February 15, 2009

Most of us worry about growing old. Some may focus on our waists getting thicker over time, others may worry about a receding hairline, or on one’s wrinkles. Especially in these times of economic uncertainty, as we grow older, doubts about our ability to remain competitive with younger colleagues may come up.

In a study by Johnson1, it was shown that attractive people, even among the elderly are perceived to be “youthful”, and are thought to be more successful in work and in life. In fact, his study concluded that attractiveness is largely determined by the appearance of youth and vigor in an individual. Such an improvement in one’s perception of attractiveness has been shown to directly translate in improving self-esteem, lifting a low mood, and making it easier to interact with others. What does it mean for our day to day lives? These findings suggest that there is nothing wrong with trying to look our best. Regardless of our age, this is a natural desire that allows us to feel better about ourselves and for others to perceive us as full of energy and youthful. In fact, clinical studies show that patients who have undergone aesthetic treatments have an improved sense of well-being2, felt more confident in social situations3 and reported improved quality of life4.

Now with the latest developments in health, we are able to make graceful and more natural improvements in our appearance even as we age. In an earlier article, I discussed the importance of exercise, nutrition and lifestyle habits in health aging. In this article, I will focus on non-invasive treatments that allow us to optimize our appearance as we grow older.

Aging changes the face in several ways. The three most common changes are shown below. An overview of possible treatment options to address these most common concerns is also presented.

  1. The skin becomes lax due to loss of collagen, and a normally oval face becomes rectangular or pear-shaped. The cheeks drop resulting in an exaggeration of the nasolabial fold and development of two lines on the sides of the mouth. These lines may make a person appear sad, and is a common complaint among Asian patients. Lack of collagen also results in our pores becoming more prominent.

There are several treatments that can improve skin laxity by building collagen in the dermis. These include the Titan, an infrared device that is also known as the “non-surgical facelift”. A photo of the Titan treatment is shown below. Titan has been demonstrated on skin biopsy to increase the amount of collagen in the skin5. Another collagen building device is Thermage, which in contrast to the Titan, is a radiofrequency treatment.

 

Treatments to reduce pores include laser rejuvenation treatments that stimulate collagen formation to close the pores. An example is Laser Genesis, which has been shown to result in building of collagen over the course of several treatments6.

Nasolabial lines or deep lines around the nose can also be temporarily addressed by injectable fillers. These dermal fillers, so-called because they “fill a line” come in various forms with varying duration of their effects.

  1. Expression lines become deeper and more prominent. These lines which form due to facial expression and muscle contraction are the lines on our forehead (“frown lines”), next to our eyes (“smile lines”), around our lips (“lipstick lines”) and others. Over time, these lines that form due to muscle contraction become fixed, and can make us look “always angry” even when we are not using the muscles of expression.

A simple way to temporarily reduce these expression lines is injection with botulinum toxin A (popularly known as Botox, but includes another brand known as Dysport). Botulinum toxin A works by temporarily weakening the muscles that form the lines of expression.

  1. Accumulation of sun damage resulting in changes in skin texture including development of fine and coarse wrinkles, formation of tiny blood vessels on the face (spider veins, telangiectasia), and sun-induced pigments including freckles, age spots or liver spots.

There are several treatments that can reduce the effects of sun damage. Some of these treatments may require a series of sessions, such as pigment removal by IPL. Other treatments may only need one or two treatments such as resurfacing devices (for example the Pearl), so-called because the damaged surface of the skin is gently removed, while stimulating the formation of new “baby” skin.

 

As we age, including these difficult economic times, we may seek quick fixes especially those with no downtime and are less expensive. When these treatments are performed for the right reason, it may make you feel more positive and empowered. In considering these treatments, talk to your doctor about whether these are right for you.

References:

  1. Johnson DF. Appearance and the elderly. In: The Psychology of Cosmetic Treatments Overview of Psychology of Cosmetics., New York: Prager Publishers, 1085:1127-43
  2. Edgerton MET, et al. Surgical results and psychosocial changes following rhytidectomy. Plast Reconstr Surg 1363; 33: 503-21.
  3. Marcus P. Psychological aspects of cosmetic rhinoplasty. Br J Plast Surg 1984; 37: 313-18.
  4. Rankin M, et al. Quality of life outcomes after cosmetic surgery. Plast Reconstr Surg 1998; 102: 2139-47.
  5. Goldberg DJ, et al. Treatment of skin laxity of the lower face and neck in older individuals with a broad-spectrum infrared light device. J Cosmet Laser Ther 2007; 9: 35-40.
  6. Schmults CD, et al. Nonablative Facial Remodeling. Erythema reduction and histologic evidence of new collagen formation using a 300—microsecond 1064-nm Nd:Yag Laser. Arch Dermatol 2004; 140: 1373-1376.