Perimenopause & Menopause

Patients ask me constantly what I actually do for myself — not what I’d recommend in the abstract, but what I’ve chosen, as someone going through this exact transition, with full knowledge of what’s available and what the evidence actually supports. I think that’s a fair question, and I want to answer it honestly here.…

I’m in my mid-40s, and for the past few years, my own face and body have been quietly rewriting the rules I thought I understood. I’m a board-certified plastic surgeon. I’ve spent close to two decades studying exactly how faces and bodies age. And still, perimenopause caught me somewhat off guard. Not because I didn’t…

“I get enough sleep. I’m not stressed. So why do I look exhausted?” I hear a version of this question constantly, almost always pointed at the eyes specifically. It’s one of the first places perimenopausal changes show up, and one of the most misdiagnosed, not because patients are wrong that something’s changed, but because most…

My patients who are going through perimenopause/menopause often describe the same feeling in different words: “I look tired.” “I look hollow.” “I don’t look like myself.” Almost always, they assume it’s one thing — skin that’s stopped doing its job. In reality, it’s usually a few separate processes happening at once, and telling them apart…