Are We Pushing The Anti-Aging Envelope?

Amy Andrade gets a Botox treatment from Dr. Jeffrey M. Kenkel at Northpark Mall in Dallas on Nov. 29, 2006. (AP Photo/Ron Heflin) AP Photo

Blogs and tabloids were recently abuzz with unconfirmed rumors that songbird and actress Jessica Simpson had gotten injections of Botox to paralyze developing wrinkles and lip fillers to plump up her smile.

And while Simpson, who was just 25, may seem rather young for wrinkles, plastic surgeons tell WebMD that for better or worse, many 20- and 30-year olds are opting for such preventive plastic surgery to actually try and stop aging before it starts as opposed to stopping it in its tracks once it has begun.

"By and large, this is a trend that we will see more of," predicts Julius W. Few, M.D., an assistant professor of plastic surgery at Northwestern University's Feinberg School of Medicine in Chicago.

"As one gets older and loses some of the elasticity of the skin, creases and wrinkles become more permanent," he explains. That said, "it's not unreasonable to believe that doing some preventive things now such as using sunscreen or getting Botox injections may stave off the process," adding that this has not been proven scientifically.

"It is a reasonable kind of impression that if someone were to have maintenance Botox injections fairly regularly then theoretically they may be able to slow the development of wrinkles," he says.

According to statistics from the American Society for Aesthetic Plastic Surgery (ASAPS), Botox injections were the top nonsurgical procedure among 35- to 50-year-olds in 2005. Botox injections work by blocking signals from the nerves to the muscles. As a result, the injected muscle can no longer contract, which causes the wrinkles to relax and soften.

For people in their late 20s or early 30s who have just the beginning of creases or depressions in their frown line, Botox is a great option because it can eliminate these problems and may also be able to slow the development of a deeper crease, Few says.

But that's not all Generation Y-ers are doing to turn back time.

"We are also seeing an increase in skin resurfacing," Few says. "Women who, perhaps in their early 30s or late 20s, have developed early sun damage or have some residual acne scars, are opting for microdermabrasion or nonablative laser resurfacing of the skin, and this also has a role in helping to slow the aging process and behave like a preventive tool."

During microdermabrasion, the doctor sandblasts tiny crystals across the face to remove dead skin.

But buyer beware: There is no surefire way to prevent aging.

"It's not appropriate to prevent all signs of aging. If someone says, 'I don't want any muscle in my face to move because I don't want to age,' that would be inappropriate and unnatural," Few says.

"I think we are seeing a lot more patients coming in earlier on," agrees Renato Saltz, M.D., a plastic surgeon at the Saltz Plastic Surgery in Salt Lake City and Park City, Utah. "This group of patients in their 20s and 30s that do take advantage of noninvasive plastic surgery will see a much different type of aging than older generations," he says, adding that sunscreen use alone, which is utilized by younger people today more than ever, will make a huge difference in the visible signs of aging. Exposure to ultraviolet light from the sunlight accounts for many signs of premature skin aging, including wrinkles.

Foad Nahai, M.D., vice president of the ASAPS and a plastic surgeon in private practice at Paces Plastic Surgery in Atlanta, likes to start his younger patients on an aging maintenance program.

"We start by giving advice on skin care including exposure to sun and smoking, and then I ask if they are using anything on their skin," he says.

Depending on the answer, he may prescribe retinoids and alpha-hydroxy acids that have some rejuvenating effects. Both products help get rid of dead skin, revealing a fresher layer of skin.

"I have patients smile and frown for me and if they have deep lines, I may suggest that Botox could help their appearance, but it will also have a preventive effect over the years," he says. "Getting Botox now may prevent lines from becoming very deep and, in turn, stave off the need for more aggressive treatments such as facelifts down the road.

"In the long run," Nahai says, "the need for invasive major facelifts will be much less because the current generation of 20- and 30-year-olds will not allow their faces to get to the stage that today's 50- and 60-year-olds have. It's too early to go under the knife, but we have needles, creams, and potions you can do and use that will not only delay the inevitable, but will also improve on what is now a youthful appearance."

Not all cosmetic surgeons are sold on pumping up 20- and 30-year-olds with
fillers and toxins. Steve Fallek, M.D., a plastic and reconstructive surgeon in New York City, tells WebMD that "if you have wrinkles, I am happy to inject Botox, but if you are 20 to 25 and worried about wrinkles, I don't think that is a great idea right now."

George Lefkovits, M.D., director of Park Plaza Plastic Surgery in New York City, agrees.

"Today Botox is so commonplace, it's almost like having cappuccino," he says. "If celebrities are having their lips plumped or having Botox, then people may think they should have it done also, but that's wrong, and this is where the plastic surgeon has to educate patients that they are not Jessica Simpson and that they have different lives. Just because the rest of world is having cappuccino doesn't mean you have to have it, too. You can have a regular cup of coffee."


Reviewed by Louise Chang, M.D.
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