"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


🔗 CONNECT

Dr. William Umansky — https://www.drumansky.com/


This conversation is for education and is not medical advice. Talk to your own physician about your situation.


Meet the Author

About Dr. Nanos

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