What Did She Do To Her Face?! | 014
Dr. Christelle Oliver-Dussault, Dr. Harpreet Lotay, and Amanda Manholt explore the many factors that shape aesthetic medicine decisions—from facial anatomy and treatment science to the powerful influence of social trends and cultural beauty standards. The conversation looks at why some results appear natural while others feel exaggerated or “off,” and how thoughtful assessment and technique play a critical role in maintaining facial harmony.
The discussion also touches on the growing impact of social media and celebrity culture on beauty ideals, and how these influences can shift expectations around treatments like Botox, fillers, and biostimulatory options. Alongside these technical insights, the hosts emphasize the importance of psychological well-being, responsible provider guidance, and a balanced approach to skincare and aesthetic care. The goal is not transformation, but alignment—helping patients make informed choices that support natural, authentic results while respecting the individuality of every face.
Key Takeaways
- Cultural trends and regional beauty standards often influence what patients request in aesthetic treatments.
- A global facial assessment helps prevent isolated treatments that can disrupt overall balance.
- Understanding the differences between neuromodulators, fillers, and collagen-stimulating treatments improves treatment planning.
- Certain skincare ingredients and treatments require careful use to avoid irritation or long-term skin damage.
- Ethical providers recognize when psychological factors may require additional support or referral.
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
Transcript
people think that money equals results.
Speaker:And we have seen celebrities that, as you said, have
Speaker:all the money in the world, but they end up looking weird, like
Speaker:alienized, right? That's what— that's a term that we use in aesthetic medicine.
Speaker:And I believe that that comes from self-direction, you know?
Speaker:So you have somebody that doesn't really have a medical background,
Speaker:they don't really understand anatomy, but they think they know what
Speaker:they want and they're directing the provider. And you have a provider
Speaker:that is, you know, is, is in a hard place because they might not
Speaker:want to lose a celebrity client, or, you know, they
Speaker:might think that that actually looks good and they're sort of put in
Speaker:a position of doing something that's not quite anatomical.
Speaker:And I think that's key. So understanding anatomy and
Speaker:then understanding how the face naturally ages will help
Speaker:you create treatment plans for patients that keep them
Speaker:looking natural. Welcome to The Beauty Equation. I am
Speaker:back with my two amazing friends, Dr. Harpreet
Speaker:Lote and Dr. Christelle Oliver-Dussault. I'm Amanda Van Holt,
Speaker:and we are The Beauty Equation. I am so excited to
Speaker:have this little chat tonight because I feel like this would be one of the
Speaker:conversations we would have in the back of the clinic. And, you know,
Speaker:oftentimes we're scratching our heads and thinking, well, you know, why do people think the
Speaker:things they do and why do they do the things they do? And One of
Speaker:the things I hear, and I think it's been
Speaker:said often, is what in God's green earth did that woman do to her face?
Speaker:And I think the last episode we talked about
Speaker:was, you know, making these decisions without fear or regret. And I
Speaker:think that's one of the biggest fears that people have is they're going to end
Speaker:up looking weird. And, you know, I don't want people
Speaker:to be having a conversation
Speaker:about why I look weird. But there's a rhyme and reason
Speaker:to why that happens, and we're going to talk about that today
Speaker:so that you can avoid the pitfalls that sometimes are
Speaker:made when people go down the road of choosing aesthetic treatment.
Speaker:Yeah, and it's, it's everywhere. So from, you know, social
Speaker:media to the movies to the grocery store. And I
Speaker:think one of the comments I get a lot is I don't understand how, you
Speaker:know, that person that has seemingly more money than they can spend in a
Speaker:lifetime looks so odd. Like,
Speaker:so those treatments just can't be for me.
Speaker:And if you look at celebrities, there are some who
Speaker:age— I'll use the word that we hate to use— gracefully,
Speaker:or look like they've had very few tweaks but have definitely had treatments,
Speaker:and others that their face becomes completely distorted
Speaker:and they no longer look like themselves. And that
Speaker:can be really confusing when you see that broad
Speaker:range of like, well, how, I want this, so how do I avoid getting to
Speaker:that? It's a great question. And to your point,
Speaker:Amanda, people think that money
Speaker:equals results. And we have seen
Speaker:celebrities that, as you said, have all the money in the world, but they end
Speaker:up looking weird and like
Speaker:other— part of the re— yeah. Like alienized, right?
Speaker:That's what— that's a term that we use in aesthetic medicine. And I believe that
Speaker:that comes from self-direction, you know? So you have
Speaker:somebody that doesn't really have a medical background. They don't really
Speaker:understand anatomy, but they think they know what they want and
Speaker:they're directing the provider. And you have a provider that is, you
Speaker:know, is, is in a hard place because they might not want to lose a
Speaker:celebrity client. Or, you know,
Speaker:they might think that that actually looks good. And they're sort of put in a
Speaker:position of doing something that's not quite anatomical.
Speaker:And I think that's key. So understanding anatomy and
Speaker:then understanding how the face naturally ages will help
Speaker:you create treatment plans for patients that keep them
Speaker:looking natural. So, you know, it's sort of a
Speaker:two-sided thing. It's the provider, but also
Speaker:the patient in the case we're talking about celebrities pushing
Speaker:the provider to do to do a particular thing and not understanding
Speaker:anatomy. So, you know, in celebrities that happens.
Speaker:Um, yeah, I think, you know, these are put in a very difficult
Speaker:position because their appearance matters to
Speaker:so much because that's, that's their business card, right?
Speaker:They're being judged on their appearance
Speaker:constantly from whether they're being filmed on set or
Speaker:having photo shoots done where it's airbrush or getting those god-awful
Speaker:TMZ shots where they're coming out of the grocery store
Speaker:with nothing on. It's relentless. And you can see how that would get to any
Speaker:person where you're constantly looking in the mirror and picking one small
Speaker:thing. And that distortion usually isn't something that happens
Speaker:with one appointment or overnight. No, it's gradual
Speaker:erosion of self-perception and
Speaker:then chasing those things and not
Speaker:having the opportunity to step back from
Speaker:what's actually going on. 100%. It's like watching
Speaker:grass grow, So I'll often talk to people and say, like,
Speaker:if you sit there in your lawn chair and you watch your grass, it
Speaker:doesn't grow, right? It doesn't change. And we are faced with
Speaker:our face every day. So we're— and, you know, we've talked about this on other
Speaker:episodes where there's mirrors everywhere, reflective surfaces
Speaker:everywhere, cameras and screens that we're on all the time
Speaker:for work and for other reasons, FaceTiming people, whatever.
Speaker:So it is like watching the grass grow. You're sitting there and you don't
Speaker:notice day to day that things are changing. Changing, but go away for
Speaker:a vacation, come back in 2 weeks. So you're like, it's 6 inches longer.
Speaker:Right. So, uh, I think, I think that happens, that
Speaker:sort of distortion. And, uh, yeah. And
Speaker:I think it's interesting that people will often attribute to these
Speaker:celebrities that look odd on
Speaker:Botox. I hear that a lot. Yeah. That's
Speaker:it. Yeah. And I'm— Botox gets such a bad rap. It really
Speaker:does. I'm like, I don't think that's, you
Speaker:know, so is it Botox? Is it filler? Is it surgery?
Speaker:I just saw a post of, um,
Speaker:Kelly Osbourne, Ozzy Osbourne's daughter, and it showed her. It was 4
Speaker:images. I don't know if any of you guys saw that, and it was her
Speaker:as a cute little kid, and then her as, you know, sort of the
Speaker:teenager phase, and then her
Speaker:I'm assuming in her, you know, as a young adult and then now.
Speaker:Ah, my, if I had to guess, I'm thinking she's had her buccal fat
Speaker:removed. Um, yeah, there's been a lot of because she even
Speaker:says she had done. Whoa. And so sometimes it's surgery,
Speaker:sometimes it is filler, and sometimes I guess it could be Botox,
Speaker:right? I mean, there's a certain, um,
Speaker:politician in the US that's had some
Speaker:Very interesting eyebrow positioning in,
Speaker:you know, over the last couple of years, you know, which
Speaker:brings me to this. I mean, do I get to talk about Mar-a-Lago
Speaker:face? Like these, these very well-to-do
Speaker:wealthy people. Yeah, I guess in a certain,
Speaker:I don't know if it's a certain area of the US, but,
Speaker:um, gosh, what was it? The wife of the Dell, the fellow that owns
Speaker:Dell computers and Yeah. Yeah. Michael Dell, I
Speaker:think his name is. Yeah. But there's a lot of those.
Speaker:Yeah. So monologues sort of look similar, right?
Speaker:It's like, that's a social adaptation, right? Like as
Speaker:human beings, we like to fit in. It was
Speaker:a survival instinct evolutionarily. So
Speaker:if you look and act the same, then you are safe.
Speaker:At the root. So, and that's why you'll find certain aesthetics
Speaker:in different pockets of the world, or you have that like
Speaker:Hollywood face or the Mar-a-Lago face because
Speaker:it's happening everywhere around you. So suddenly you,
Speaker:when you start to feel different, you start to try to mirror, or you even
Speaker:see it in like, you know, teenage girls, right? They all
Speaker:like, you get a group of girlfriends together, they seem to eventually all kind of
Speaker:look the same. The hair is the same, the outfits are the same, they talk
Speaker:the same. It's social adaptation. It is, it is.
Speaker:Yeah, I think then it's interesting because you see that in other
Speaker:situations, but this Mar-a-Lago thing
Speaker:is, if you think about it in that
Speaker:light, Kristel, as you mentioned, it's very much
Speaker:to fit into social expectations, right?
Speaker:Because that entire culture is around
Speaker:assimilation and around similarity
Speaker:and, you know, being
Speaker:very similar, like you said, right? So belonging,
Speaker:yeah. And it's— and so if someone higher on the
Speaker:social hierarchy starts to look a little certain
Speaker:enhanced, let's call it, there is this trend towards
Speaker:becoming more enhanced looking. And you see this in other cultures, like in
Speaker:Russia, people who get aesthetic treatments
Speaker:want to make sure that those aesthetic treatments are seen or
Speaker:visible to other people on purpose because
Speaker:it signals status, right? I recently had
Speaker:a patient who came in and she was
Speaker:originally from the Middle East, but her— she had beautiful curved,
Speaker:very natural looking eyebrows, but that's not the look she wanted
Speaker:with Botox. She wanted a fox-eye look. So to flatten
Speaker:the middle curve of the brow, lift the tail, And,
Speaker:you know, we got a very straight look, and to me it was very striking,
Speaker:and it's not something my aesthetic
Speaker:sort of resonated with, but it made her feel happy. And
Speaker:it's— Botox is a treatment that does not cause permanent
Speaker:disfigurement or harm. So that's one thing that
Speaker:people should know. But
Speaker:people's aesthetic sort of look can vary
Speaker:regionally for sure. And one last place
Speaker:that I've seen it and wanted to touch on is actually plowing. Plastic surgery
Speaker:conventions. So, you know, when
Speaker:I've gone to a plastic surgery convention, it— everything
Speaker:is just a little bit more enhanced. It's changing now as the
Speaker:overall culture of plastic surgery is changing, but
Speaker:still you see lips sometimes, many, many lips, and you're
Speaker:surrounded by lips that are slightly anatomically different.
Speaker:And it's very slight, but it's— you can see it. And then
Speaker:over the course of the 3, 4 days that you're at the convention and
Speaker:con— you're like, you kind of don't see it anymore and you think,
Speaker:is, is that normal? Yeah. Yeah. It's very interesting.
Speaker:It is. It's, um, and then like it's a slippery slope. We haven't touched
Speaker:on it, but there's a, an element of body dysmorphia
Speaker:that occurs, um, which is, is
Speaker:quite predominant in this industry because
Speaker:it, some people are just continually
Speaker:chasing further improvement and then they get so used to that.
Speaker:Face that it's about something else and something else. And sometimes it's a deeper issue.
Speaker:It's a psychological concern and they're looking
Speaker:externally to address that. Yeah. Yeah.
Speaker:How would you describe body dysmorphia to people who
Speaker:don't know what that means? Uh, that is,
Speaker:I'm not going to give you the DSM definition cause I can't think of it
Speaker:off the top of my head. Just pop, pop, pop psychology.
Speaker:It to me is a disconnect between
Speaker:how one perceives themselves
Speaker:with how others in the world see them
Speaker:and how they feel internally. And it's often— So like someone who
Speaker:always thinks that they're overweight, but when you look at it objectively,
Speaker:they're not. That would be a form. Yeah. Similar to people who
Speaker:have like an eating disorder who would think that they're overweight, but they're
Speaker:not. These people will think that a certain
Speaker:body part to them is very ugly or
Speaker:grotesque, and in reality it isn't. And there's
Speaker:oftentimes like a deeply rooted psychological issue around
Speaker:like self-worth. Yeah, yeah. And
Speaker:I think when we see those people, it behooves us to have those
Speaker:conversations and make the referral to the right
Speaker:people to help them and not to do further harm, right?
Speaker:So I think that's key. So. Yeah,
Speaker:yeah. I think of the young ones that come in and I think, oh my
Speaker:gosh, like, it was hard enough growing up when, you know,
Speaker:being a teenager in the '80s, you know, and you had all of these like
Speaker:skinny, skinny models and, you know, it was the, it was the era of the
Speaker:supermodel, right? And, um, it's coming back.
Speaker:Yeah, like Linda Evangelista. I'm trying to think of all, you know,
Speaker:Christy Turlington, you know, all of those Gals in
Speaker:the church. That, that was one thing. And it, I, I
Speaker:never was gonna compare to or add up to any of those kind of
Speaker:women, but social media is just a
Speaker:whole other level. Like the, you know, you've got these young girls that
Speaker:are, you know, everything's so filtered
Speaker:and so fake really. It distorts
Speaker:your concept of reality from a very young age.
Speaker:Very young age, right? And so they're coming in and, you know, you know,
Speaker:maybe you've got somebody that's like 19 or 20 and they're wanting
Speaker:lips that look like this picture, which, okay, maybe that
Speaker:looks, maybe that looks good on that person and in
Speaker:that photo and that angle with that, but that's not actually what that person
Speaker:looks like in real life. And then to make it worse, these
Speaker:aren't models and superstars. This might be somebody that lives down the street for
Speaker:them or a friend of a friend, but it still
Speaker:looks so amazing, but it's, it's so fake. Yeah. And
Speaker:because they have filters or they have AI modification
Speaker:or the influencer you're following is AI. Yeah.
Speaker:That's a whole nother level. That's a whole other stereotype. Yeah. That's right.
Speaker:That's a whole other thing. You know, so then as a provider, I, I think
Speaker:it's, it's a bit of a struggle cuz I feel like
Speaker:we do such a good job of really keeping
Speaker:the patient's best interest at heart, you want to give
Speaker:these young girls a little something so they don't go somewhere and do
Speaker:something crazy. Yeah, I don't know if that
Speaker:maybe— Yeah, I think that's worth mentioning. Yeah. So I think it comes
Speaker:down to how do you, how do you not look weird? So you want to
Speaker:do something, you're not sure
Speaker:what, what would keep you looking not weird. And I want to
Speaker:touch on also what does Botox do versus fillers? Because to your
Speaker:point, everybody who comes comes in and says, well, I don't, I don't, you know,
Speaker:that person had Botox and they look weird. Well, how do you tell
Speaker:the difference between one and the other? So generally, if you see
Speaker:people who are puffy or they have enlarged cheeks or their
Speaker:lips are bigger, that's not Botox, that's filler.
Speaker:And Botox works by stopping muscle movement,
Speaker:right? So it just stops muscle movement so your skin can fix the
Speaker:wrinkles that you kind of etched in there repeated creasing. So
Speaker:if somebody might have a dropped brow or they don't have
Speaker:movement in an area of their face that would normally see movement, like
Speaker:the crinkles of your eyes, etc., that's more likely to be
Speaker:Botox. The beauty of Botox is that it goes away.
Speaker:There's no permanent damage that can happen to you with
Speaker:Botox. So I
Speaker:feel very confident that that's a safe treatment, and if you don't like
Speaker:it, it's going to go away. So for those of you who are considering, you
Speaker:know, stepping into something. Botox is pretty,
Speaker:pretty safe. I say that with my chest as a
Speaker:family physician who's interested in your health.
Speaker:Right. So fillers are different. They're— I
Speaker:look at them as being somewhat semi-permanent. People feel
Speaker:like, oh, you know, I can get filler and it'll go away in 6 months
Speaker:and then I can just top it up or whatever. It doesn't work like that.
Speaker:So in my opinion, they are semi-permanent.
Speaker:You, you need to approach them with a little bit more Caution
Speaker:and small amounts and work with somebody whose aesthetic that
Speaker:you respect and also somebody who's going to tell you
Speaker:no and guide you. Right. So that's
Speaker:key. And good skin looks good, good on
Speaker:anyone. So you're never wrong sort of investing in good skincare
Speaker:and protecting your skin and all that. So, you know, those are some
Speaker:easy things to do. Yeah, and don't focus
Speaker:on one thing, right? One feature, one
Speaker:line, you know, try to look at the overall
Speaker:impression that you're
Speaker:experiencing when you look in the mirror and share that with your provider. Like,
Speaker:hey, I feel saggy, not can you give me a syringe of filler
Speaker:in my nasolabial folds, which are the lines from your nose to
Speaker:your smile lines, right? So those are kind of the tips and tricks that I
Speaker:would have. Do you two have anything that you would suggest to patients when
Speaker:they're looking looking to venture into this? I would say
Speaker:kind of tagging along what you mentioned about
Speaker:having a global picture and maybe taking a step backwards, I view
Speaker:also having a variety of photos because one photo can just catch at the wrong
Speaker:angle in the wrong light, and that's not actually a concern. And
Speaker:you only— you see yourself as a reflection, so it's very
Speaker:different to what others see of you. And you
Speaker:really can only see yourself front on. And when we do the assessment, we're really
Speaker:taking a global assessment and Right. I mean, I even—
Speaker:it takes me back to a consult I had today. Like those photos that we
Speaker:take from all angles. I think if you have a provider
Speaker:who will sit down with you and show you your face from multiple
Speaker:angles and explain what you're seeing
Speaker:and why it's happening from all those different angles, that can give you an
Speaker:understanding both what's going on and can help you
Speaker:zoom out from that one area. Like one
Speaker:of the consults I had today was very much came in I
Speaker:don't like my nasal labial folds and my marionettes that are happening. And then when
Speaker:we looked at the global picture, she had a— was very lucky, had
Speaker:really nice chin projection, but she had a lot of temple volume loss. She had
Speaker:a lot of loss in her cheeks and then just in front of her ears,
Speaker:the preauricular area. And she just needed that support
Speaker:back. And we took a lot of time to go through that. And you could
Speaker:tell she was like, oh, understood. And then was completely
Speaker:moved away from looking there and could even And she was one—
Speaker:we always will have a bit of asymmetry, so difference between our right and our
Speaker:left face, and hers were much more prominent on the left,
Speaker:less on the right. So when we looked at the right versus the left, she's
Speaker:like, oh, and like from the different angles she could really understand. She said, well,
Speaker:I've never seen myself from that angle before. Exactly. Yeah.
Speaker:You know, having that, you know, if you have a practitioner that's engaging with you
Speaker:that way, that is quite helpful.
Speaker:Do you have anything to add to that? Oh, I
Speaker:would just say, you know, like I've said before, if
Speaker:the person that is treating you looks
Speaker:odd, you're not in the right place, you know. So
Speaker:we all have our ideas about what we think is
Speaker:attractive, and it can really
Speaker:vary from one person to another. So,
Speaker:and I mean, if you like giant cheeks and giant lips and
Speaker:your provider looks like that, and you feel great,
Speaker:go for it. But if that doesn't feel—
Speaker:if it doesn't resonate with you and that person looks odd, then you're—
Speaker:you definitely want to run out of there. Yeah. Don't be scared to leave.
Speaker:Yeah. You don't have to— you don't have to commit to a treatment
Speaker:that day. So, you know, remember that. Yeah.
Speaker:Can we talk about Lindsay Ullman? I don't
Speaker:know that much about Lindsay Lohan. Tell me. I feel like she reminds me—
Speaker:I'm pretty sure you're the same age, you're only a few years apart, but I
Speaker:feel like there's this wave of moving away from
Speaker:that Mara Largo face to more natural aesthetic
Speaker:that's starting to creep in. And from what I'm seeing
Speaker:on social media, she's almost being hailed as the,
Speaker:um, mascot for what we should be achieving. She looks very different
Speaker:than when she was younger, and then, right, you know, because she
Speaker:She's kind of grown up in the public eye. Right. Yeah. To
Speaker:me, she looks quite different. I wouldn't recognize her
Speaker:as the person she was maybe when she was a
Speaker:teenager, early 20s, but she definitely looks better than she did at 30.
Speaker:Have a look at— Yeah, she looks— she's
Speaker:beautifully refined, like whatever she's doing. Oh my
Speaker:goodness. Okay, I'll have to take a look. Yeah,
Speaker:yeah. The other thing— yeah, the other thing I just want to
Speaker:mention, because we, we talked about Botox and fillers, but one thing that we didn't
Speaker:touch upon was biostimulatory treatments like
Speaker:polylactic acid or calcium hydroxyapatite.
Speaker:Beautiful, beautiful treatments that work with your body to make
Speaker:more collagen and really counter some of the changes that happen
Speaker:with aging. And, um, now with the advent of
Speaker:sort of sort of medical
Speaker:directed weight loss with GLP-1s like Ozempic, etc.,
Speaker:we're seeing a lot of skin changes and volume loss in the face. And
Speaker:these bio stimulatory treatments are perfect for that. And it's
Speaker:also perfect for people who don't want rapid change in their appearance,
Speaker:but they want to do something to sort of counter the
Speaker:collagen loss that happens with age. So I don't want to forget about those.
Speaker:So there are so many options. You do not need to be scared of looking
Speaker:weird. Just, just work with the right people and with the right
Speaker:mindset. Yeah, I think that's exactly it.
Speaker:And I think it will be interesting to see like in the next 10 years
Speaker:what we sort of see coming out of Hollywood in terms of,
Speaker:you know, I'm hoping that it's the pendulum swings
Speaker:back towards looking a little bit more anatomically accurate. I think it's swinging.
Speaker:Yeah, I think it's swinging. Yeah. Conversations we may
Speaker:have in future episodes is maybe exploring a little bit more in depth
Speaker:what bio stimulation and bio regeneration means and what those
Speaker:treatments are. And also caveats with that is there's so much
Speaker:excitement in the field that sometimes industry is ahead of
Speaker:the research and the data. So there's always a fine line. But it's—
Speaker:I think it's very— we have very interesting times ahead
Speaker:in terms of options. Yeah.
Speaker:And on that note, if you have questions about any of these treatments
Speaker:that we talked about today, please shoot us an email, info@thebeautyequation.com.
Speaker:And like, subscribe, share with your friends. And we look forward to seeing
Speaker:you on future episodes. Take care. And that's me. Bye. Bye for
Speaker:now.
