Turning back the clock without looking desperate

Michael Howard Swann, MD
Article by
Springfield Dermatologic Surgeon

If you are like most of us, you want to look younger without looking like you're trying to look younger.  The days of face-lifts are certainly not over, but the characteristic over-tightening of skin that comes with more aggressive lifting procedures should be over now that excellent choices exist to keep you looking like ... well ... you, albeit a bit younger version.  

Here are my tips for natural-looking skin intervention, which will have you looking amazing without looking desperate.

  1. Protect yourself from UVA and UVB.  Yes, the first thing on the list is to limit the damage you incur. I recommend daily SPF. I prefer a SPF 45 lotion that has a stabilized avobenzone (blocks UVA or aging sun rays), but the key is getting an excellent UVA blocker.
  2. Relax more often for less.  Early BoTox treatments used larger quantities to paralyze muscles. Relaxing your frown muscles with BoTox should not be dosed identically for all patients. The most expressive patients will achieve excellent results and keep their naturally expressive personality by limiting their initial dose of BoTox and carefully titrating the dose. This does require a bit of patience by the patient and the doctor, but will yield the most natural results. Patients should know that these lower doses are cheaper, since you generally pay for BoTox by the number of units used, but it's effect will generally be a bit shorter (4 months instead of 5 in my practice).  Spread the fun/cost out and keep it natural.
  3. Peel regularly.  As we age our skin maturation slows, which dulls skin tone. Peeling is one of the most effective ways to keep your skin turning over. What's more, regularly peeling the skin increases the thickness of the epidermis, which improves the appearance of fine lines. Glycolic peels are a very mild option. Jessner's peels are indicated for improved skin tone and texture in patients who have any brown skin discolorations and to improve skin tone and texture. These peels should be performed in series for best results. TCA peels are deeper peels and intended for more significant skin damage with brown spots and precancerous lesions. TCA peels require more downtime and achieve more obvious results, but you still look just like you.
  4. Vitamin A, Retin-A, for example.  Retin-A will improve your skin tone and texture as well as lessen your downtime for other rejuvenation procedures.  If you have comedonal acne (very small bumps), you'll get the added benefit of a more polished look. A must for the money as this will cost approximately $150-200 per year.
  5. Fractionate. The days of glossy skin and leftover white areas after facial skin resurfacing are over since the fractionated lasers have come to market. Theses lasers offer excellent results that are comparable to old "flat beam" machines with a fraction of the side effect risk. These come in all shapes and sizes for different intended purposes, so just because someone offers a fractionated laser does not mean you are getting the same results. Erbium:YAG, Erb:glass and carbon dioxide lasers are the major players.  A thorough discussion with your dermatologist or laser surgeon should include before and after pictures.
  6. Fill your losses.  How many times have you cringed at the sight of overfilled lips?  For a natural look, bring a picture to your cosmetic physician so they can appreciate your real volume loss that is normal with age. Filler is easy to add and difficult/impossible to remove, especially in the lips where a small amount goes a long way.  Fill your losses, but don't try to create someone else's lips, for the most natural youthful look.