Just Aging" Is Not a Diagnosis

August 25, 2026

You looked in the mirror and something had changed. The jawline, the neck, the way your skin sat on your face. And when you brought it up, someone told you it was just aging. Or just hormones. Or nothing.

Dr. Georgine Nanos sits down with Dr. William Umansky, a board-certified plastic surgeon with more than 30 years in private practice in La Jolla, trained at Stanford, selected by his own physician peers as one of San Diego's Physicians of Exceptional Excellence, and ranked by his patients among America's most compassionate doctors.

This is not a lecture on what's trending in aesthetics. It's the specific, plain-language conversation most women never get to have, about what estrogen actually does to skin, what rapid weight loss does to a face, how to tell a good surgeon from a dangerous one, and what's true and what's marketing.

In this episode:

What estrogen is actually doing in your skin — and why the change can feel like it happened overnight
Where the fat goes in perimenopause, and why the breasts and abdomen change first
Rapid weight loss and the face: what's really happening, and why it was never about the medication
Fillers vs. a facelift — where the line is, and what fillers can and can't buy you
Why nobody's afraid of the surgery, they're afraid of looking like they had it
The technique debate, honestly explained and why he chooses the conservative option
The part that should alarm you: no medical board prevents a physician in another specialty from performing your facelift or liposuction
Why "cosmetic surgeon" is not a recognized board, and the 5-minute check that protects you
Breast implants, completely: saline vs. silicone, how long they last, when to scan them, the rare lymphoma, and whether mammograms are safe
Tummy tuck vs. body contouring — it comes down to skin, not fat
When a good surgeon tells you no, and why that's the one you want
The two red flags to walk out on
An hour of surgery that changes a child's life, every year, in Mexico
Rapid-fire: sunscreen, side-sleeping, filler migration, and "preventive" facelifts