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How the Face and Body Age... and how we can combat the telltale signs

Did you know teenagers and even children can have crow's-feet? Fortunately, however, the signs of aging don't really begin to kick in until our forties. Then it's only human nature to become preoccupied with that middle-aged spread, those wrinkles and jowls. We also start noticing our peers may look older - or younger - than we do.

Toronto area plastic surgeon, Dr. John Taylor observes that Caucasians age faster than Blacks and many Asians because they have thinner skin. And that's the same reason women show signs of aging earlier than men. While aging is inherently genetic, it can be accelerated by our lifestyle. Studies of identical twins prove that smokers and sun worshippers age much more quickly.

"As we get older, 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."

Skin quality deteriorates over time too; age spots appear, wrinkles and fine lines develop, and skin elasticity weakens. "Collagen becomes disorganized in the deeper layers of the skin, muscle tone declines and there's a sagging of fibrous fatty tissue," says cosmetic facial surgeon Dr. Peter Adamson. "A combination of these different aging factors leads to cheek furrows and jowls, as well as to a deepening of both the nasolabial folds, and the melomental folds or 'marionette lines.' Upper eyelids may droop, and pouches develop underneath the eyes."

But that's not all. "By the age of fifty, most of us wear down 25 per cent of the length of our teeth, so this also detracts from our youthfulness," says Toronto dentist Dr. Ed Philips. The chin and nose are scrunched closer together, the upper lip tends to fold under the teeth and wrinkles at the corner of the mouth are more pronounced.

"When it comes to the body, aging is characterized by a decrease in lean body or muscle mass, and we have a natural tendency to put on fat inside the abdomen where it's harder to get rid of," says Weiglein. Weight issues, pregnancy and breast-feeding can also affect the way we look.

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:

For the eyelids and forehead

Upper eyelid surgery eliminates baggy lids by excising skin and fat, and lower eyelid surgery minimizes unsightly bags, says Adamson. A forehead lift can create a refreshed look around the eyes by raising a sagging brow. Those horizontal forehead lines, frown lines between the eyes, and crow's-feet can be smoothed by regular injections of BOTOX®.

For the cheeks, jowls and neck

Adamson notes that endoscopic and short scar facelifts deliver more modest results than the SMAS procedure, which improves the jowls and also the upper neck. In his opinion, though, it's 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 collarbone - become more prominent. "In a procedure known as 'platysmal plication,' these bands can be tightened by an incision made under the chin," he says. Liposuction may be performed to reduce a double chin, and in some cases, chin or cheek implants used to achieve more definition.

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

For the lips and teeth

Laser resurfacing, a chemical peel, or a filler can help minimize those vertical "smoker's lines," and lips can be plumped up by a filler or Gortex implants. Increasing the length of your teeth gives better support to the lips, reduces marionette lines at the corners of the mouth and helps lips to look fuller. This can be achieved by veneers, or the latest techniques in bonding. Philips uses a method called "freehand couture bonding" that's less expensive than veneers and usually done in one visit. Tooth whitening rejuvenates teeth that have yellowed with age.

For the nose and ears

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

For the skin

Intense Pulse 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 improving skin texture and elasticity. Depending on size, spider veins can be treated by laser or by a process called 'sclerotherapy.'

For the hands

Callaghan observes that aging hands may be improved by rejuvenation techniques and fat injections, but he cautions that results are mixed.

For the breasts

"Drooping breasts can be rejuvenated with a breast lift," says Weiglein. "Depending on where the nipple lies, 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 on hormone therapy for prostate cancer may develop breasts, which can be reduced by surgery or ultrasonic liposuction.

For love handles and sagging abdomens

Liposuction can be used to slim down body fat, but Weiglein observes that a good result depends on our skin elasticity: "After the late forties, skin won't shrink reliably," he says. Abdominoplasty can be done on both men and women. "Excess skin and fat are removed, and if the rectus abdominus muscles are separated, they can be sutured together," explains Taylor. "Your best defense is good posture, staying at a normal weight and doing sit ups."

For the arms, thighs and buttocks

Some older women develop hanging flesh on the upper arms. If skin elasticity is good, liposuction can be done. Otherwise, skin and fat may be excised in a procedure called a brachioplasty. Sagging buttocks and thighs can be surgically lifted too, says Taylor. But these procedures are not commonly done because they leave long scars, and a buttock lift or thighplasty involves a recovery period of two to three weeks.

Laser Skin Resurfacing Surgery Information Guide

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