmorphia

in this industry, not only with patients, but I think also

it's with providers. Let's be real. We've all been to conference.

Yes. Yeah, yeah. And I would like to add that, you know, make

sure you're being injected in a clinical setting and it's not,

you know, a conjoint party or something like that where

you can't guarantee sterility and so on and so forth.

Yeah. And make sure that it's legitimate product.

I. You know, there's always ways to

get. For people to get their hands on things. And unfortunately,

you know, we even had a situation where we are,

where, you know, the woman was charged. She was making

claims about her credentials that were

untrue and that was really upsetting for the

people that had had treatments. They felt ashamed, they felt

embarrassed. And here's the thing that's crazy to me is if

something had happened that had been terrible, like she doesn't have

a governing body. No. There's no accountability.

No. So, yeah, generally speaking, I would say

aesthetics is very safe. We use products that have been studied for

decades and in the right hands, in the right credentialed people,

it's quite safe. So,

yes, it's safe and no, it's not vain. I don't think

it's not vain. It's safe. You still have

to be careful, I think, and I think that was part of the reason why

we wanted to do this is so that the listener,

you. The listener has the tools to assess whether it's

safe. So if the price is too good to be true. Yes, that is

a bit of a red flag. If there isn't any licensing body, that

is a bit of red flag if the place doesn't Seem clean. I think that's

just a no brainer. It's a medical procedure. Their provider

should be washing their hands and putting on gloves and the rooms are cleaned after

every person. So, yeah, just common sense, stuff like that. And then

like to your point, Amanda, if you like the appearance and the

aesthetic of someone who's injecting you, then you probably

have a similar view to what beauty is

and to it you feel. And to each their own. And just make sure you

feel heard when you're talking to your provider if you feel like they're not

understanding you don't ever feel pressured to get a treatment on the day. So.

Absolutely. Yeah. Yeah. There's probably a lot more

that we could go on about this topic. The other thing that I really value

with both of you is that there isn't this

pressure to bring in the latest thing.

It's very much, there's a lot of critical thinking that goes into it because. I

think it's very easy to get. Caught up into marketing.

Hoorah, rah about the newest, the latest, the greatest.

I really respect the fact that there's critical thinking about, okay, well, does

this make sense? Does this resonate with what I want to do or

what you want to do as physicians? Right. The

questions I always ask are like, okay, well, what were the side effects in the

study? What went wrong? And I like to wait till it's been out a bit

so other people can experience those mistakes.

Yeah. And you know, it is a

industry that is impacted tremendously by

marketing and there are always products coming

out that don't stand the test of time and don't

stand up to critical scrutiny when you come and

look at the data. So it is important to

insist on that scientific rigor, I think. Yeah.

So to everyone listening today, thank you for

tuning in. If you have questions on today's episode,

you can send us an [email protected] or

as if you're watching, put a few comments below. We always love to hear

from you and we will see you or chat to you

soon. Bye.