When should I start getting Botox®? Is it time to incorporate retinol into my skincare routine? What is a “mommy makeover”? How about a “daddy do-over”? Do I really need to, as the saying goes, sacrifice my ass for my face? Should I swap my hyaluronic acid fillers for something a bit more permanent?
When it comes to beauty and aesthetics, there is no such thing as one size fits all. But there are some tried and true principles that will keep you looking and feeling your best. In this series, Coming of Age, The AEDITION answers your most pressing questions about the best treatments, procedures, and practices — from surgery and skincare to health and wellness and everything in between — to consider at any age.
It was Jane Fonda (now 81) who quipped that “she bought herself a decade” when she got a facelift, while Sharon Osbourne, 67, has been opening up about going under the knife for her rhytidectomy in August. At 65 years old, Christie Brinkley recently started working with Ultherapy® skin tightening, and 53-year-old Robin Wright has professed her love of Botox®.
Needless to say, these stars can, first and foremost, credit a healthy lifestyle for their transcendent glow (a balanced diet, regular exercise routine, and daily sunscreen application are always musts), but they have also chosen to age on their own terms with the help of rejuvenating professional treatments that can serve both men and women alike. Here, The AEDITION dives into some of the best surgical and non-surgical cosmetic procedures to try after 50.
For the Face
While there are plenty of minimally invasive procedures that promise to lift and firm, the gold standard of gravity-defying treatments will always be the rhytidectomy (a.k.a. facelift) thanks to its ability to reduce wrinkles and sagging skin around the face, neck, and jaw.
Like any cosmetic procedure, the decision of when to get a facelift is a personal one — but there are some general markers to keep in mind. “Patients who were exposed to the sun regularly, who smoke, who have lost a significant amount of weight, who have undergone early menopause, or who have thinner skin (i.e. English or Irish heritage), will often age earlier and wish to have a facelift,” says New York City-based board certified plastic surgeon Melissa Doft, MD. “These patients usually visit the office in their early fifties, while patients with thicker skin (e.g. Asian, African Americans) may schedule in their later fifties.”
While facelift results are not permanent (they will be impacted by the aging process), they tend to last at least 10 to 15 years for most patients and, when coupled with less invasive treatments, can persist even longer.
If a facelift is too still too invasive, you wish to complement your procedure, or you are simply looking to address a loss of volume, dermal fillers — like Juvéderm®, Radiesse®, Restylane®, and Sculptra® — can both smooth and plump the skin.
“Fillers are great for the aging face,” says Dr. Doft. “They are used to restore volume where it is lost with age and to camouflage wrinkles. Adding fillers to the wrinkles changes how light reflects onto the face, and the shadows become less significant.”
While filler temporarily restores lost volume, it cannot correct excessive skin sagging like a facelift. But the inverse is also true. In fact, some patients may experience hollowness in certain areas after a facelift, at which point their surgeon may recommend dermal filler to enhance the surgical results.
Since the hollowing of the face is one of the most common signs of aging, Dr. Doft recommends routine maintenance of soft tissue fillers every six months to a year.
If skin tone and texture is your concern, dermabrasion (and the less invasive microdermabrasion) can be performed to brighten and even out the complexion. The deeply exfoliating procedure involves using an abrasive brush or wand to remove the outer layers of the skin.
Many patients liken the post-op sensation to that of a burn, which subsides in a few days. The healing process, however, lasts several months, and sun exposure should be avoided for a minimum of six months. Dr. Doft says she suggests microdermabrasion (which yields a more superficial exfoliation) for people who are looking for less downtime, but dermabrasion is more effective in targeting deep wrinkles.
For the Eyes
Another common symptom of aging is drooping and puffiness around the eyes. According to the American Society of Plastic Surgeons 2018 Statistics Report, the most popular procedure among people over the age of 55 was blepharoplasty (i.e. eyelid surgery). Yes, that means it was even more requested than a facelift.
“As you age, the upper lid starts to sag and the lower lid fat becomes more prominent,” Dr. Doft explains. “A blepharoplasty will correct both and make your eyes look brighter and younger. Most patients will have a blepharoplasty alone in their late forties or fifties or in combination with a facelift.”
The procedure (usually performed under local anesthesia) takes about two hours to complete and involves cutting along the natural lines of the eyelids, separating the skin from the underlying tissue, and removing any excess fat and skin.
“It is a very popular procedure and one which is easily tolerated,” she says. “I will often perform upper lid blepharoplasty under local anesthesia in the office, but I usually will perform upper and lower eyelid surgery in the operating room.”
While the procedure is typically classified as cosmetic, patients who find that the excess skin interferes with their vision may be able to have their eyelid lift covered by insurance. After surgery, the eyelids usually heal in about two weeks. The results for the upper eyelid will last about five to seven years, while lower lids last indefinitely. But, as with a facelift, it is important to remember that the eyes will continue to age naturally.
Frequently combined with other procedures (like a facelift), a brow or forehead lift can reduce the appearance of fine lines and wrinkles and address sagging skin. There are two types of brow lifts: classic and endoscopic. “The classic brow lift can make a more significant change than the endoscopic option,” says Dr. Doft. “But the endoscopic option leaves smaller scars and will affect hair regrowth less.”
For both types, there is about two weeks of downtime and it is recommended to keep the head elevated and iced during that time.
For the Body
Due to poor circulation, genetics, hormones, skin tone, and more, varicose and spider veins can become more noticeable and troublesome with age. While they are not medically dangerous, they can cause aesthetic concerns and take form anywhere on the body — though the face (for spider veins) and legs (for varicose veins) are most common.
While there are a few techniques to reduce the appearance of veins, sclerotherapy has become the go-to treatment. The targeted vein is injected with a fluid called a sclerosing agent, which irritates the vein and causes it to disappear.
Dr. Doft recommends using sclerotherapy to treat medium and large veins, while laser treatments are the better choice for smaller ones. “It is important to treat the feeding veins that cause these small veins to appear,” she says. “I often recommend that patients consult with a vascular surgeon when they have a significant amount of varicose veins.”
There is minimal downtime from the treatment — though it may take around six weeks to see improvement and several sessions may be required. The upside? The results are permanent.
Whether you’re looking to take your minimally invasive cosmetic procedure routine to the next level or want to dive into the market for the first time, patients over 50 can consider an array of surgical and non-surgical procedures that lift, firm, and tone the face and body with long-lasting results.
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