10 AGING GRACEFULLY

Now that you have the tools to keep yourself looking (and feeling) younger, fresher, firmer, and more like you, let’s talk about what happens next. I can’t stop you from aging, but I will give you a final checklist of what to do every day, week, and month for the rest of your life to maintain the work we’ve done in this book. Learn it, live it, make it part of your routine, and don’t be surprised if, as the years roll by, people stare at you and ask, “Why is it that you never age?” or even, “Have you had work done?” Of course, you can answer however you like, but perhaps you will just smile mysteriously. Or tell them that you have a very good doctor. I’ve organized this by decade, but even if you are somewhere in the middle, read all the decades, because sometimes I want you to keep doing something you’ve been doing (or could have been doing) from the decade before.

IN YOUR TWENTIES

In your twenties, the main thing to be concerned about is maintaining. You have the benefit of youth, but the goal for the rest of your life is to keep things looking and feeling young. Give up any bad habits that you might have begun during your late teens, such as smoking and eating foods that are bad for you, like fast foods and processed foods. The goal is to establish a healthy lifestyle that you will maintain for a long, long time. You can also:

Prepare: Use a cleanser appropriate for your skin type (check out chapter 4 if you aren’t sure what that might be).

Treat: Your skin should look great, since you are young. Therefore, you don’t need to spend a lot of money on prescription-strength products (many people in their twenties can’t afford them anyway).

Begin applying an inexpensive, over-the-counter antioxidant cream in the morning. Vitamin C creams are plentiful and are great for your skin in your twenties.

If you are able, you can also purchase an inexpensive retinol cream. Unless you have acne issues, prescription-strength tretinoin is probably more aggressive than you need, so retinol will do. It starts fighting off the aging process at this stage in your life. It also helps the cellular turnover of your skin and can very gradually lighten any early sun spots.

Protect: Sunblock is the key during your twenties. Although a golden tan might be considered attractive, any sun damage your skin gets in your twenties will begin to show up as aging in the next ten to twenty years. You can do a lot to prevent that now. Think ahead! Apply sunblock every morning as a part of your daily moisturizer or separately.

Interventions: Don’t waste your money on invasive or expensive treatments in your twenties. This is the time to enjoy your youthful face and body!

IN YOUR THIRTIES

In your thirties, the main thing to be concerned about is early aging. If you aren’t taking good care of yourself, you will begin to see age-related changes during this time. Many people look great in their twenties, no matter the lifestyle they lead. Youth allows the body to bounce back without much difficulty. Sorry to say that begins changing in your thirties. If you haven’t done so, now is the time to start leading a healthy lifestyle. Cut back on sugar, processed food, and unhealthy fats, and focus on eating foods rich in antioxidants, omega-3 fatty acids, and whole grains. Your thirties are also the time when treating age-related changes becomes just as important as preventing aging.

Prepare: Continue to use a cleanser suited for your skin type. This is also a time to begin exfoliating your skin a couple of times a week if you aren’t already. Your skin cell turnover slows down in your thirties, so you can really benefit from this now.

Treat: Now is also the time to consider more aggressive antiaging treatments for your skin.

If you haven’t started a retinol cream, your thirties is a great time to start. Better yet, if your skin tolerates it, see a plastic surgeon or dermatologist for prescription-strength tretinoin. This can be your number one antiaging cream for the rest of your life.

Also continue with your antioxidant cream, such as vitamin C. If you have the financial means, then consider a higher-end version, as these formulations may be more stable and effective.

Begin using an eye cream, preferably one that contains retinol with rich moisturizers. Most people start noticing changes in the thin skin of the eyelids in their thirties, so this is a good time to get started treating them separately from the rest of your face. See chapter 7 for suggestions.

Protect: Moisturizer, then sunblock, sunblock, sunblock. Oh, and did I mention sunblock?

Interventions: Your thirties are the decade to start thinking about minor treatments to keep your skin and body looking youthful.

No-downtime lasers and peels are great ways to exfoliate your skin and keep it looking smooth, tight, and youthful. More aggressive lasers and peels probably aren’t needed at this stage, unless you are treating a specific condition.

Many people begin injections of Botox now to smooth newly developing crow’s-feet and frown lines. These easy treatments will help to prevent these wrinkles from becoming settled and getting too deep.

Many women also begin noninvasive cellulite treatments in their thirties. You’re still young enough to rock a two-piece, but a little help with your skin can make you look practically indistinguishable from those twenty-year-olds!

IN YOUR FORTIES

In your forties, you have probably noticed additional and more obvious wrinkling and other visible signs of aging. The life you’ve led up to this point will show in your forties, and your youthful indiscretions will catch up with you. People who’ve led an unhealthy lifestyle will look older than people who’ve been practicing healthy habits since their twenties. But that doesn’t mean you can’t still have fun—if you haven’t already discovered their charms, now is a good time to learn about the benefits of dark chocolate and red wine. Become a connoisseur of these healthy, antioxidant-rich foods (making sure to partake in them conservatively). Our forties is also the time when the face visibly loses volume or gets more gaunt. This is therefore the decade when most men and women consider more invasive and expensive treatments to look younger.

Prepare: Cleanse. Also continue exfoliating several times a week, as your skin is definitely turning over at a slower pace in your forties. If you haven’t yet, consider buying a Clarisonic-type device.

Treat: Stay the course, with a few additions when relevant:

Continue retinol or tretinoin as your main antiaging cream.

Continue an antioxidant cream, such as vitamin C.

Also continue with a good eye cream.

This is also a good time to consider adding a regular skin-brightening cream, such as one with niacinamide or kojic acid. You may notice your skin developing age spots more quickly and easily than ever before.

If your age spots are significant, then see a plastic surgeon or dermatologist to start a regimen of prescription-strength hydroquinone. Once the spots have disappeared, return to your usual regimen of a nonprescription skin brightener, as you shouldn’t be on hydroquinone indefinitely.

Protect: Moisturizer. And I hate to belabor the point, but… sunblock.

Interventions: The interventions from your thirties still apply, with a few additions:

Regular no-downtime chemical peels or laser treatments can continue to rejuvenate the collagen in your skin.

You may also consider a more aggressive skin-tightening and rejuvenating treatment, such as a series of moderate-depth chemical peels or fractional laser treatments, if you want to see a more dramatic change.

Botox can keep your forehead, frown lines, and crow’s-feet areas as smooth as they were in your twenties.

Consider fillers for nasolabial folds and facial revolumizing. The nasolabial folds (deep grooves extending between the sides of your nose and corners of your mouth) become more prominent in most people in their forties. Injectable fillers like Restylane and Juvederm are great treatments for this. You may also notice that your cheeks are becoming more hollow and your lips thinner. Voluma and Sculptra are nice, nonsurgical options for subtle volumizing of the cheeks, and a conservative amount of Restylane or Juvederm can be used to plump the lips back to what they used to be.

Cellulite treatments are popular at this age. Yes, even in your forties you can rock that two-piece! Noninvasive cellulite treatments, especially ones that can take inches off (see chapter 8), can be a great way to help keep your figure.

IN YOUR FIFTIES

For women, menopause probably causes more aging effects than anything else, and most women go through menopause in their late forties or early fifties. As hormonal changes ramp up, women often notice their skin getting thinner and drier, so you may benefit from topical products that are more moisturizing. In virtually everyone, women and men, our skin begins to droop visibly in our fifties, in addition to the changes that we noticed in our forties (fine lines, age spots, and cellulite). Depressing, right? Wrong! There are many things that you can do in your fifties to continue looking young and vibrant. Some of these, unfortunately, may be invasive and include some downtime. But in today’s world, I truly believe that fifty is the new thirty. Celebrities like Michelle Pfeiffer, Tom Cruise, and Vanessa Williams have proven this!

Prepare: Cleanse. You may benefit from switching to a creamier cleanser that retains more of your skin’s essential oils. Keep exfoliating, too. Your skin needs this now more than ever, as the normal cellular mechanisms for skin cell turnover have definitely slowed down.

Treat: It’s time to make a few more tweaks to your skin treatments:

The thinner and drier skin that accompanies menopause may be more sensitive to the drying effects of regular tretinoin. If this is the case, you may want to switch to the moisturizing, emollient form of tretinoin, called Renova or ReFissa.

If prescription-strength tretinoin (in any form) is too aggressive and drying, then consider retinol creams, or substitute these with a serum or cream that contains growth hormone or peptides. Even if you are tolerating your tretinoin or retinol, adding growth factor and/or peptide creams can provide even more of an age-reducing effect!

Continue with a skin-brightening cream (non-hydroquinone) to fight off age spots and keep your skin looking luminous.

Continue with an antioxidant cream.

Continue with an eye cream—if you notice that your lower eyelids are getting puffy, one with caffeine can help reduce this.

Use prescription-strength hydroquinone as needed for short periods of time (as directed by your plastic surgeon or dermatologist) to reduce sun and age spots.

Protect: In addition to your old standbys, moisturizer and sunblock, add a night cream, preferably one that contains antiaging ingredients such as retinol, growth factors, or peptides. Menopause can rob your skin of the moisture it used to have, so a rich, moisturizing night cream can be very helpful in rejuvenating your skin while you sleep.

Interventions: This is the decade when you may begin to consider interventions you hadn’t considered before:

Use regular no-downtime chemical peels or laser treatments for maintenance, and consider being a little more intensive with moderate-depth chemical peels or more aggressive laser treatments to tighten skin and improve fine lines.

Botox and fillers can continue to make a big difference in your fifties.

You can’t prevent a certain degree of sagging, but skin-tightening cellulite treatments can still help your figure to look at least a decade younger.

The fifties are when some people begin to consider surgical options, as issues such as drooping eyelids or neck become more noticeable and annoying. Most women, however, are happy to simply ramp up their regular beauty routine and keep exercising for the youngest possible look without surgery.

IN YOUR SIXTIES, SEVENTIES, AND BEYOND

The changes that you begin to see in your fifties (such as sagging skin, deeper wrinkles, and dryness) unfortunately progress in your sixties and seventies and throughout the rest of your golden years. There’s no way to prevent this from occurring, but all of the recommendations of how to treat your skin in your fifties should slow this process down significantly. Continue with these recommendations, and you’ll be doing everything you can to keep aging at bay. If you need more inspiration, think of the many celebs who look fantastic in their sixties, like Christie Brinkley, Denzel Washington, and Jane Seymour. Your sixties are the time when surgery can often provide the most dramatic results. Although surgery isn’t for everyone, this is the time most people make their definitive decision on actual surgery. Either it’s not for them, or they want to obtain the dramatic changes in their appearance that can accompany it. Do what you feel is right for you.

Once you get into the habit of caring for and maintaining your skin and your body, you will realize that you have this youth-and-beauty thing down. Sure, we all age. None of us can look like twenty-two-year-olds forever (and would you really want to?). But every single one of us can look pretty darn good for our age. It’s all just a matter of taking good care, and taking advantage of science and technology, as well as the products of the natural world when they are available to you.

A FINAL WORD

In this book we’ve covered many ways to look younger and change your figure to more closely resemble the one you always wanted, but in the end, I hope you will always remember that it’s really not all that important how you look. What really matters is how you feel about yourself. Surveys reveal that confidence is the feature most attractive to most people, and although we all have our own perceived flaws and our own insecurities (even supermodels and the most glamorous Hollywood actors and actresses), the best thing you can do for yourself and your life is to be happy with who you are right here, right now. I meet so many people who are so concerned about their appearance (and tiny perceived flaws) that they allow it to run or ruin their lives. Don’t let that happen to you. Don’t let others make you feel unattractive. Don’t let anyone convince you to have anything done that you don’t want to have done. No one truly needs cosmetic surgery.

If there is one thing that I’ve learned in the past sixteen years as a plastic surgeon, it’s that being healthy is the key to retaining our youth. In the end, that’s really what the Age Fix is all about. Following the Age-Fix healthy diet guidelines, exercising regularly, taking care of your skin, smelling the proverbial flowers every so often, and having a positive outlook on life are truly the best ways to stay young forever. If you take no other advice from me, I hope you will take this to heart.

And if you still want to change something? If you still want to look younger, just because you enjoy feeling good and looking good, just because you want to do it for yourself? Then by all means, try the tips, strategies, and suggestions in this book. Nobody will do everything I recommend, nor should they, but find the suggestions that speak to you—and most of all, have fun taking care of yourself. It’s your body and your life, and taking care of yourself will make you feel better every day, no matter how many years young you happen to be.