EP 2: The Neuroanatomy of How We Interpret Faces | DEEP FOCUS

In this episode, I break down the neuroanatomy of facial perception and explain why so many people say, “I don’t look how I feel.” I walk through the brain regions, neuromodulators, and subconscious cues that shape how we interpret our own faces - and how that creates cognitive dissonance when your external appearance doesn’t reflect your internal vitality. You’ll learn how to think about alignment between identity, biology, and aesthetics so you can make intentional changes that actually reduce friction in the mirror - not just chase surface-level fixes.

CONNECT WITH HOST 
Website: https://clinic5c.com/ 
Instagram: https://www.instagram.com/chesnut.md/ 
YouTube: https://www.youtube.com/@chesnutMD 
LinkedIn: https://www.linkedin.com/in/cameron-chesnut-a6910baa/ 

WAYS TO WATCH/LISTEN 
YouTube: https://www.youtube.com/@5CodesPodcast 
Spotify: https://open.spotify.com/show/1FZ7vpmq21iA1noPcFhixb?si=992ef6c8d859463f 
Apple: https://podcasts.apple.com/us/podcast/5-codes-podcast/id1866214238 
Instagram: https://www.instagram.com/5codespodcast/
 
TIMESTAMPS 
00:00 - Intro
01:12 - “I Don’t Look How I Feel”
03:51 - Fusiform Face Area
05:02 - Amygdala
07:47 - Hippocampus
09:45 - Orbital Frontal Cortex
11:13 - Nucleus Accumbens
12:14 - Masking With Botox and Fillers
13:42 - Where I Come In
15:36 - Symmetry
17:08 - Enhanced Human Performance
18:00 - What I Hear From Patients
21:34 - Key Takeaways
24:50 - Outro

ABOUT HOST 
Dr. Cameron Chesnut is the host of the 5 Codes podcast and the founder of Clinic 5C, where he leads a team dedicated to integrative cosmetic surgery, regenerative medicine, and functional health. An internationally recognized facial plastic surgeon, Dr. Chesnut is known for producing natural, refined results that enhance rather than alter one’s appearance. His approach blends surgical precision with biological optimization and disciplined restraint, drawing patients from around the world who value excellence, longevity, and holistic care. On 5 Codes, Dr. Chesnut uncovers the mindsets and evidence-backed strategies he lives by, helping high performers perform better, recover smarter, and feel their best in every area of life. 

DISCLAIMER 
The views shared on this podcast are my own and are not associated with, affiliated with, or representative of my clinical teaching role at the University of Washington School of Medicine. This content is for general educational purposes only and should not be considered individualized medical advice.

Transcript

0:00

Welcome to the Five Codes Podcast, where we discuss evidence-based methods to elevate yourself to the next level, optimizing the way you look, move, perform, feel, and connect. I want to look how I feel, or I don't look how I feel. These are the most common things that I hear from my patients when I'm first meeting them about why they reached out to me in the first place. In today's episode, we're going to dive into everything about that, basically the neuroanatomy of beauty, or the neuroanatomy of how we interpret faces would be a better way to say it, the faces of ourselves and the faces of others, how we are interpreted by the world and how we interpret ourselves. So much of my practice is based on understanding this on a nerdy, deep level, and then working to be able to know what levers to pull, to relieve what is essentially a little bit of cognitive dissonance or friction when you look in the mirror and don't see exactly what you expect to see or don't see the way that you feel on the inside. There are explanations in our brain as to why this happens, and this is what my practice is based around. So let's dive on in and see what's going on. First of all, when somebody says, "I want to look how I feel," that makes sense. That resonates with all of us. That's alignment. That feels good. On the flip side of that, when they say, "I don't look the way that I feel," it's not a vanity thing. It's not a cosmetic thing as much as it is literally a self-identity when we are looking in the mirror. There are reasons that this happens. There are specific brain regions that light up when this happens. There's a lot of neuroscience about facial perception. And so I really wanted to dive into this area from my own obsession and fascination and call it curiosity about what's happening here so that I could help relieve some of that cognitive dissonance and some of that tension because that's what I felt like I was doing over the years. Really, my goal is to help you take that way that you feel, all the things you're doing, pulling all the leverage you can, your metabolic health, your sleep, how you're eating, how you're exercising. I want to make the way that you look, reflect all that other hard work that you're doing, or all the things you're putting into your life. Sometimes, we have kids, stresses, things like that that take away from it, but in general, our long-term sense of ourself has to reflect or sing in the mirror. That is what gives us that positive feeling and that's what I really want to do. So as I dove into the neuroanatomy literature on this, all the studies that have been done, there's a lot in there. There's a lot of it's based around different things and that exact sentiment of looking how you feel. A lot of it's based around interpreting other people's faces, how we interact, the nonverbal communication, mate selection, trustworthiness, all of these things that we identity, all these things we read from people's faces. There's a lot of information out there about this and so I had to sort of synthesize these two worlds that I was experiencing in my own practice, what I'm hearing from people, that exists in the world of neuroanatomy, neurobiology because there's neurotransmitters that play into this as well or neuromodulators, we might say, that play into this as well. So I live at this intersection of these two areas and my practice revolves, I'm not going to get into the details of all the little procedural things that we do because I do lecture to my colleagues about this as well, understanding the neuroanatomy here on a actual functional technique level or the things we can do to leverage this. This is more targeted towards us understanding the fascination of how we interact with each other but also how we see each other in the mirror and exactly what that looks like. So I want to talk about five brain regions that really play into how we interpret faces. These are very unique things that quite literally make us human. The first one of them is called the fuziform face area. This is very unique. This for me makes me view our face as part of our nervous system, which I don't know that I've ever heard anybody else talk about it this way or think of it this way, but I think of our face as part of our nervous system, partially because we have this very unique fuziform face area. It's whole job is to recognize that we are looking at a face. Nothing else gets this. Nothing else in our body and the world gets this. It is, I'm looking at a face. This is a face. It lights up immediately when we see that. Then there's some assessment that goes into that and again, this is very unique that we have this hardware in our brain that recognizes human faces. And again, to me that makes this part of our nervous system something that we should really, really be focusing on. So in a nutshell, this fuziform face area helps us identify faces, helps us get the identity of people and it is one of the reasons that little changes can feel really big when we look at somebody else but that we may not notice in ourselves as much over time this idea of perception drift. When somebody has a little change in their face that's a little bit off, that lights up for you. It tells us that it's off and it can then transition into the second area of our brain that I want to talk about which is our amygdala. Amygdala is famous because this is the emotional center of our brain. So now we've talked about a recognition area. We have an emotional area. We're going to have some reward systems and some memory down the line but the emotional area. This makes sense to us. This is when we recognize it something's off. Sometimes we get even a little emotional sense of like feeling a little bit of disgust or something to us. The idea of an uncanny value or something kind of looks facial or humanoid but isn't quite there that elicits an emotional response in our amygdala. It's also why we immediately judge somebody's trustworthiness, their warmth, their presence. This is all happening emotionally in our brain, literally in our emotional center in our amygdala that's coming from the face of the fuziform face area is communicating with the amygdala. You'll very commonly here and I usually point this out to people when I'm consulting with them is that I feel tired when I look in the mirror or I feel like I look this way. The word feel gets attached to our face all the time. We notice this all the time and it's because of the amygdala's very specific role. So not only is it helping us communicate trustworthiness, likableness, it is also communicating sort of how we feel. And we are interpreted by the world, somebody else is amygdala is going off and saying that person looks tired or when you see your own face in the mirror you might interpret yourself as looking tired because of all these features that we'll talk about down the road but it's really important to understand the emotional response. Particular areas of our face even trigger this more heavily. You hear me talk about the eyes being the most important all the time and this is rubber meeting the road in our amygdala where this becomes very very important. Our eyes, our mouths, the corner of our mouths, our forehead and brow, the things that we used to nonverbaly communicate in general really activate what's happening in the amygdala. It's very very important there and you know it's interesting that I could make a very small facial expression or many of us could make a very very small facial expression that we may have trouble putting an actual name on from an emotional standpoint or language centers may not allow us to label that but we know what that is. We know that it triggers something in our brain like that person is feeling this and I can tell just by this little twitch of a muscle in their face. That's your amygdala. That's your fuziform face area and your amygdala communicating with one another. You can't even put a name on it but it changes everything about how you're interpreting that person and what you know is happening in them emotionally at that time. So really really interesting how those places kind of fill in together with the fuziform face to the amygdala which then communicates with this next area that I want to talk about which is in our hippocampus and this is really important to ourselves because this is our memory center of our brain. So we have a recognition area, we have an emotional area and now we're on to our memory area, our hippocampus. This is important to your self identity. This is when you look in the mirror you have a memory of yourself over decades really and maybe you're in your 20s and you can remember back to when you looked 14 there's not a huge change that happens in those years and so our sense of self, our self identity when we look in the mirror is strongly labeled inside of our hippocampus, our memory of ourselves and it makes sense that as our aging curve starts to steepen a little bit and we start to decline faster, our memory centers of ourselves do not keep up as quickly as our external appearance actually does change. So the reason the external appearance changes is aging changes, it's inflammatory, it's metabolic, it's genetic, it's all those things that we're going to talk about that our brain is really good at picking up on for all the reasons that we know why faces are so important, the judge age, beauty, expression, we pick up on those very quickly but our hippocampus, the memory centers of our brain do not keep up fast enough. This is where the friction comes from, this is where the dissonance, the disconnect comes from with what we see in the mirror and what we're feeling or what we remember on the inside, this ties into our hippocampus. So this is strongly labeled to life changes, aging and when we look at other people's faces we want to have memory of that face as well. So it makes sense just from a recognition and a human interaction standpoint that we want these strong memories when it comes to faces. If anybody ever tells you how I don't remember faces well or I remember faces really well, whatever it is, there's probably truth, you do remember faces really well, there's a special neural network just for that to happen in our brain and it's really important to our sense of self. This then plays into the fourth area that I want to talk about which is our orbital frontal cortex. This is the first time we get into like a little bit more of an analytical part of our brain because this is a pleasure and reward center of our brain. So yes, faces look and feel and become pleasurable to us. If you look at a beautiful face, something that triggers you as being really beautiful to look at, really warm, really trustworthy, that's going to trigger a reward, a center in us that feels pleasurable to look at faces and we know this, babies look at faces and they will linger on a beautiful face longer. There's no question about it. We pass a lot of instantaneous judgments and it changes our behavior about a face. Babies also use their use faces to recognize identity and a lot of non-ruble communication because far before a baby can understand the language that you are speaking to them, they can understand the changes that are happening in your face. So from a hard wiring standpoint, this is quite literally there and we know this in babies, identity, emotion and they will linger on a beautiful face for longer. They have no actual sense of cultural beauty but we know that these very symmetric, very healthy, very beautiful faces cause a lingering effect and this is where it happens in our orbital frontal cortex and the pleasure and the reward centers of our brain and that makes sense to a pretty significant degree and it kind of plays into the fifth area as well which is in our nucleus accumbens or our ventral, which is part of our ventral stratum. This is heavy in our dopamine reward center. So this is our reward and our motivation centers. We had reward and pleasure in the orbital frontal cortex but we also our faces trigger reward event action and this would make sense in a mating situation where you look at a beautiful face, you have this pleasurable response, you have a reward to it and then we want to take action to that. We see this play out in a lot of social communication as well where beautiful faces just tend to almost carry more favor actually and I don't think that this is a mystery in that. This is where it happens for us as humans is that when we see a beautiful face we are more motivated to interact with that face whether it's from a mating standpoint, from a business standpoint, from a communication standpoint and all of these things become very, very important to us. A couple of side notes that I'll pull out of this neuroanatomy talk that aren't really the point of this I will say but often come up in conversation, have to do with anything we do to change our face to blunt those things. I'm specifically talking about Botox and Botox family of neuromodulators, other things like that and even things like filler that are quite literally intended to modulate the muscular contraction in our face when we're talking about Botox that leads to nonverbal communication clues. It gets interpreted as aging clues as well but if you are purposefully masking with filler like putting a gel mask on the surface of all these little fine muscular contractions that are supposed to happen or you are frankly taking away the muscular contraction we are interacting with multiple centers in our brain that have to do with recognizing the face, the emotional response to that face, recognizing your emotional positioning, all the reward centers, all the pleasure centers those are getting distorted by things that we do to our face. It's not always negative but I do want to be aware of that even that what I mentioned about babies, right? If you're only a way of communicating with your baby is nonverbaly and you're blunting some of that that would be worth thinking about that interaction. That's a very quick, that could be a whole podcast in and of itself as to how those interact but I see this very commonly, my patients are telling me I look in the mirror, I don't see exactly what I want but I had filler and it changed my smile. This is exactly what they're talking about, they cannot put their finger on what changed exactly but they know that their expression is different because of things that they did to their face. So this becomes very, very important and this is where I sort of come in and this is where I think I carry a unique lens to this and that I have this deep understanding of what's happened when we get to the nuts and bolts from an aging standpoint. This is metabolic health, this is anatomy, this is qualitative changes, this is our aging of our face. I also have a unique analogy of or a unique lens on things that we can do to change some of those aging things to improve them but what does improving mean, right? Most of my patients don't want to actually look younger, they're not like I want to look younger, they want to look like they feel, they want to look more vital because they feel more vital, they want to look more well rested because they feel more well rested, they want to look happier because they feel happier and you can look tired, angry and like you're pretty dull and not vital just based off of what your face looks like. And so I start to try to work to align those things a little bit like I said this has to do with reflecting your metabolic health as well because your skin is telling us what's happening from an inflammatory state, what's happening inside of your liver. There are all kinds of metabolic overall systemic health things are communicated via our facial structure, our skin, what's happening with our fat pads, the positioning. I mean if we want to get really into it, the shape of your jaw helps us communicate what your airways are like. So it gets very, very deep into here and we read all these things as human. That's why some of these pleasure centers get really triggered with like a pleasant face is relatively symmetrical which is important. This is one thing that I'm constantly focusing on when it comes to eyes and doesn't have to be perfectly symmetrical. That's not what we're looking for but symmetry gives this ease on our brain. It reduces the friction there's not as much to look at so it's a more pleasant face. When we get into babies and why they view beautiful faces for longer it's because it's easy, literally easy for them to look at a beautiful face. They don't have any friction. They're not trying to work out exactly what's going on from there. If we take that into real life when you see somebody who's got big lip filler or something going on with their face that's not quite right. There's a lot of friction you're trying to put your finger on like what's going on there. Something's off. I don't even know what's going on but it's attracting my attention right and that's distracting and it gets away from all these pleasure and reward and memory centers. We don't want to do that. I think one of the things you'll see with a lot of my results and I hear this all the time is kind of one of my calling cards. I would say in a positive way is when I look at these before and after videos and photos and this person's talking I can't even tell what happened to them. I don't know exactly what it is but I know that they look better and they look more well rested, look more vibrant and energetic. That's exactly what I want to happen. These are the little levers that I'm pulling and seeking to deeply understand so that we can make those things happen. I can reflect better energy so I can reflect better metabolic health in you, better inflammatory states, all those things line up much better as to how we can do it and this is where the rubber meets the road and what I'm really trying to work on. As we bring all these things together, all of this neuro-natomy, all of this experience with how you're feeling, it all makes sense. We want to reduce this friction. I want to reduce the friction of how you're experienced in the world by other people and by what you put out there, by what you see in the mirror. This changes human performance as well. Unquestionably, lots of good science and studies to show that the way that you look and are interpreted by yourself and by the rest of the world impacts how you perform. Your impact on the world, if you will, is driven by how you look, how you feel and what you're putting out in the world, how you're experienced. There are a lot of facets to this from your own identity to what you're actually accomplishing to what the world is seeing about you and even into the mating and dating scene, which isn't as much of what people are focused on, like I said, people just want to align. It's really common that I hear that people knew that this was happening and this is what I should say I hear this after we're done. We're down the road, results are there. You can see this in a bunch of videos when I'm interviewing people after their procedures and we're just kind of talking through. They say, "I knew that I felt sort of out of alignment and didn't look how I felt before, but it's hard to explain the relief that you get when those things line up again and all the different facets of their lives that it was affecting in their family and their work usually in their professional lives, how they were experiencing themselves." It all makes sense when you understand the neuroanatomy and the complexity of reward, of emotion, of action, of motivation, how all those things play together. For me, it was like this beautiful aha moment as I was taking my interest when I'm hearing in the world these tools that I can use, these levers that I can pull in these very, very stealth ways, and then I'm aligning it and overlapping it and cross pollinating it with the neuroanatomy literature that exists and the neurobiology of how we're interpreting faces that's so well established. And as I put this all together, I felt like I was making this massive discovery of this sort of aha moment of like, "Yes, this is how we're interpreted in the world. This is how we interpret ourselves. This is why our performance is driven this way. There are really good explanations to this and it plays into where you're at now, what you should do moving forward, what you shouldn't do moving forward, which are things that I talk about a lot that meet a lot of friction on that end of trying not to blunt these things. The next level of this, I guess, I'm not going to get too technical on this, but I'm looking at areas to simply improve symmetry of muscular function because I don't want to stop your muscular function. I want your muscular function to be optimized and that has to do with your skin and your fat pads and how healthy they are and they look, which gets into our metabolic health, which overlaps with how we're interpreted emotionally because we want our muscles creating the right types of expressions to communicate what our internal state is with the world, which is often our internal state is better than what we may be communicating at baseline. I want to understand when these changes start to happen. This is very natural, almost beautiful alarm that as we're getting this mismatch starting to form in the mirror, it lines up very well with overall metabolic health and hormonal changes that start to decouple the sense of our hippocampus memory of ourselves identity and what we start to see in the mirror. That's no accident, right? This happens for a reason. I love realigning that. My fulfillment and my work, there are great ways to do it that are very stealth, which creates those results. I look so much better, but I don't know what happened exactly. That's my goal. I don't want you to look and be like, that person had a lower facelift. You're never going to never say never, but you're never going to find me doing that, right? That's chasing a metric of some little narrow myopic view of what's happening in an overall system. I'm not going to mess with one part of an overall circuit, if you will, without understanding what it's doing to the rest of the circuit. You'll find me being very comprehensive in my approach for that reason to make the whole neural circuit work better of facial interpretation, facial beauty, self identity, and the function that we're able to get out of that as we put it out into the world. My key takeaways from this overall message are that your brain stores an internal view of yourself that is relatively steady over time. As our normal aging changes start to take place, reflection of our metabolic health, reflection of our genetics and reflection of time, we start to get a mismatch. This is natural. Our brain does not update as quickly as our mirror does, and this is why most people coming in to see me are not trying to look younger. That's not actually what's happening. They're just trying to align their vision of their selves internally with what they're seeing in the mirror, which happens to be from when they were younger. That's the actual goal. When that happens, the amount of relief that you get from getting rid of that dissonance and friction is hard to fathom unless you've experienced it. I've heard that over and over again. I believe that very, very much to be true. My patient population, this is often reflecting an internal metabolic health reflection, an internal vitality reflection, productivity reflection. All of these things line up very well. Often it's a combination of all those things. My entire goal, my entire nerdy obsession with my results is really trying to line these up. One size fits all approach. It's very unique to you, but it comes with this view that a face is almost an important part of our nervous system. The fuser form face area really argues for that with me that it's an important interpretation. It's part of our nervous system. It needs to be treated as a neural circuit, as a whole unit, and that's why you won't find me doing a lot of individually focused things. I'm focused on the whole and how that whole is interpreted by our brains. And so a very unique point of view, very unique lens. I would love you to sit with that, be introspective. Think about where you're at, what you see in the mirror, what you think the things are that line up to you is I'll often ask, what are your pain points? What are the friction? Where do you feel it? For a lot of people, they're noticing their ancillary types of areas. Their jawline or their neck because when you look in the mirror yourself, you're getting more of that analytics. You're doing less of the initial emotional interpretation because you sort of know your emotional state already. And so when you look in the mirror, you tend to get more analytical. When somebody else looks at you for the first time, that analytical part's way down the neuroanatomic road. They're going first through the emotional state of you. They're going through the reward centers. They're going through their memory. It's a whole different experience. And so a lot of times if you really sit and get introspective, you'll notice that yeah, it really is my eyes, my mouth. Those are the things that I'm really picking up the most. And I interpret it in my angst a little bit as like it's my jawline and my neck because certainly those are aging changes that happen. But when we think from an early anatomic standpoint, they tend to be actually a little bit down the road. So that's why it's nice to do all those things together. You don't want to do just the things that maybe aren't going to move the needle enough with your neck and your jawline. Maybe that helps yourself interpretation but doesn't in help how you are interpreted or subjectively by the rest of the world. So I love having these conversations with people and I have it almost every single consultation in a very unique way to what you're putting out, what you want to feel, trying to line those things up. And I hope this helps you get a little bit of a better understanding of the cool things that make us uniquely human and how we interpret faces even from just a fun social interaction standpoint, whether it's your kids interpreting you, you interpreting your coworkers, all of these little cognitive biases that can come out of these things, whether it's based off age, attractiveness, gender, vitality and all the emotional aspects that come with it. But also for you to just understand that a little bit of cognitive distance and friction that you get and how we can help to relieve that. If you have any questions or topics you would like me to explore further, please leave them in the comments. I read them all and they often help shape the future conversations here. If you would like to learn more about my surgical practice, you can visit clinic5c.com where you will find additional information on my approach to surgery, recovery and performance focus care. I also want to be clear that the views shared on this podcast are my own and are not associated with or representative of my clinical teaching affiliation with the University of Washington School of Medicine, nor should this be taken as individual medical advice. Thank you for spending your time with me. I appreciate you being here and I will see you on the next episode.