Decades of Face: The Thirties, The Prevention Decade

Doreen Wu (00:00):
Welcome to another episode of Park Avenue Plastic Surgery Class, the podcast where we explore controversies and breaking issues in plastic surgery. I'm your co-host, Doreen Wu. I'm excited to be here with Dr. Lawrence Bass Park Avenue, plastic surgeon educator and technology innovator. Today, we continue our series, Decades of Face. The title of today's episode is Decades of Face: The Thirties, The Prevention Decade. We are back with another episode in our Decades of Face series. In the first episode, I was fascinated to hear about how many different things could be treated in the twenties decade, and about how much variation really occurs. But now we're moving on to the thirties. Why are we calling it the prevention decade?

Dr. Lawrence Bass (00:43):
This is a decade when most people still look young, but small signs of aging are showing almost universally at some point over the decade. That means that this is the time when it is essential to start working on skin maintenance, to prevent aging changes, or at least slow the rate of change in the skin from young metabolically active skin to thinner, older, slower metabolizing skin. So we don't want to let things snowball. We want to prevent an accumulation of changes.

Doreen Wu (01:21):
What are some of these changes that begin to emerge in the thirties?

Dr. Lawrence Bass (01:25):
As skin begins to age, it becomes thinner. And this is especially true in fair skinned people who have thinner skin to start with. Two of the biggest preventable factors in skin aging are sun exposure and smoking. We also start to have a change in our features, though not just our skin quality. And this begins volume loss in the face, which at first is probably a good thing, but eventually is a little bit of a a bad thing. So we may have our best face in terms of shape at some point in the thirties, but as we continue to lose volume in the face, you know, we've lost that baby face of being in our twenties, which is a good thing. We look a little more sculpted. But then as that becomes too much of a good thing, we start to hollow and deepen and see a number of things that are early signs of aging.

Dr. Lawrence Bass (02:32):
So the elevens, those vertical lines in between the eyebrows crow's feet or lines out at the corner of the eye, and sometimes dimpling in the chin will begin to show in our thirties. Also, the nasolabial fold will deepen. And, you know, I'll share my thoughts on chasing the nasolabial fold. I mean, it's natural to have a fold in between the cheek and the upper lip. Even when we're 15 or 20 years old, there's a fold there. But in our thirties, particularly the latter half of the thirties, that fold starts to get deeper and craggier, and that's not a good thing. So to the extent that it's deepened, we should probably restore it. Some people only want to boost the cheek to affect the nasolabial fold, and I think that's a mistake. I think you need to do a little bit in multiple places rather than a lot in one place.

Dr. Lawrence Bass (03:39):
But we don't have to a face or eliminate the nasolabial fold because that's a natural shape, even in a youthful face. On the other hand, the marionette line area, the line from the corner of the mouth down to the jawline, is not a line that we see in a youthful face. And if that makes its appearance at some point in the thirties, we always want to chase that because that is always a sign of aging. In addition to those lines, sometimes we see the beginning of flattening or creasing in the cheek and the beginning of hollowing in the temples. That's less common in the thirties. Somewhat variable, but it can be seen at this juncture.

Doreen Wu (04:27):
Okay, so now that we have a broad overview of the aging changes in our thirties, let's talk about typical treatments in this decade. What kind of beauty plan should I start considering?

Dr. Lawrence Bass (04:37):
So things like Botox or other neuromodulator treatments to chase some of these dynamic lines in the forehead. The crow's feet, the elevens, that's something that very commonly is included in beauty plans for people in their thirties. And filler treatments. If some of these other lines or shapes are starting to really come out of their youthful configuration, we can start chasing those using injectable fillers. If the skin is looking thinner, parched, starting to get a rough texture, chemical peeling, and a variety of energy based treatments with lasers or radiofrequency devices, microneedling or even microneedling with PrP, platelet rich plasma, all these things can help restore and maintain the quality of the skin if the skin is starting to look older. But before we get to in-office treatments, it's always going to be using a couple of really good home skin care products. So that almost always in the thirties starts out with a retinoid, retinol, retin-a or similar product or a growth factor based product. Some people will use the very inexpensive products like the glycolic acid products and all of these things exfoliate, increase skin turnover rate, and so the skin is getting a little metabolically slower. It's a way of gooing the skin and getting it to perk up a little bit and work a little harder at staying youthful.

Doreen Wu (06:34):
Let's discuss surgery for a moment. What are the surgeries that often happen in the thirties?

Dr. Lawrence Bass (06:39):
So if we look at the American Society of Plastic Surgeons 2020 statistics, which is the current most recent statistics available from that society. They show the surgical procedures in the thirties focused on things like breast augmentation and liposuction, as well as breast reduction. And the other really big item, which is the face procedure is still rhinoplasty. We talked about rhinoplasty being probably one of the most common face surgeries in people in their twenties, and that's still true of people in their thirties. In smaller numbers you'll see things like breast lifts, tummy tucks and that sort of thing. A lot of that relates to body changes after childbirth, but if we look at things on the face it's rhinoplasty, which is an extension of that perfection decade of the twenties. And sometimes people might have liked to have done it in their twenties, but they didn't have the disposable income to do it or they just became more aware of how it impacted their appearance in their thirties. And so things like rhinoplasty and cheek implants still play a role. And we're starting to see eyelid surgery become a surgery on folks in their thirties because the lids typically start to show aging changes in most people to a greater or lesser degree in the second half of their thirties.

Doreen Wu (08:29):
Let's go back to non-surgical treatments for a moment. For those of us who want to turn back the clock but would prefer not to undergo surgery just yet, what options are available?

Dr. Lawrence Bass (08:40):
So the thirties are when Botox and fillers become really, really big. So for Botox, it's more than 10 times as many people in their thirties receiving Botox treatments as people in their twenties. It's actually almost 15 times and five times as many people are getting fillers. Now that's probably because filler use is fairly common in the twenties as people are getting lip filler or lip augmentation. But fill of other areas on the face for aging changes really starts to kick in in the thirties. We also see a big uptick in the numbers of laser resurfacing, chemical peels, and microderm abrasion for skin quality improvement and doubtless other energy treatments that are not well captured by these statistics in the survey.

Doreen Wu (09:38):
Lastly, before we conclude Dr. Bass, what are some important takeaways that our listeners should remember from this episode?

Dr. Lawrence Bass (09:46):
The really important takeaway message is that the thirties are a decade when skincare and skin treatments are essential to avoid starting down the pathway of looking, obviously older and important to delay that process for as long as possible. There's a lot of variation in how old the skin looks in people who are in their thirties and so your baseline skin quality and how much treatment is needed given how the skin looks and your personal desires about how much treatment you're willing to put yourself through at this stage of the game varies a lot individual to individual, but always remember doing something is way better than doing nothing at this stage. When it comes to the face, we're still largely in a non-surgical arena except for face perfecting procedures, but there are not a lot of antiaging surgeries in the thirties, with the exception of eyelid plasty, which really starts to play a bigger role typically in the second half of the thirties for many people. Finally face volume restoration and dynamic wrinkle treatments, treatments with basically injectable fillers and with neuromodulators like Botox are the main line in office treatments and they're widely utilized to great benefit by people in their thirties. So this is still a sweet spot of when you can look nearly perfect, get maximum benefit from treatments and a lot of responsiveness from your skin. If you do go ahead and do a treatment

Doreen Wu (11:40):
Well after today's episode, I certainly see the importance of being proactive when it comes to skin maintenance and preventative treatments. After all, we can never completely stop the aging process, but we can do our very best to get, get ahead of it. As always, thank you Dr. Bass for sharing your knowledge and expertise with us and giving us some useful advice on how we can age gracefully through our thirties. And thank you to our listeners for joining us today to learn about how having a beauty plan in your thirties can go a long way in delaying the aging process. If you think of other exciting developments or trends in plastic surgery that you would like us to discuss in upcoming episodes, please reach out via email or Instagram. We'll see you next time. This is Doreen Wu thanking you for joining Dr. Bass and me for this discussion of aging prevention in your thirties and the steps we can take to slow down the aging process. Be sure to tune in next time, and don't forget to subscribe to our podcast to stay up to date with all of the exciting content that is coming your way.

Speaker 3 (12:35):
Thank you for joining us in this episode of the Park Avenue Plastic Surgery Class podcast with Dr. Lawrence Bass, Park Avenue plastic surgeon, educator and technology innovator. The commentary in this podcast represents opinion. This podcast does not present medical advice, but rather general information about plastic surgery that does not necessarily relate to the specific conditions of any individual patient. No doctor patient relationship is established by listening to or participating in this podcast. Consult your physician to advise you about your individual healthcare. If you enjoyed this episode, please share it with your friends and be sure to subscribe to our podcast on Apple Podcasts, Google, Spotify, Stitcher, or wherever you listen to podcasts.