By Stacey Stapleton

The skin is your body’s largest organ, and just like other vital parts, the way it stands the test of time is based largely on your lifestyle: How much time you spend in the sun, what you eat, and whether you smoke or engage in yo-yo dieting all have an effect.

According to John Williams, MD, a dermatologist at Overlook Hospital, skin ages in two ways: intrinsically and extrinsically. Intrinsic aging refers to the changes that happen to skin naturally over time, as well as the changes that are genetic. Extrinsic aging refers to the changes that take place because of the way we live. It is this extrinsic aging that we can exert some control over and help determine how we’ll look ten and even twenty years from now.

In Your Thirties

What Happens: As the aging process begins, skin becomes drier and may lose that “youthful glow” you had in your early twenties. The rate of cell turnover (meaning the rate at which dead skin is shed and the complexion renews itself) also slows, and your skin may start appearing dull and washed out. “You also may begin to notice age spots and broken blood vessels, which are the result of years of sun exposure,” says Williams. In your later thirties, you may even start to see fine lines creeping their way across your eye and mouth areas.

What you can do: “The sun is the number one cause of extrinsic aging,” says Williams, “so the best skincare advice is to minimize your sun exposure and avoid tanning beds.” Williams suggests making a moisturizer with an SPF of at least 30 part of your daily skincare regimen.

Regular facials can be helpful in enhancing circulation and encouraging cell turnover, but to really combat wrinkles, talk to your dermatologist about prescription topical retinoid products such as Retin-A and Renova. But beware of over-the-counter substitutes that contain retinol and promise equally dramatic results. Williams explains that these products can be as much as 200 times less potent than their prescription-only cousins. Your dermatologist can also help you get glowing with treatments like a chemical peel (which uses glycolic or salicylic acid to break down dead surface skin) or microdermabrasion (which relies on aluminum oxide crystals to whisk away dull skin).

Of course, what you eat matters too. If you’re nourishing yourself with healthy food, your skin will respond by looking radiant; if you’re not, you’re likely to experience breakouts and dull, discolored patches. Your skin needs a variety of vitamins to thrive, including vitamin A, which promotes cell development and nourishes skin and hair; and vitamin C, which encourages collagen production and has antioxidant properties to help fend off environmental damage.

If what you’re looking for are more dramatic results, a plastic surgeon, like Overlook’s Beverly Friedlander, MD, FACS, can help. “The area around the eyes is the most popular area of focus for women in their thirties,” she explains, “since early signs of aging—such as bags, heavy eyelids, and frown lines—show up here first.” A variety of procedures aimed at correcting these issues can be performed in conjunction with popular injectibles like Botox to maintain your youthful look.

Sun Sense

The sun is by far skin’s worst enemy, and the amount of time you spend exposed to the sun is the single biggest factor in determining how your skin ages. Sun exposure (and exposure to artificial rays like those in tanning beds) can result in a number of skin issues that are related not just to vanity but to your overall health as well. The effects of sun exposure include wrinkles; dull, washed-out complexion; leathery skin; age spots; a tendency to bruise easily; spider veins; and, of course, skin cancer.

To protect yourself on a daily basis, be sure to apply a moisturizer with an SPF of at least 30. Protect your face with a wide-brimmed hat and try to avoid being in the sun between 11 a.m. and 2 p.m., when rays are strongest. Since children under four are especially sun-sensitive, protect them with SPF 50 and keep them in the shade as much as possible.

You should also remain on guard against the early signs of skin cancer. See your doctor immediately if you notice any moles on your face or body that begin to change in color or texture, or grow larger than the head of a pencil eraser. Each member of the family should also visit a dermatologist for a complete body check to look for any moles or growths that may be problematic.

In Your Forties

What Happens: As precious collagen starts to break down, facial muscles begin to carve deeper lines on your forehead and at the outer corners of your eyes (hopefully from years of smiling). Changes in facial appearance associated with gravity, sun exposure, and heredity are manifesting themselves as well. “Skin also starts to get naturally thinner and less firm,” explains Williams, “and the best place to really see this intrinsic change is on sun-protected areas like the thighs. You may also notice that your complexion has become rougher and mottled by age spots, discolored patches, broken blood vessels, or enlarged pores.”

What you can do: The wide variety of laser treatments on the market, such as Fraxel lasers, are aimed at minimizing the signs of photo-aging: age spots, enlarged pores, broken blood vessels, and more. Some lasers can even boost the production of collagen to help smooth subtle lines and wrinkles. Recent advances in laser treatments have made many of them non-ablative (meaning the top layer of skin is not irritated), so that results can be had in a single treatment with little or no downtime. You can even purchase non-ablative laser-treatment devices to use at home.

The most popular solution for wrinkles, however, is Botox, which freezes the muscles responsible for those laugh lines. Originally used exclusively around the eyes, Williams explains that Botox has recently come into use on the lower half of the face to correct the downturning of the mouth that can occur naturally with age.

For deeper wrinkles that cannot be eliminated with Botox, fillers like Restalyne and Juvederm are the solution of choice. According to Friedlander, injectables have boomed in popularity since, like the latest lasers, they provide immediate improvement with little or no recovery time. The one downside to Botox and many popular fillers is that they involve costly repeat treatments. Some fillers, however, like the brand-new ArtéFill, are permanent, so talk with your doctor about which options are best for you.

In Your Fifties...and Beyond

What happens: As facial fat shrinks, skin becomes looser and more heavily wrinkled. Fat cells begin to accumulate around the neck and chin, and you may begin to notice that your jawline is not as defined as it once was. Skin’s natural oil production also declines, leaving skin dry and in many cases with a more reddish hue than you had in your forties.

What you can do: While injectables and laser treatments are still effective for women in their fifties, many choose to have surgical procedures; Friedlander reports that eyelid lifts, followed by face-lifts, are the most commonly performed. She adds that other procedures, including forehead lifts, cheek lifts, and neck lifts, can also be performed simultaneously to help re-create facial harmony. And although plastic surgery is still a very viable option for women in their sixties, Friedlander points out that the demand for surgery usually declines in this decade. “Fewer than five percent of plastic-surgery procedures are performed on women greater than 65 years of age,” she says.

On the cosmetic front, foundations and moisturizers with a green base can help counteract the redness that naturally occurs with age. Although temporary, these products can enhance the complexion on a daily basis or for a special event.

Considering Plastic Surgery? What you should know

Plastic surgery is more common than ever, and the stigma once attached to “having work done” has all but disappeared. Even men are starting to turn up in doctor’s offices across the country, looking to turn back time. Overlook’s Beverly Friedlander, MD, FACS, credits the media for much of the recent plastic-surgery craze. “Magazines, as well as programs such as Dr. 90210 and Nip/Tuck, have brought an awareness to the vast nature of procedures available, both surgical and non-surgical, which can help women everywhere improve their self-image,” she says.

Of course, the decision to have plastic surgery is a personal one, but if you’re ready to go under the knife, finding a reputable doctor is key. A friend’s recommendation is a great way to find a surgeon whose work you have already seen, or feel free to ask your primary-care physician for a referral. Once you have found a doctor you are interested in, you should check him or her out using the following criteria.

• Look into his or her credentials and experience. It’s important to work with a plastic surgeon who is board-certified and has been practicing for several years. Don’t be swayed by a surgeon who shows you a laundry list of professional societies he or she belongs to; many of these organizations have minimal screening procedures for members.


• Make an appointment for a consultation. This meeting will give you the opportunity to get to know a surgeon before undergoing treatment and decide if he or she is right for you. The prospective doctor should address all of your concerns, show you before-and-after photos, and be open to questions about his or her background. You should also feel completely comfortable with the surgeon’s bedside manner and style of communication. Be wary of doctors that make big promises. “During the consultation process, a reputable surgeon will offer the patient realistic expectations for their individual results and recovery,” says Friedlander.


• Tour the hospital or clinic where the surgery will take place and check to see that it is also accredited. The operating room should be clean and professionally equipped.


• Check if the doctor has privileges at a local hospital. Plastic surgeons permitted to work at hospitals have likely been meticulously reviewed by other physicians.