Perimenopause & Menopause

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…

Facelifts are increasingly offered to younger patients in their 30s and 40s as a “preventative” option. I have strong opinions about this trend, because a traditional facelift is often the wrong tool for what’s happening to your face at this stage, and I think it’s worth explaining why. Two different problems, at two different points…