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How the face and body ages and how we can combat the telltale signs

Did you know that teenagers and even children can get crow’s feet? Fortunately, however, the signs of aging don’t really start to show until the age of forty. So it’s just human nature to worry about that middle-aged expanse, those wrinkles and double chins. We also begin to notice that our peers may appear older, or younger, than us.

Toronto-area plastic surgeon Dr. John Taylor notes that Caucasians age faster than blacks and many Asians because they have thinner skin. And that’s the same reason why women show signs of aging sooner than men. Although aging is inherently genetic, our lifestyle can accelerate it. Identical twin studies show that smokers and sun worshipers age much faster.

“As we age, many of us lose facial fat and the natural fullness of youth,” explains Dr. Otto Weiglein, a plastic surgeon in Burlington, Ontario. “This is particularly noticeable in women two to three years after the onset of menopause.”

The quality of the skin also deteriorates over time; Age spots appear, wrinkles and fine lines develop, and skin elasticity weakens. “Collagen is disorganized in the deeper layers of the skin, muscle tone is decreased, and there is sagging of fibrous fatty tissue,” says cosmetic facial surgeon Dr. Peter Adamson. “A combination of these different aging factors leads to furrows in the cheeks and jowls, as well as a deepening of both the nasolabial folds and the melomental folds or ‘marionette lines.’ The upper eyelids may droop and bags form under the eyes.”

But that is not all. “By the age of fifty, most of us wear down 25 percent of the length of our teeth, so this also detracts from our youth,” says Dr. Ed Philips, a Toronto dentist. The chin and nose are closer together, the upper lip tends to fold under the teeth, and the wrinkles at the corners of the lips are more pronounced.

“When it comes to the body, aging is characterized by a decrease in lean or muscle body mass, and we have a natural tendency to accumulate fat inside the abdomen, where it’s harder to get rid of,” Weiglein says. Weight problems, pregnancy and lactation can also affect our appearance.

The good news is that there have never been so many cosmetic procedures available to help us look younger. Here’s a quick survey of the most popular solutions available:

What are some solutions for aging eyelids and forehead?

Upper eyelid surgery eliminates baggy eyelids by removing skin and fat, and lower eyelid surgery minimizes unsightly bags, Adamson says. A brow lift can create a refreshed look around the eyes by raising a drooping brow. Those horizontal forehead lines, frown lines between the eyes, and crow’s feet can all be smoothed out with regular Botox injections.

What are some solutions for aging cheeks, jowls and neck?

Adamson notes that endoscopic and short-scar facelifts provide more modest results than the SMAS procedure, which improves the double chin and also the upper neck. However, in his opinion, it is the deep plane facelift that gives the best result because it addresses all the tissues. Ottawa plastic surgeon Dr. Bryan Callaghan explains that some of us develop a “turkey neck” where the platysma, those two vertical bands that run from the chin to the clavicle, become more prominent. “In a procedure known as ‘platysma plication,’ these bands can be tightened through an incision under the chin,” he says. Liposuction can be performed to reduce double chins, and in some cases, chin or cheek implants may be used to achieve greater definition.

Non-surgical options include thermage, which uses radiofrequency to tighten collagen, and a permanent or semi-permanent filler to reduce less prominent nasolabial folds.

What are some solutions for aging lips and teeth?

Laser resurfacing, a chemical peel, or filler can help minimize those vertical “smoker’s lines,” and the lips can be filled in with a filler or Gortex implants. Increasing the length of the teeth provides better support for the lips, reduces marionette lines at the corners of the mouth, and helps the lips appear fuller. This can be achieved with veneers or with the latest bonding techniques. Philips uses a method called “freehand couture bonding” which is less expensive than veneers and is usually done in a single visit. Teeth whitening rejuvenates teeth that have yellowed with age.

Do I need to think of a solution for aging nose and ears?

Callaghan says that the nose and ears don’t actually grow as we age, but they may appear to as the tissue droops or thickens. But do not worry. “We can elevate the tip of the nose with a rhinoplasty and trim those sagging earlobes,” she says.

What are some options to combat aging skin?

Intense Pulsed Light (IPL) treatments target sun damage like brown spots, yellow areas, and broken blood vessels; they are also effective for rosacea. Laser resurfacing, trichloroacetic and phenol peels work on fine lines, wrinkles and age spots, as well as improve skin texture and elasticity. Depending on the size, spider veins can be treated with a laser or through a process called “sclerotherapy.”

Can I rejuvenate the skin of my hands?

Callaghan notes that aging hands can be improved with rejuvenation techniques and fat injections, but cautions that the results are mixed.

How can I prevent my breasts from aging?

“Sagging breasts can be rejuvenated with a breast lift,” says Weiglein. “Depending on where the nipple is, this could also be combined with an augmentation.” A woman whose breasts have become heavier with age may choose breast reduction, or a man may have gynecomastia. If this sounds strange, Taylor explains that older men receiving hormone therapy for prostate cancer can develop breasts, which can be reduced through surgery or ultrasonic liposuction.

How can I get rid of love handles and sagging abs?

Liposuction can be used to slim down body fat, but Weiglein notes that a good result depends on the elasticity of our skin: “After our forties, skin doesn’t shrink reliably,” he says. Abdominoplasty can be performed on both men and women. “Excess skin and fat are removed, and if the rectus abdominis muscles are separated, they can be sutured together,” Taylor explains. “Your best defense is good posture, maintaining a normal weight, and doing sit-ups.”

How does aging affect the arms, thighs and buttocks?

Some older women develop hanging flesh on their upper arms. If the elasticity of the skin is good, liposuction can be performed. Otherwise, the skin and fat can be removed in a procedure called a brachioplasty. Sagging buttocks and thighs can also be surgically lifted, says Taylor. But these procedures aren’t commonly performed because they leave long scars, and a butt lift or thigh lift involves a recovery period of two to three weeks.

Last but not least is cellulite. It affects most women and accelerates as we get older. Unfortunately, liposuction will not help. But non-surgical techniques like endermologie, which uses suction and pressure, and mesotherapy, which injects vitamins and drugs into the middle layer of the skin, help improve those dimpled thighs.

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