Thanks to the $62 billion U.S. beauty and cosmetics market, we are constantly bombarded with all types of products and services to help us look our very best throughout life. Take Christie Brinkley, for example. She (and her two daughters) graced the pages of the Sports Illustrated Swimsuit Issue in early 2017 at 63 years old and looked fantastic! Many others feel as one of my patients recently said, “I feel younger than I look.” But there are some of us who refuse to be intimidated by the media onslaught, so this article is about a basic decision: to age gracefully or do all you can to keep looking and feeling great. So is there a special time or age when the decision needs to be made?
All of us have a visual concept of how we look. After all, who hasn’t looked into a mirror thousands of times? For most of us that “visual photo” is pretty much embedded into our memory until one day we wake up, look into the mirror and the “spell” is broken.
Several studies have shown that we tend to see how we used to look rather than how we look at a particular time. Although it can happen at any age, it usually occurs around age 40. I have seen more new patients seeking a better smile around that age than any other. In plastic surgery it is becoming even younger. So the basic three options today are fillers, plastic surgery or do nothing.
Dr. Foad Nahai, a plastic surgeon with the Emory Aesthetic Center, states that he has new patients even in their early twenties for preventative measures. “Now that we can advise patients on preventive anti-aging measures such as diet, lifestyle changes, skin care, and minimally invasive or noninvasive treatment, we are encouraging patients to come in as early as they wish for an evaluation. Although we may recommend preventive measures such as avoiding sun exposure and smoking, skin care can include retinoids, facials and light peels.”
Don’t Forget the Positive Impact of a Healthy Diet
Dr. Arshia Payman, director of Medical Aesthetics at Derm Clinic in Atlanta, believes that the best nutrition for healthy skin is a diet rich in a variety of vegetables and fruits, as well as healthy fats and foods rich in antioxidants. Antioxidant rich foods include blueberries, fish rich in omega 3 fatty acids, and green leafy vegetables. In addition, hydration of the body is key in maintaining optimal skin health, as dehydration may result in a sallow, sunken appearance to the skin, especially the skin around the eyes. Foods high in sugar and refined carbohydrates may aggravate acne and inflammation of the skin.
Anti-Aging Claims: Be in the Know Before You Buy
Anti-wrinkle creams are a billion-dollar industry. Buyers should be aware that product companies advertise to have “anti-aging” wrinkle creams with abilities to make physical changes to the human body are violating FDA regulations, according to Dr. Payman. Making such claims indicate they are drugs, and they have not, in fact, been FDA tested and regulated. When searching for creams, which can actually produce a significant research-backed result, look for key active ingredients. Dr. Payman’s favorite ingredients are the family of retinoic acids and hydroquinones. These come in prescription strengths, are backed by research, and proven to incur change in the skin. Dr. Payman says that “moisturizers and anti-oxidants are great for hydrating skin and plumping up fine lines and wrinkles, but do not possess the ability to stop or prevent aging, and do not have the many years of FDA-regulated research to back their claims.”
Is it Time for Fillers?
The first timely question that should be addressed is when to think about fillers. Dr. Nahai believes that the ideal time to have Botox and/or fillers would be when the patient is ready or when the patient starts seeing some lines and wrinkles that change their skin quality, plus deepening of the folds in the face. Specifically, Dr. Nahai recommends Botox for young individuals who are at risk of developing permanent deep lines in the forehead and around the eyes. He also advises fillers for young individuals who are beginning to show aging signs around the mouth. This includes deepening of the folds which can reduce the appearance of lines or wrinkles such as the lip lines best described as lipstick creep.
According to Dr. Nahai, “Wrinkles are a result of the function of muscles of facial expression, those which make us smile, frown, etc. Sun damage and smoking contribute as well. They can be mostly prevented by limiting sun damage, not smoking, plus skin care with moisturizers. Most effective though are the retinol creams such as Retin A, light peels and of course and best of all, Botox, which prevents the establishment of frown lines along the forehead and the crow’s feet areas.” Gorgeous model Cindy Crawford discussed what works for her in In Style UK, October 2015. She said, “All I can count on is vitamin injections, Botox and collagen. I have a very simple, healthy life, which works miracles. I owe the quality of my skin to my cosmetic surgeon.”
If you are looking into treatments that may last longer, Dr. Nahai says that there is a lot of research into fillers and new fillers, coming on the market all the time but not in the U.S. The FDA regulations delay introduction of new fillers. The best examples, according to Dr. Nahai, are Voluma and Perlane, but these have to be injected deep so they are best for the cheeks. Christie Brinkley, author of Timeless Beauty: Over 100 Tips, Secrets, and Shortcuts to Looking Great, wrote, “I have used fillers in super tiny doses and, just like make-up, the best ones are imperceptible. I’ve used them on marionette lines around my mouth.”
Are Botox Injections Considered a Filler?
Dr. Payman routinely uses a variety of hyaluronic acid-based fillers for patients improving the appearance of lines and wrinkles. The results are immediate and there is no downtime. She says, “Unlike Botox, fillers have immediate results. The benefits of hyaluronic acid fillers [versus other fillers] are that the results are reversible if desired. Fillers are great because they can treat static lines and wrinkles that are present when the facial muscles are not contracted or in movement. If you are wondering which is best for you, Botox treats lines when the muscles are contracted, and fillers treat lines when facial expression is at rest.” She feels fillers are a great asset to rejuvenating the aging face as a bridge to a face-lift in the future, or when plastic surgery is not desired by the patient.
Is There a Point Plastic Surgery May not Help?
When it comes to facial rejuvenation, fillers and surgery accomplish very different things. As we get older, we lose volume in our cheeks, bone begins to resorb, and the collagen composition in our skin changes, which leads to loose skin. Injecting fillers in the face helps to restore facial volume and smooth out fine lines and wrinkles. Fillers are a great option to achieve extra volume and rejuvenate the face, however they will need to be repeated.
When fillers alone will usually not suffice, then plastic surgery can provide additional options. Although the face-lift is commonly talked about, there are other surgical options. Many times, a combination of surgery and fillers may be advised.
Have Celebrities Contributed to Normalizing Plastic Surgery?
Plastic surgery is now a $15 billion industry in the U.S. When I first met the legendary comedienne Phyllis Diller, she had just completed her plastic surgery. She had a face-lift done and wanted me to change her smile to complement her new face. I created a more youthful curve in her front teeth, which finalized her vision of a younger and more beautiful face. Phyllis was always incredibly open about the procedures she had done and opened the doors for others to feel comfortable about their plastic surgery. Sharon Osbourne, 65-year-old celebrity co-host of The Talk, discussed how she is on her “third face.” She is open about her many procedures including her face-lifts, eye lift, tummy tuck, liposuction, breast lift, bum implant and gastric band.
What if You Change Your Mind?
A great number of women, who were perhaps very attractive in high school and college, decide to age naturally. There is no doubt that a number of people chose not to make a decision early on. I’ve talked to many patients who wanted a new smile to have a younger look. When I asked them if they had plans to do something else cosmetic related, they responded that they felt it was too late. This decision had nothing to do with money, and everything to do with a belief that they waited too long. Not that they had to do anything, but by doing nothing, the choice was made.
The reason I ask the question is because when shaping the smile to support the lips and cheeks, many times it is dependent on whether the patient wants lip or cheek surgery later on. For instance, I had one patient who in the middle of treatment went to a plastic surgeon to have her lips enhanced. This created more of a shadow on the front teeth. Fortunately, we had time to create a lighter shade since our ceramist had not started constructing the final ceramic restorations.
For those who wonder if they have passed the point of no return, Dr. Nahai has advice. “With older individuals and those who have had a little more sun than is good for them, have smoked and did not pamper their skin, the wrinkles may be too deep, the aging changes too far advanced, so the only options are surgical. I would predict that with growing awareness of how the face ages, and the readily available preventive measures, we will see far fewer patients who are too far advanced for non-invasives.”
The Do Nothing Philosophy
I have seen many aging patients who are just not interested in fillers or plastic surgery and are content to let age take its course. But would you expect celebrity models, movie and TV stars to think the same? If you said “no,” you would be wrong. Celebrities are no exception to the power of time. Perhaps the most interesting of quotes from those who have not taken advantage of fillers or plastic surgery was cited on Purpleclover.com.
Famous supermodel Lauren Hutton, 70, known for the space between her front teeth, has said, “Our wrinkles are our medals of the passage of life. They are what we have been through and who we want to be. I don’t think I will ever cut my face, because once I cut it, I’ll never know where I’ve been.”
Popular English actress Emma Thompson, 57, stated, “It’s not a normal thing to do, and the culture that we’ve created that says it’s normal, is not normal.”
Never at a loss for words, Diane Keaton, 70, commented, “I just don’t know if I want to mess with that. The point is, no matter what you do, you’re going to get older and you won’t be here forever. So how do you grapple with it? How do you feel good about yourself?”
Always a fitness buff, Jamie Lee Curtis, 57, has regrets about her procedures in the past. She told More Magazine in 2002, “I’ve done it all. I’ve had a little plastic surgery. I’ve had a little lipo. I’ve had a little Botox. And you know what? None of it works. None of it. I am appalled that the term we use to talk about aging is ‘anti.’ Aging is human evolution in its pure form. Death, taxes and aging … We are ALL going to age and soften and mellow and transition.”
And certainly one of Hollywood’s best, Julia Roberts, 47, said, “(Botox) was not a cute look for me. My feeling is, I have three children who should know what emotion I’m feeling at the exact moment I’m feeling it.”
Movie and TV star Jennifer Aniston, 48, is adamant about keeping her natural looks. She told Yahoo! Beauty editor, makeup artist Bobbi Brown, “I am grateful to learn from their mistakes because I am not injecting s**t into my face.”
If there is a “bottom line” to this article it is to be totally aware that you do have options. And the sooner you make your decision, the better. So plan as early as possible which route you will take so that when you get to an older age you will be content with your earlier decision – and the way you aged.