Thank you for your question! However, I am pretty sure the vast majority of plastic surgeons follow our lead in extolling the virtues of Retin A. Retin A has a long history of not only improving aging skin, but more importantly preventing photodamage. I can recall, the legendary dermatologist Albert Kligmen, now a nonogentarian, and developer of Retin A showing us residents in the late 1970's, photographs of women whose wrinkles definitely appeared less pronounced after two months of Retin A. In 1986, although many dermatologists had been prescribing it for years for skin aging, Kligman published an article in the Journal of the American Academy of Dermatology and Vorhees in JAMA showing its positive affects. This hit the cosmetic world, like a firestorm and even physicians outside our specialty began recommending it. Later, Retin A grabbed FDA approval for photoaging. It appears that Retin A or tretinoin, regulates gene activity, and by this means leads to the control of cellular proliferation, differentiation and embryonic development. These essentially make younger looking cells and thickens an epidermis which has been thinned by aging and the sun. Retin A also increases collagen synthesis and prevents some collagen breakdown. It helps with the vascularity that nourishes the skin. Since that time Ortho has come out with a gentler version called Renova. By substituting aromatic rings for double bonds (for you molecular biochemists out there), Retin A has become more light stable and less irritating. One, not very well known secret: the Retinoids work even better on non-facial skin. Thus, I recommend it for use on the back of the hands, often a give-away of age. Try this on yourself, if you don't believe me: use Retin A on the back of one hand and nothing on the back of the other. Check it in three months. You should see a noticeable difference. I strongly believe it is excellent for long term use. A Retinoid should be a key player in everyone's skin anti-aging program. If you use a Retinoid , along with other products I have already mentioned in prior answers, beginning at the age of 20, by the time you are 50 your skin will look 5-10 years younger than your peers. Best of luck!