Beat the Clock
It’s no secret that combating the signs of aging is a big business; department-store and drugstore shelves are filled with products promising one miracle after another. And although good skincare and a healthy diet are important, to really turn back the clock your best bet is a reputable dermatologist or plastic surgeon.

By Stacey Stapleton

Skin Savers

Your first stop on the journey to younger-looking skin should be a dermatologist, who has an arsenal of anti-aging weapons in four distinct categories: topicals (which include creams and serums), peels (and microdermabrasion), injectables, and lasers.

Topicals: Anti-aging skincare products (or cosmeceuticals, as they have come to be known) are probably the largest growth area in the anti-aging category, and, thanks to science, they can actually have a profound effect on the quality and appearance of your complexion. But the most important thing you can put on your face is still—and always will be—sunscreen. “About 70 percent of skin aging comes from environmental factors, such as the sun and smoking,” says dermatologist Chris W. Sciales, MD, FAAD.

Fellow dermatologist Teresa V. Notari, MD, FAAD, agrees. “A tan is not a beautiful thing,” she explains, “but rather your skin’s response to being damaged by the sun.” This means you should use an SPF of at least 30 whenever you’re outdoors for long periods, and cover up or sit in the shade during prime sunburn hours (11 a.m. to 2 p.m.).

But what about the damage that’s already done? To erase past sins, you’ll need powerful products formulated with antioxidant vitamins C and E to reverse sun and environmental damage. Retin-A, originally used for treating acne, can help, as it has been found to minimize wrinkles and age spots and even firm the skin’s precious stores of collagen. “The best-possible anti-aging skincare regimen consists of an antioxidant vitamin C product in the morning, followed by sunscreen and then a Retin-A product at night,” advises Sciales. Just make sure your vitamin C serum is a medical-grade formula containing 20 percent vitamin C.

If age spots, redness, or discoloration is your main concern, Notari suggests glycolic-acid products and prescription creams with hydroquinone to even out your skin tone. Just beware of over-the-counter wonder creams. “Although over-the-counter hydroquinone products can be helpful, prescription formulas are much more powerful and may even have some Retin-A in them to help with the fine lines and loss of elasticity that naturally come with the aging process.”

Peels: Compared to other in-office procedures, peels are a relatively inexpensive way to improve skin texture and shrink pores, and many require no downtime at all. The one catch is that these kinder, gentler peels need to be repeated several times to achieve maximum results. That’s not to say that you can’t get a more aggressive peel: Sciales has been offering his patients a trichloroacetic acid (TCA) treatment, which requires about a week to recover from—but the results can be well worth it. “The TCA peel has become very popular lately with the economic downturn, since it can deliver similar results to pricier laser treatments, but for just a few hundred dollars,” he explains.

Although you may be tempted to run right out for a peel of your own, Notari adds that peels ideally should be done in the fall or winter. “The results from a six-month course of peels can actually be undone in just two weeks of sunbathing,” she says, “so why waste your money having one right before a beach vacation?”

Injectables: If every time you think of dermatological needles you think of Botox, you’d be right only about half the time. Although Botox is incredibly popular, cosmetic injectables come in many varieties for a wide range of purposes. One thing they all have in common, however, is that they require a commitment of both time and money, since none of them provides permanent results.

The first type of injectables are fillers, used to add volume to the cheeks, lift sagging skin, and plump up thinning lips, smile lines, and nasal labial folds. “We now know that wrinkles are not the only way we show our age,” says Sciales. “In fact, loss of volume in the skin is just as big a problem as fine lines. Many patients are actually surprised to find that once they put a little volume back into their skin, their wrinkles seem smoother and less obvious.” The best news is that over the last ten years, the results of injectable fillers have become softer and much more natural than the over-plumped looks women used to get. Patients can choose between temporary fillers made from hyaluronic acid (like Juvederm and Restylane, which typically last from three to four months), or longer-lasting options like ArtéFill and Radiesse, the results of which typically hang around for up to one year.

Botox, the second type of injectable, is used to relax muscles whose contractions are carving wrinkles into the upper face, resulting in such undesirables as forehead furrows and crow’s-feet. Botox can also be used very effectively in the neck to minimize the early loosening of skin, thereby gently lifting the jawline. “You can get a very natural result from Botox, without that severely pulled look that sometimes happens after a face-lift,” says Notari. “This makes it great for women in their thirties and forties who have just started showing signs of aging.” Bear in mind, however, that the results of Botox last only three to four months, so you’ll need to return for repeat treatments to maintain your youthful look.

Lasers: One of the major developments in skincare in the last ten years, lasers can be used for a wide array of purposes, including hair removal and facials. They also can be used to reduce redness and discoloration from things like rosacea and age spots, to treat wrinkles that can’t be addressed with injectables, and to tighten skin around the jawline (although this can be painful). Before undergoing any laser treatment, though, remember that this, too, is only a temporary fix and you will most likely require two or three treatments to see maximum results. Despite the downsides, Notari explains that lasers are much less of a commitment than Botox and other fillers: “You can have a course of lasers once or twice a year rather than visiting your doctor regularly every three months for injections.” She advises her laser patients to seek treatment in the fall or winter (as with peels), so as not to re-damage freshly lasered skin.

Does the thought of laser treatments leave you feeling queasy? That’s understandable: Lasers used to be incredibly invasive, leaving patients burned and oozing for days after treatment. But the newest lasers (like Fractionated Pearl Lasers such as Fraxel) poke microscopic holes in the skin to solve problems from the inside out, with little pain or recovery time (and no searing of the top layer of skin). “If you’re interested in laser treatments, the most important thing to remember is to choose an experienced practitioner,” says Sciales. “Although the recovery time is less with modern lasers, they’re still powerful instruments and can burn and damage skin if used incorrectly.” Be sure to ask your doctor how many laser treatments he or she performs annually and whether or not he owns his own equipment. Many less-experienced doctors rent laser equipment for just a few days a month, but physicians like Sciales have their own lasers and perform procedures on a regular basis.

Surgical Solutions

If you’ve been agonizing over whether the time is right to have plastic surgery, some of the best advice doctors offer is not to start too young. “The results of most surgeries last around six years, since the patient still continues to age,” explains David Daniels, MD, a plastic surgeon at Overlook Hospital, “so it’s best to have that first operation later in life, closer to 50.” When Daniels encounters younger women seeking surgery, he usually suggests injectables and lasers instead. “Many times a patient comes in wanting an eye-lift and what she really needs is just cheek fillers to put that youthful supple volume back into her face,” he says. “In these cases we can treat the patient much more cost-effectively and even offset surgery by five years with noninvasive techniques.”

Of course, if you’re looking for the more dramatic results that creams, peels, injectables, and lasers just can’t achieve, surgery is still your best bet—as long as your goals are realistic. “If a patient doesn’t have reasonable expectations of what her results will be, I won’t operate,” says Daniels. This is why it’s vital to find a reputable surgeon who will talk about what you’re hoping to achieve—before wheeling you into an O.R. “Sometimes I like to start a patient off with a simple procedure to see how she handles it before diving into a more invasive operation,” says Daniels. “All doctors need to remember that each patient is a person and needs counseling.”
Your surgeon should be trained and experienced in your particular procedure, so if complications do arise, he or she knows exactly how to handle them. A good doctor will also want to make sure you’re healthy enough to have an operation. Says Farrokh Shafaie, MD, a plastic surgeon at Overlook Hospital, “A patient needs to be medically fit for elective surgery, which means they must be free of heart and circulation problems, do not smoke heavily, and have no prior surgical complications.”

If you’re tempted to opt for surgery but are still overcome with fears about looking pulled and tugged like so many aging celebrities, don’t let your anxiety dissuade you. Neck-lifts, eye-lifts, brow-lifts, and full face-lifts have come a long way in recent years, and the results are more natural than ever. Many procedures, including the Shafaie Lift (named for Dr. Shafaie), can be performed without separating the skin from the underlying muscle (which leads to that unfortunate pulled looked and odd facial movements). “What’s more, unlike traditional face lifts, the Shafaie Lift can be done repeatedly through the years as a patient continues to age,” explains Shafaie.

Another very popular procedure is the endoscopic brow-lift, which brings up the eyelids without that permanent look of surprise so many women dread. “This operation actually lifts the brow foundation, so there’s no pulling on the skin,” explains Daniels.

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For a referral to a dermatologist or plastic surgeon, call (866) 817-4834.

You Are What You Eat

Despite everything dermatologists and surgeons can do about wrinkles, age spots, and other signs of time, you still need to play an active role in preserving your looks by eating right. And while all dieticians promote a well-balanced diet that’s low in fat and rich in vegetables, whole grains, and lean protein, foods that are rich in antioxidants are especially good at helping you look younger, longer. Here’s why: Antioxidants help the body fight off free radicals, which (other than the sun) account for much of the environmental damage done to your skin over the years. When you eat antioxidant-rich foods regularly, you can actually decrease the harm free radicals do to your complexion. The next time you get the munchies, do your body good and reach for one of these snacks.

• Tomatoes: Loaded with vitamins A and C (two of the most important antioxidant nutrients), tomatoes are a cinch to work into your diet in juices, sauces, sandwiches, and salads.


• Spinach: An easy salad base or side dish, spinach is full of enough vitamins A, C, and E to send most free radicals packing. It even tastes great when added to soup or stew.


• Fruit: You’ve got a lot of choices here, as antioxidants can be found in a slew of yummy fruits, from peaches and apricots to citruses and berries. Add a little low-fat whipped cream and they make a great dessert, too.


• Green tea: Instead of coffee, start your day with a cup of green tea. Not only will you get that caffeine boost, but green tea also helps the body flush out free radicals and other toxins.