Tune In: All The Things Things You're Not Paying Attention To That Are Aging Your Face

I first met aesthetics rejuvenation specialist Lisa Goodman, MPAS, founder of Goodskin Clinics, years ago at her old Los Angeles office. To this day I remember leaving the meeting feeling utterly refreshed by our conversation. I was in my mid-20s, and the meeting was during the height of the preventive Botox and filler craze. Just about every other consultation or work appointment I had with a derm or esthetician left me feeling anxious that I hadn't yet started getting anything "done." 

But Goodman was just helpful. She explained to me how she suspected my face might age with time, talked about what lifestyle changes might help, and reassured me that there were plenty of options available should I ever feel ready. During the meeting, we also talked about how wrinkles were natural and not to be feared (even if, at the time, everyone's definition of "youthful" was actually "wax-like"). I felt empowered, like I could age on my own terms. 

Years later we reconnected when I visited her New York office. I was delighted to find that her signature aesthetic hadn't changed—and had in fact, become more sophisticated with the evolving in-office technology. But most of all, I was relieved to find she still approached aging with the same kindness and levelheadedness. "Wrinkles are a sign of life. Wrinkles are earned. Wrinkles do not make people look bad," she says on today's episode of Clean Beauty School. 

Throughout the episode, I chat with Goodman about her philosophy, the five elements of facial aging (three of which we're covering here), what we're getting wrong about neurotoxin use, and what you should ask your aesthetic practitioner before getting treatments. 

As we talk about in the episode, aging isn't just about the surface—even if that's what most of the beauty industry focuses on. It's actually a mix of changes to the bone structure, muscles, lymphatic system, fat, and then skin. 

While we may not think of supporting our skeletal system and bone health as parts of our beauty routine, bone density loss is actually one of the main drivers of aging. 

"Women will tend to lose bone in their midface and next to their nose. And that's why women will have a longer upper lip with age, and that's one of the telltale signs of aging that most people don't even realize," she says. 

"Aging isn't all about wrinkles—it's about facial balance, the position of things," she says, noting that when our bone structure changes, that information reads as aging. "So at an earlier age, we want to help women retain bone." 

When we talk about muscles and aesthetic aging, we tend to talk about how facial movements can be a driver for expression wrinkles. But that's really not the biggest way that muscles age us. Rather, it's how muscles shape our faces over time—oftentimes, contributing to asymmetries.

"Muscle is something that needs to be evaluated on each person because it's so individual," she says. "Asymmetries of the face will be due to muscle imbalances, which you can often take a step further and track to bone differences. It's all connected." 

So how do we support muscles with age, hopefully ensuring they remain in balance? Well, one part is being mindful of how you move and hold your body. But Goodman also notes that you can use neurotoxins (like Botox) to balance overactive versus underactive muscles. 

People naturally lose facial fat as they get older–we've even nicknamed it "losing the baby fat." But where fat is lost can cause common aging concerns to creep up. Most notably? Sallow, dark circles pooling around the eyes.

"Under the eyes, for both men and women, is the first place we lose fat pads. Science shows that this starts happening in your twenties," she says. "So your under-eye fat will recede faster than the fat pads in the rest of the face." 

Given fat pad loss is not something that can be fixed topically, you'll need to visit a professional if the appearance is bothering you. "People think, 'I'm going to use every eye cream, I'm going to do all the lasers, I'm going to try all the things,' but it will still be hollow and dark—that's because we have to look at the underlying issue, which is fat loss."