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How To Age Well
by Shirley Madhère, M.D.

Aging is a natural phenomenon; we will all experience it. How we age is a matter of a number of variables, including genetics, lifestyle, health, stress, the environment, and choice. One such choice that is popular in age management is within the realm of plastic surgery. For those who choose to undergo some “intervention,” it may be in the form of minor, in-office procedures as injectables (Botox, fillers, etc.) and skin rejuvenation (laser, chemical peel, Vitaglow, etc.), or a “nip/tuck” (operative plastic surgery). Nevertheless, regardless of how one chooses to manage and show one’s age, whether or not with the help of a surgeon’s needle or knife, it is beneficial to age well and to look good for one’s given age, i.e., to be a better version of one’s current self. Before one can undertake an age management program, it is important to empower oneself by understanding how we age and what can be done to influence the process.

There are a number of factors that contribute to aging. These may be generally classified as intrinsic and extrinsic. Intrinsic factors are those with which we were born and thus cannot be controlled. Extrinsic factors are typically learned or acquired and therefore can be altered. Factors that lend to aging which may not be adjusted include genetics, skin type, and pore size, while those that may be changed for improved health include lifestyle, nutrition, and stress. Of note, appearance and how one feels about different variables of his/her life are now believed to play an increased role in wellness. In fact, the World Health Organization modified the definition of health as “… a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” Moreover, wellness has been defined by the National Wellness Association as "an active process of becoming aware of and making choices toward a more successful existence." Therefore, aging well is an individualized and holistic process that encompasses internal and external aspects of health and living.

The outward manifestations of aging occur on the level of the skin and begin by age 30. As we age, the facial skin becomes dry, less elastic, less firm (from the loss of collagen), and may show signs of sun damage. It may also be uneven, discolored, sagging, and develop wrinkles and loss of volume or facial fat. These manifestations are the result of a combination of natural aging (intrinsic) as well as extrinsic aging. Although each individual is genetically programmed differently and the rate of aging will vary from one person to the next, these changes will nonetheless occur to some extent at some point. For example, the 40 year old woman will have hopefully built a healthy skin foundation that she began in her 20’s, adjusted for her 30’s and now, in her 40’s, will modify to suit the particular changes her skin has undergone, namely dryness, loss of firmness and elasticity, and possible sun damage. Typically, more definitive steps should be taken to address these issues. While a healthy skin regimen should be a part of every woman’s (and man’s) routine, it may be appropriate also for women in their 40’s to consider office-based rejuvenation procedures as Botox (to soften hard facial lines), fillers (to add lost volume), chemical peels (to even out skin tone), Vitaglow (to help increase facial blood flow and help stimulate collagen), and plastic surgery to help manage excess, sagging skin that may not respond to other therapeutic modalities. The decision to undergo any of these procedures is highly personal, where one considers one’s beauty philosophy, budget, time, and expectations, and should discuss with her plastic surgeon.

Taking a holistic approach to beauty and wellness is how I advise my patients to look as great as they feel. I believe that beauty emanates from within and that healing occurs from the inside out. Therefore, to age well, I “prescribe” the following 10 tips to looking fabulous at every age:

1. Establish a good foundation: take care of your skin. Moisturize it, protect it from the sun, and stop touching it throughout the day! Whether with injectables or actual surgery, healthy, well-moisturized skin responds better to the needle and the knife;

2. Practice a holistic approach to beauty. The healthier you are overall, the better your skin and tissues will respond to a surgeon’s “interventions” or any other treatments. Also, know who you are and know who you are not: understand what effects look good on you; know your own face. What fits your best friend’s cheeks may not be suitable for yours;

3. Keep your mind active and your brain performing; engage in lifelong learning;

4. Stop smoking. Period. If you need help, get it;

5. Avoid prolonged, unprotected sun exposure. Enough said; you have heard it all before;

6. Be emotional: maintain an optimistic attitude and try to live an emotionally enriched life every day. Also, nourish your spirituality and have faith. Explore your metaphysical core. Be present. Practice detachment. Look for deeper meaning;

7. Honor your temple with good nutrition. A proper eating regimen will help to ensure normal healing, maintain active metabolism, and encourage efficient elimination of toxins. If healthful eating is lacking, take vitamins and supplements as directed by your physician or nutritionist as a complement to eating well. Limit intake of sugar, fat, and alcohol and stay hydrated to help your body clear itself of toxins. This is particularly helpful after surgery when your body enters into a state of relative dehydration and is briefly deprived of nutritional support;

8. Remain social: studies have shown that a strong social network may improve health and that close friendships may increase natural immunity;

9. Exercise regularly. There is really no way around it;

10. Manage stress effectively and often. Get consistent and adequate sleep every night. Listen to your body.

Aging well is as dynamic as the aging process itself. To look and feel well involves a balanced lifestyle that incorporates a variety of factors to help achieve successful living. With or without the knife, it cannot be argued that beauty is health and healthy is beautiful!





Dr. Shirley Madhère is a plastic surgeon who practices “holistic plastic surgery” in New York City.
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