Decades of Face: The Thirties, The Prevention Decade

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Welcome to another episode of
Park Avenue Plastic Surgery Class,

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the podcast where we explore controversies
and breaking issues in plastic

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surgery. I'm your co-host, Doreen Wu.

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I'm excited to be here with
Dr. Lawrence Bass Park Avenue,

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plastic surgeon educator and
technology innovator. Today,

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we continue our series, Decades of Face.

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The title of today's episode is
Decades of Face: The Thirties,

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The Prevention Decade.

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We are back with another episode
in our Decades of Face series.

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In the first episode,

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I was fascinated to hear about how many
different things could be treated in the

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twenties decade, and about how
much variation really occurs.

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But now we're moving on to the thirties.

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Why are we calling it
the prevention decade?

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This is a decade when most
people still look young,

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but small signs of aging are showing
almost universally at some point

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over the decade.

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That means that this is the time when
it is essential to start working on skin

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maintenance, to prevent aging changes,

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or at least slow the rate
of change in the skin from

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young metabolically active
skin to thinner, older,

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slower metabolizing skin. So we
don't want to let things snowball.

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We want to prevent an
accumulation of changes.

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What are some of these changes that
begin to emerge in the thirties?

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As skin begins to age, it becomes thinner.

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And this is especially true in fair
skinned people who have thinner skin

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to start with.

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Two of the biggest preventable
factors in skin aging

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are sun exposure and smoking.

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We also start to have a
change in our features,

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though not just our skin quality.

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And this begins volume loss in the face,

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which at first is probably a good thing,

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but eventually is a little
bit of a a bad thing.

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So we may have our best face in
terms of shape at some point in the

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thirties,

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but as we continue to lose
volume in the face, you know,

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we've lost that baby face
of being in our twenties,

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which is a good thing. We
look a little more sculpted.

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But then as that becomes
too much of a good thing,

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we start to hollow and
deepen and see a number of

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things that are early signs of aging.

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So the elevens,

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those vertical lines in
between the eyebrows crow's

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feet or lines out at
the corner of the eye,

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and sometimes dimpling in the chin
will begin to show in our thirties.

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Also, the nasolabial fold will deepen.

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And, you know, I'll share my thoughts
on chasing the nasolabial fold.

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I mean, it's natural to have a fold in
between the cheek and the upper lip.

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Even when we're 15 or 20 years
old, there's a fold there.

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But in our thirties, particularly
the latter half of the thirties,

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that fold starts to get deeper and
craggier, and that's not a good thing.

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So to the extent that it's deepened,
we should probably restore it.

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Some people only want to boost the
cheek to affect the nasolabial fold,

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and I think that's a mistake.

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I think you need to do a little
bit in multiple places rather than

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a lot in one place.

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But we don't have to efface or eliminate
the nasolabial fold because that's a

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natural shape, even in a
youthful face. On the other hand,

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the marionette line area,

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the line from the corner of
the mouth down to the jawline,

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is not a line that we
see in a youthful face.

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And if that makes its appearance
at some point in the thirties,

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we always want to chase that
because that is always a sign of

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aging. In addition to those lines,

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sometimes we see the beginning of
flattening or creasing in the cheek

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and the beginning of
hollowing in the temples.

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That's less common in the
thirties. Somewhat variable,

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but it can be seen at this juncture.

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Okay, so now that we have a broad overview
of the aging changes in our thirties,

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let's talk about typical
treatments in this decade.

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What kind of beauty plan
should I start considering?

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So things like Botox or other

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neuromodulator treatments to chase
some of these dynamic lines in the

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forehead. The crow's feet, the elevens,

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that's something that very
commonly is included in beauty

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plans for people in their
thirties. And filler treatments.

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If some of these other lines or
shapes are starting to really

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come out of their youthful configuration,

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we can start chasing
those using injectable

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fillers. If the skin is looking thinner,

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parched, starting to get a
rough texture, chemical peeling,

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and a variety of energy based
treatments with lasers or

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radiofrequency devices,

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microneedling or even
microneedling with PrP,

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platelet rich plasma,

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all these things can help
restore and maintain the quality

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of the skin if the skin
is starting to look older.

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But before we get to in-office treatments,

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it's always going to be using a
couple of really good home skin care

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products.

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So that almost always in
the thirties starts out with

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a retinoid, retinol,
retin-a or similar product

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or a growth factor based product.

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Some people will use the very
inexpensive products like the

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glycolic acid products and
all of these things exfoliate,

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increase skin turnover rate,

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and so the skin is getting a
little metabolically slower.

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It's a way of gooing the skin and getting
it to perk up a little bit and work

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a little harder at staying youthful.

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Let's discuss surgery for a moment.

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What are the surgeries that
often happen in the thirties?

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So if we look at the American
Society of Plastic Surgeons 2020

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statistics,

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which is the current most recent
statistics available from that society.

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They show the surgical
procedures in the thirties

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focused on things like breast
augmentation and liposuction,

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as well as breast reduction. And

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the other really big item,

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which is the face procedure
is still rhinoplasty.

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We talked about rhinoplasty being
probably one of the most common

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face surgeries in people
in their twenties,

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and that's still true of
people in their thirties.

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In smaller numbers you'll
see things like breast lifts,

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tummy tucks and that sort of thing.

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A lot of that relates
to body changes after

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childbirth, but if we
look at things on the face

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it's rhinoplasty,

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which is an extension of that
perfection decade of the twenties.

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And sometimes people might have liked
to have done it in their twenties,

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but they didn't have the disposable
income to do it or they just

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became more aware of how it impacted
their appearance in their thirties.

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And so things like rhinoplasty and
cheek implants still play a role.

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And we're starting to see
eyelid surgery become a surgery

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on folks in their thirties because
the lids typically start to show

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aging changes in most people
to a greater or lesser

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degree in the second
half of their thirties.

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Let's go back to non-surgical
treatments for a moment.

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For those of us who want to turn back
the clock but would prefer not to undergo

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surgery just yet, what
options are available?

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So the thirties are when Botox and
fillers become really, really big.

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So for Botox,

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it's more than 10 times as many
people in their thirties receiving

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Botox treatments as
people in their twenties.

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It's actually almost 15 times
and five times as many people

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are getting fillers.

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Now that's probably because filler use
is fairly common in the twenties as

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people are getting lip
filler or lip augmentation.

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But fill of other areas on
the face for aging changes

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really starts to kick in in the thirties.

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We also see a big uptick in the
numbers of laser resurfacing,

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chemical peels,

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and microderm abrasion for
skin quality improvement and

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doubtless other energy treatments
that are not well captured by

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these statistics in the survey.

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Lastly, before we conclude Dr. Bass,

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what are some important takeaways that
our listeners should remember from this

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episode?

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The really important takeaway message
is that the thirties are a decade when

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skincare and skin treatments are
essential to avoid starting down

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the pathway of looking,

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obviously older and
important to delay that

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process for as long as possible.

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There's a lot of variation in how
old the skin looks in people who are

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in their thirties and so
your baseline skin quality

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and how much treatment
is needed given how the

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skin looks and your personal desires
about how much treatment you're

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willing to put yourself through
at this stage of the game varies a

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lot individual to individual,

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but always remember doing something
is way better than doing nothing

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at this stage. When it comes to the face,

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we're still largely in a
non-surgical arena except for

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face perfecting procedures,

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but there are not a lot of
antiaging surgeries in the thirties,

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with the exception of eyelid plasty,

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which really starts to play a bigger
role typically in the second half of

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the thirties for many people.

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Finally face volume restoration and

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dynamic wrinkle treatments,

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treatments with basically injectable
fillers and with neuromodulators

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like Botox are the main
line in office treatments

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and they're widely utilized
to great benefit by people

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in their thirties.

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So this is still a sweet spot of
when you can look nearly perfect,

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get maximum benefit from treatments
and a lot of responsiveness from your

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skin. If you do go ahead
and do a treatment.

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Well after today's episode,

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I certainly see the importance of
being proactive when it comes to skin

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maintenance and preventative
treatments. After all,

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we can never completely
stop the aging process,

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but we can do our very best to
get, get ahead of it. As always,

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thank you Dr. Bass for sharing your
knowledge and expertise with us and giving

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us some useful advice on how we can
age gracefully through our thirties.

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And thank you to our listeners for joining
us today to learn about how having a

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beauty plan in your thirties can go a
long way in delaying the aging process.

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If you think of other exciting
developments or trends
in plastic surgery that

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you would like us to discuss
in upcoming episodes,

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please reach out via email or
Instagram. We'll see you next time.

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This is Doreen Wu thanking you for joining
Dr. Bass and me for this discussion

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of aging prevention in your thirties and
the steps we can take to slow down the

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aging process. Be sure
to tune in next time,

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and don't forget to subscribe to our
podcast to stay up to date with all of the

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exciting content that is coming your way.

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Thank you for joining us in this episode
of the Park Avenue Plastic Surgery

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Class podcast with Dr. Lawrence
Bass, Park Avenue plastic surgeon,

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educator and technology innovator.

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The commentary in this
podcast represents opinion.

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This podcast does not
present medical advice,

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but rather general information about
plastic surgery that does not necessarily

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relate to the specific conditions
of any individual patient.

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No doctor patient relationship
is established by listening
to or participating

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in this podcast.

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Consult your physician to advise you
about your individual healthcare.

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If you enjoyed this episode,

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please share it with your friends and
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