Dr. Christelle Oliver-Dussault, Dr. Harpreet Lotay, and Amanda Manholt explore the complex and often emotional relationship women have with their appearance as they age. They unpack the common experience of looking in the mirror and no longer fully recognizing oneself not because of a desire to look younger, but because the outside no longer reflects how women feel on the inside. The conversation touches on how aging is a gradual process that can feel sudden, especially when influenced by hormonal shifts and cultural pressures that quietly tell women they should “do better” or try harder.

They discuss how many women internalize these changes, often blaming themselves or feeling isolated in their struggles, while emotions like anger remain difficult to express or even acknowledge. The hosts emphasize the importance of creating space for honest conversations about aging and self-image, both in clinical settings and beyond. Through a thoughtful discussion on ethics in aesthetic medicine, they reinforce the idea that less is often more, and that compassionate, patient-centered care should always prioritize authenticity, emotional well-being, and helping women feel like themselves again rather than chasing youth.

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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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/

Guide them in that very vulnerable space. We get so much

pressure as women, um, in the public sphere to look a certain

way that it's important that we do

the right thing. Less is more and embrace the aging

journey to look more rested and not try to give

unrealistic results or unnatural results. Welcome to The Beauty

Equation. Today we want to start with something that we hear all

the time, quietly, almost apologetically.

A lot of times women will come in and say, I don't feel this

tired, or I don't feel this old. I

don't feel like myself anymore. Essentially, they don't recognize who

they are in the mirror anymore. Oftentimes women, they'll say to

us that they don't want to look younger.

They just want to be able to reflect the world how they feel

on the inside. And it starts

away at their confidence. They'll wake up, and I think we all do this. I

know I do it myself. You know, you wake up in the morning, you don't

have your makeup on, you're still tired, you've just about

washed your face, and you feel like the dark circles under your eyes look darker,

the wrinkles look deeper, your face might look a little bit puffier.

And what you— that reflection that you see in the mirror, it does affect your

confidence and how you hold yourself.

Oftentimes what women are trying to

express to us is that they want

something so that they wake up feeling, looking refreshed

and start their day on a good foot. And yeah,

it's a change that sometimes women will express as they feel like it's

happened overnight, but it's actually quite a slow process

when you come to understand it. And there are a lot of little things we

can do along the way, but We won't be jumping into

treatments today. We're really gonna be kind of

exploring that disconnect that happens,

why sometimes in midlife that might feel so sudden, and

also explore why

we tend to always blame ourselves for that experience.

Yeah, and it's so common and we don't talk about it,

right? And you know, that whole idea, and I find

that this is so common amongst women later on in

life. You know, when you're younger, you're interested in makeup

maybe, and you're like, oh, the contour, the this and that and whatever.

But I'm telling you, I want none of it. Like, if I could

just get up and go, that's what I want. And I hear that

all the time. Like, I just can't be fussed about it.

But at the same time, I want to look good and refreshed.

So yeah, it's an interesting time. I think that reflects the

community that we're in too. We are based

in a very outdoorsy community where a lot of women

like. To be able to get up and. Go and feel

confident when they're out on their hike, not wearing any makeup, maybe just a

bit of sunscreen. Oftentimes the first thing that will appear,

which I find, and I think Amana, you can probably attest to that, to a

lot of your skin consultation. Is the

pigmentation changes that will happen that will make you look

more aged, or you'll feel like you want to cover up. And that's

when things kind of can start to like creep in and affect the way you

feel about yourself and feel like you need to wear that makeup.

Yeah, I think the biggest— one of the biggest sort of themes, um,

one in conversations that I get to have with women is

that disconnect between how they feel on the inside

versus what they're seeing in the mirror, whether that is brown spots or

wrinkles or bags under their eyes. And

it's just so prevalent. And oftentimes

they don't come into the consultation saying,

you know, my inside, my outside don't match. Sometimes they do,

but, but often they don't. More often than not, I would say they don't. They

come in because the they're bothered by maybe a particular line or a,

you know, a brown spot. And then, you know, through

the process of having a consultation, you know, we can delve a little

further and it often sort of comes back to that central

theme of, I don't like, who is that person in

that picture? Like, oh my gosh, is that what I look like? Yeah. I hear

that a lot. Yeah. I've, I've heard a lot, like, you know, I saw a

picture and I didn't recognize myself. Or I look like my dad.

That's one that we hear sometimes, right? And, you know, to your point,

our face changes. It changes slowly for

sure. I would agree with you, Crystal, but it's a funny thing.

And a lot of our patients will say this to us. It does feel like

there's a point in time where the change is rapid.

And I think that's— I certainly

experienced that. I do think that it coincides with

some of the changes that happen hormonally. With our

estrogen going down, our progesterone going down,

and we start to get that collagen loss, we start to get that

skeletal resorption and all of that. But it kind of

plugs along really slowly, almost kind of like you're holding your

own. And then it's like something snapped the camel's back and it

just all changes. It may not be overnight, but it can

happen within the period of a year or so. And I

feel like there's a

breaking point almost where once you pass that

threshold of volume loss or pass that little threshold of,

you know, we lose 1% of our collagen per year, yada, yada, yada,

but that adds up. And when it gets to 30% or 20%,

you see visible changes with like that skeletal and

volume loss. So it's experienced that way.

And it could be that leading up to those years, you know, socially

we're very busy. I think of my life,

like I don't have time to look in the mirror when my kids are— I

like 2 years ago, I was driving 4 hours a

day, taking my kids to their various activities. I

have a son and a daughter and they were both not driving yet.

I I didn't, didn't have a minute in the day. And I'm sure you can

attest to that as well, Amanda. And you know, you have younger kids,

Christelle, but like I don't have time to like sort of look.

And then when you have that space to sit down and you're

like, oh my God, things are different. So I think it

all plays into it. Or when you catch yourself in the rearview

mirror of your car, I find that that's the one where you're like. The rearview

mirror is just evil. It's like airplane

bathrooms. Right. I always say, well, I guess you

can't bring tweezers now, but you know, it's The airplane bathroom is a good place

to find those hairs that just randomly pop up.

And I think that's why they randomly, like all of a sudden pop up

too. It's not like they grow 40 feet a day, but it's like, you don't

stop to look at yourself. And then when you do, you're like, what the heck?

Like, and why didn't anybody tell me that I had a 2-inch hair growing out

of the mole on my neck?

I think fatigue, the, the lack of sleep as well has a

huge impact. So you'll see it in phases. So like in those early

years where, like, you know, mothers are

breastfeeding, getting up a few times a night. You're not actually sleeping and

having the chance for your tissue to regenerate. Same thing

starts to happen in the perimenopausal year where your sleep gets quite

broken, and that's often hormonally driven. It

affects your circadian rhythms, your sleep cycle, and you'll get that middle of the

night or early morning waking, and then you're not getting that regeneration.

And it's a process that as you mentioned, it's the fluctuations in

hormones and sometimes it'll be stable and then you get a period of chaos.

And then if you throw in life stressors within that, you'll have

those huge changes that you're getting, the hormonal

changes affecting the tissue. You're not sleeping, you're not regenerating, and maybe you

have a lot of stressors either in work or in your personal life,

and that creates a lot of inflammation and that will show up on your

face. So it has quite a compounding effect.

Yeah. All of it. Right. Oh yeah. And I think, I

think a lot of times though, like to, to that, so it's

interesting listening to these conversations about menopause and sleep and

all that too. Like it can be a little bit anxiety provoking.

And I think a lot of times people feel like they have to do

everything all at once. And here's one more thing that I got to do now.

I'm like bullied into eating protein, right? Like we've all

seen that, right? So

it's a lot. And then I think that naturally

a lot of patients are like, I must be doing something wrong.

This is only happening to me.

Pile on top of that, the sort of

lack of evidence and wrong evidence, frankly, that we had around

hormone replacement and the impact of our hormones on our health in

general as women. That

comes very easy and quickly to us that it's something to do with

just me. I'm the only one. So

I mean, I think that's point— one of the points of our conversation.

It's not just you. It's totally normal

and it happens to everyone. And let's start talking about it like

it's normal human aging.

Yeah, I guess The question is, is like, if it's so

common, then why do we all feel—

well, or why do many people feel alone

in this struggle? Right. Good question.

I think. Oftentimes

we're embarrassed or we're afraid to show our vulnerabilities. We live

in this culture where you

should be showing up in a certain way. This, you know,

image or these masks that we put into the public

eye. And you almost feel left behind or

like something is wrong with you if you're not

fitting in that mask or that image of how you

should look and feel. Or it'll go to the other

extreme where there's almost the sarcasm, the comedy around it.

And there's a lot of women in this middle ground being like, well, which camp

do I belong to? Am I happy to go just

full-on satirical on what's going on in my life, or do I

want to pretend like everything is fine? And then a lot of the times

when you're not feeling great, you'll go maybe to your family physician

and nothing shows up on your blood work because there's nothing that we

can test for because of the way things are.

And then you're like, well, if nothing's medically wrong with me, maybe it's all in

my head. And A lot of the times women will feel too

uncomfortable to even mention it to their friends, or, you know, they suffer in

silence. Well, I have a few thoughts on that.

I mean, one of them is that as women, we just can't get it

perfect, right? We're not allowed to. Either you're too much,

you're going overboard, trying too hard, or you're not trying too

hard. And somehow that says something about your moral character,

which, I mean, it's ridiculous, but we see it in all

aspects, not just our— how we look, right?

It's how do we take care of our families? Do we take, you know,

do we helicopter our kids or not? Like, name it, anything,

right? So I think that's one thing. And then I think

that, you know, celebrities

are not completely honest about the length to which they have to

go to maintain their appearance, right? They have celebrity

chefs. They have people that help them work out. They have people that handle— Has

anybody seen Oprah lately? Yeah.

Like, like, WTH,

like what the heck? I, I'm like, how old is she? 72.

And she's, she looks better

than she's ever looked. I feel like she did like in the

'90s. Right. I know. It's incredible. And

don't tell me that didn't come with a whole heck of a lot of help

and money. Like everybody's supposed to live up to that. Like,

it's not realistic. With the surgery, like, when do

we get to stop? When do we get to get off? It's a lot. It's

a lot. So yeah, to your point, it's, you're kind of,

we're all damned if we do and damned if we don't, right? Yeah. You

know, and there's so much shame and guilt tied

into, you know, doing for ourselves.

In so many ways as women. Yeah.

You know, I'd love to see the younger women, right? Like,

yeah. Who does she think? Like, they jump their in with shoes, right? Yeah. Yeah.

Like, they have no compunction about

investing in themselves, you know, but

it's always the over 50s that come in that are like, I

can't, you know, they're close to retirement. They've done

everything for their kids. They've taken care of their financial responsibilities.

And even yet, to spend that little bit extra

on something that they view as frivolous, right, is

hard for them. So it's just interesting to

walk along people and help them through this, right?

It's different for everybody.

And I feel like, would you agree with the statement that

women often blame themselves? I think

that's an emotion that comes easily to us. Yeah. It

feels easier. Yeah. We take accountability

for a lot of things that aren't even within our realm.

And we have to learn to get mad. We talked about this today.

Yeah. Christelle and I were talking about this today. How anger isn't— not

an emotion that is easy for a lot of women.

Uh, no, we're very much socialized against it. Well, at one point

you could be hospitalized for it, couldn't you? I mean, you would be a hysteric,

right? Hysteria was— you would be hospitalized,

right? I mean, let's— that wasn't even that long ago,

maybe 2 generations. It didn't take much.

Just wanting to have a little bit of freedom and

voicing that could land land you, you in

a place that you maybe didn't want to go. So yeah,

anger is dangerous for us, or has been. Mm-hmm.

So we certainly don't wanna wear it on our faces. Heck no.

And that's probably one of the first treatments

that people kind of in our, you know, in the fifties,

if they haven't done anything, it's often they start to feel like they look

annoyed or angry or unapproachable. And it's, you know, coming in and

addressing their frown lines. It's pretty common. Yeah. Even in

their, from their thirties onwards. Often

is the anger, um, or

the feeling like you're unapproachable. Yeah.

Yeah. And it wasn't, you know, I said to Christelle earlier

today, I said, I'm white Anglo-Saxon Protestant. Like, we, we

are good at repression. And in my family,

getting mad and being loud like that, it just

didn't happen. Right. So it's definitely not something

I've ever really identified with. So yeah, I look forward

to finding my anger in my second half of life.

We sit more comfortably with like sadness and disappointment.

Yeah. Right. Yeah. Yeah. Or tired.

Right. It's interesting because what I've tried to have

conversations with people in my life who don't feel comfortable with

that. Emotion. And I might say,

oh, you look— you— are you angry? They're much—

they'd much rather say, I feel tired. Just tired.

Yeah, it's interesting. So, I mean, I hope

that as we can learn from our younger

women in our lives how to take agency over things,

and there are so many things that we can do from, from

skincare to preventing some of this

aging things that happen. We have lasers, we have

so many things, but my wish for

women is to be able to talk to people like us, just to

talk about how they feel. And it doesn't always mean that you have to

go under the knife or do the injections or do anything really, because

I always like to say we're not saving any lives, but we sure can make

them a whole heck of a lot better. Just by giving

you space to have that discussion and then sharing evidence-based

things that you can do that are still going to be okay

for your health, right? Yeah. I think, and when like women were able to

feel comfortable to open up about what

they see and not be taken advantage of.

I was just recently had a girls weekend and

a handful of the women there had gotten treatments. One

was after multiple bereavements in her life, and

she just wanted to have something back, some

spark after all that loss. Someone else was, you know, turning 40

and wanted to do something for her. And they were showing me photos

from that time in their life and the treatments they had done, and they were,

they were overtreated. They were sold things that they didn't need. And

that's where I think the responsibility lies with the providers, where you— it

is really important to respect that person in front of you

and, and guide them in that very vulnerable space.

We get so much pressure as women, um, in the public

sphere to look a certain way that

it's important that we do

the right thing. Less is more and

embrace the aging journey to look more rested and not

try to give unrealistic results or unnatural results.

I had a conversation with a young professional woman

a week or so ago, a couple weeks back, and what

bothered her was really she had seen video

of herself from the side and she

didn't like her profile, and in particular this sort of angle under the

chin and down towards the neck. And,

you know, we sat and we talked, and, you know, when I actually

palpated the area and kind of had a look. She didn't, she doesn't have a

lot of fat. It's just really more her

anatomy and her structure. You could feel that there wasn't fat under the skin.

It was more, you know, just, you could feel the neck

and all of the space. There was nothing that, you know,

we weren't, there wasn't like a little fat pocket we could melt and her chin

hadn't sunken back enough. So what she settled on was just

to start with You know, just addressing these frown lines here.

And it was funny because she said to me after the conversation, she goes, wow,

she goes, I probably would have like bought anything you told me to

do, but thanks for being honest.

And I was thinking, wow, yeah, I guess

I could have said, oh, you need a bunch of chin filler and let's CoolSculpt

that, even though there was no fat there. And you know what I mean? I

think that's the danger in We're kind of sidelining the

danger in this industry where it is private

work. It's not as regulated as traditional medical work.

And. Because the

training is very much dependent on the individual and there's no

set, say, residency program, we don't tend to have discussions

around the ethics. I don't know if you've had many

conferences or meetings you've gone to where we really focus on the ethics of

treatment. And the responsibility. I think it's

a conversation that's starting to happen now and is well

overdue. Yeah, well, I think so many different things

can play into it. You know,

there's a few things. So there are many different types of

providers in the industry. So from nurses

to physicians to dentists and pharmacists

even, and, you know, in other countries, beauticians. So

their exposure to thinking about ethics

is different than physicians. So I find that most

physicians have an idea around the ethics to the point that sometimes they get

deterred from even entering the field. But I would

argue that the emotional sort of toll that

aging takes in our patients, we see the difference that

we make in their quality of life. So I personally don't have qualms around that

at all. But, you know, we have a variety of

professionals in the field. And so that's one thing. And the other thing

is that because the training is not

standardized and sometimes because we don't all

think of aging the same way, and we may not have the

same breadth of knowledge around the technologies available,

and new technologies keep coming on the market rapidly.

And most of our knowledge is gained through industry partners,

which have their own motives. Yeah, not every

provider that you go see is gonna have an idea of what's actually gonna help

you. So many times people will sit in the chair and say, I don't like

my side profile. I think I need a chin because they've seen

a TikTok or whatever. And that person might not

have the ability to analyze things and not

because of a lack of ethics, but because of a lack of just experience

or knowledge, they might just go do it. So I think there's a lot

at play here. So it's not always

malice or malintent that sort of— I don't— Yeah.

Has people. Yeah. So it, it's a

complicated thing, isn't it? Yes. Very. And, and I think too,

like if all you have is a hammer, then pretty much

everything looks like a nail. I think that, that happens in this

industry sometimes where whatever that particular

treatment is, whether it's a device or an injectable.

And it's just a lot more complicated and more complex than that.

And each person, each of our patients has to come

to their own decisions with our guidance. And

so, yeah, I'm just glad we can have these conversations.

So if you're feeling like things happened overnight,

or who is that old lady in that picture,

Yeah, you're not alone. You probably just crossed that little

threshold where— come on, where I am, come on in.

And yeah, I mean, and that's the other thing too,

like the whole term anti-aging is kind of gross really

when you think about it in the sense that it's something to

be loathed or feared. And I

think The best thing about what we're able to do

is give people a little agency, right? So

they can just feel like the inside and the outside

are more aligned. And

I can't think of one person in all of the conversations

I've had over the years that, you know, has said, you know, here's a, here's

a photo of me at 20. This is what I want.

That never happens. And it's really like.

I just want to feel and look a little bit more like myself again.

Totally. Totally. I'm so glad we had this

conversation. Yeah. So for all of you

listening, please put in the comments if this is

something you've experienced and, you know, let's have

these conversations. Let's bring it out. I certainly have seen changes

in myself and I want to hear about your experience.

Yeah. So if you'd like help making

more sense of what you're seeing, then hang out with

us. We have some great things to chat about. Yeah.

We'll be going into what actually happens down the line and

discussing treatments and answering questions as they come along.

So subscribe so you don't miss an episode and we will chat to you soon.

Bye for now. Bye.