Is 50 Really the New 30?: How Modern Aesthetic Medicine Has Given Us A Decade of Delay in Facial Aging

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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.

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I'm your co-host Doreen Wu and I'm
excited to be here with Dr. Lawrence Bass

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Park Avenue plastic surgeon,
educator, and technology innovator.

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The title of today's episode
is, "Is 50. Really the New 30?

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How Modern Aesthetic Medicine Has Given
Us a Decade of Delay in Facial Aging."

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Today's episode. Title
is really interesting.

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It's especially relevant because phrases
like 50 is the new 30 and 40 is the new

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20 are becoming more and more
commonplace. So, Dr. Bass,

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what does the title of the episode mean?

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Well,

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it's really about how our
appearance or what people typically

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look like at a given age has
really completely transformed

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since we were younger. Life is better.

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We're traveling through life, better,
healthier, we're living longer.

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And as a consequence
of that better health,

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we look better and it's
not just our health,

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but it's also the things we're doing to
preserve and maintain our appearance.

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So how, how we look at 50? What,

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what the mental image of that
is for most people is what

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somebody who was in their
thirties used to look like

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in our parents' generation. We,

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it's also a change in
what our expectations are.

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And if you go younger
and younger and younger,

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you see that change in expectation,

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millennials and people younger
than millennials are already

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planning that they're going
to do things to not accelerate

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their aging appearance.

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They're going to do things to prevent
and preserve their appearance in

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ways the past generations just didn't
get involved in partly they didn't

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get involved because life was
different. There was less affluent,

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partly because a lot of the technologies
and treatments didn't exist.

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But it's a complete transformation
in what we're doing at

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a given age and how
we're expected to look.

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Exactly.

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I think as the world's population is
getting older and we're living longer,

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more and more people are looking for
ways to combat the signs of aging and

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maintain their useful appearance by
kind of having this beauty maintenance

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routine and establishing that early
on. Why has this shift occurred?

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What has really changed?

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Well, it's really the ascendance
of nonsurgical options.

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The ability to make really
substantial changes in appearance

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without doing aesthetic surgery.
And I'm a plastic surgeon.

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I like aesthetic surgery.
It's my industry.

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And I think it can really do
tremendous things for people,

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but it's not the right
maneuver for many stages of

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aging, particularly early stages of aging.

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And we really didn't have a good
option for people early in the game,

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people in their twenties,
people in their thirties,

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we needed those options.

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And there has been huge
output from American

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industry and around the world to create
meaningful non-surgical treatments

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that help us.

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And so that's not just protection,

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but prevention and maintenance,
along with restoration.

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Let's start with lifestyle changes.

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First people in this generation are living
drastically different lives than say

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their parents and their grandparents.

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What are some of the ways
our lifestyle has evolved?

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The two biggest factors in
skin aging are sun and smoking.

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So obviously there are some big changes
in lifestyle compared to our parents and

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grandparents, many fewer people smoke.

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And we clearly recognize
the impact of sun on

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skin aging, wrinkling,
all kinds of skin changes,

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pigment changes, and also
skin cancer, of course.

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So we don't always stay out of the
sun, but at least we're aware of it.

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And we have sunscreen that
we can use to help protect.

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There's also much better fitness
and much better understanding of the

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importance of participating in fitness
activities compared to previous

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generations. And our diet has
improved. We eat less fat, less salt,

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less carbs, and we understand the impact.

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These things have on health and not
just health, but also appearance.

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It's good to know that we're taking
steps in the right direction.

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We're adopting healthier habits
and living healthier lifestyles.

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What has happened in plastic
surgery and aesthetic medicine?

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So there are several categories of things
that have really made a big impact.

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And again, are in that category
of nonsurgical options.

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One is the durable or modern fillers
that started to come on the market about

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2003 and 2004.

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Another is Botox and other
neuromodulators Jeuveau,

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Dysport, Xeomin, that

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helps smooth out wrinkles and keep
us from ironing in these wrinkle

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changes over decades.

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There are energy devices
that are used to tighten the

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skin to support skin health,

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to clear out pigmentary
lesions and redness and

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their skincare.

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Okay. Let's take them one at
a time, starting with Botox.

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So, as I said, the idea
is not to iron in changes.

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There there's a lot of
lines on the face that are

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dynamic in nature that
are promoted by muscular

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tension, even resting tension.

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And certainly by the muscular
pressure that we experience when

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we smile or talk or animate.

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Naturally people wonder when is the
right time to start getting Botox?

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So opinions differ about
when it's a good idea,

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there's this notion of,

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of prevention or what some
people call prejuvenation versus

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waiting until you need
to maintain the skin. But

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as the skin ages,

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we wrinkle more because
our skin is not as elastic.

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So if a 20 year old smiles and
they make a big enough smile,

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they'll crinkle up the corner of their
eyes. But if they make an average smile,

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they won't because their skin is
pretty firm and springy. If you're 40,

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if you make even an average
smile, you'll wrinkle up.

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Typically some of the corner of your eyes,

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because your skin is less elastic
than it was when you were 20.

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So our need for looking our best

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with Botox goes up as we age,

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but the benefit of not starting to iron
in lines when we're young is something

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that we still think is worthwhile.

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Where do fillers fit into this picture?

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Well,

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fillers are about volume restoration
and volume changes in the face.

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And the beginning of shape change
in the face is one of the earliest

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changes we see in aging. So
the fillers support shape,

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they help minimize the
appearance of early laxity.

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And every time we inject
fillers, we get some neogenesis.

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We get some rebuilding of
the collagen in the skin.

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And because filler injections are
repetitive treatments over time.

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These things make the skin much better
than it. Otherwise would've been,

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had you been doing no treatment at all?

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Now let's talk a little
bit more about skincare.

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What are the big things
happening in that realm?

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Skincare is, is a huge category.

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And there are literally thousands
of skin products out there

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and other kinds of skin
treatments, not products per se,

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that are being done. So
it's really, really big.

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But the basic idea is that some

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skin products on the face and some
attempts to care for your skin beyond

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just washing your face is an
important thing to be doing.

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There's a huge buzz right now around
clean skin care, retinols, vitamin A,

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all of that type of stuff. What are
the main categories of materials?

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There are several categories that many
of the medicated skin products fall into.

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So the basic idea here is
that a good skin product.

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That's a sort of a cosmetic product or
an over the counter product you might get

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at the store.

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They'll typically improve the appearance
of the skin and they'll protect the

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skin. You know, the skin needs
an Alion protective layer.

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We don't want the skin to be
stripped raw because it's,

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it's exposed that way.

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So a little bit of protection from
a good skin product is a good thing,

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but the doctor's office products,

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prescription products will
typically have medications in,

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in them that modify the biology
of the skin in some way that is

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favorable or helps restore
youthful behavior in the skin.

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So the big categories are things
like Elafin, beta hydroxy acids.

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These are things like glycolic
acid, lactic acid, pyruvic acid,

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that's one big category of products.
And those are very affordable products.

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Typically they exfoliate
and they stimulate some skin

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turnover at a higher rate, which
again is more like youthful skin.

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There are retinoids. These
are vitamin A analogs.

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These do the same kind of
things they're exfoliating,

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but they significantly
stimulate new collagen and help

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improve organization of collagen. And
maybe even some impact on elastin.

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Another category nowadays are
products that have significant amounts

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of growth factors of one
sort or another growth

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factors that stimulate
blood supply in the skin,

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or that stimulate collagen production.
They're all manner of products,

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but these are things that
try to stimulate the skin to

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turn on things that are
slowing down or working less

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efficiently as the skin ages.

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There are other products that have
botanicals that have similar kinds of

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bioactivity. Uh,

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and there's a huge host of products with

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variable levels of
impact to chase pigment,

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to chase skin quality and texture. Uh,

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but overall,

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an important start even when we're young
are things that are protective so that

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the skin is adequately moisturized
and has that protective Amalian layer.

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And finally, the, the other
big thing is sunscreen. I mean,

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sunscreen is critically important.

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We're always getting exposed to
ultraviolet indoors and outdoors

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and some level of protection
from that, which is, again,

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one of those two big
preventable factors in skin.

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Aging is critical. If you want
to maintain your appearance.

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Lastly, we have energy based
devices. What do they do?

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And how do I pick the right one?

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So again, this is another huge
subject onto itself where there are

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literally hundreds of devices out there

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using variations on several
different strategies for the skin.

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So there are things
like laser resurfacing,

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which is kind of the gold standard for
creating a lot of rejuvenation in the

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skin, addressing wrinkles,
pigment, texture, many,

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many things in the skin,

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but that's something that's most
appropriate during the restoration

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phase. If you're in that stage of aging,

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there are a whole spectrum of
devices that are more focused on

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prevention and earlier restoration.

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So there are many sizes to fit all needs,

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whether you need a little improvement
or more moderate improvement,

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you really can't say, okay,

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here's the device that's
right. Or the best or great,

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because they're all trade offs in
terms of how many treatments you need,

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how much improvement you're likely to get,

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how good a fitted is for your type
of skin and your stage of aging.

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The important thing to remember is
it's always going to be about steps,

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maintenance and prevention is a process.

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It's not an event, so it's not
gonna be something you do once.

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This is an American sentiment.
We want to do one treatment,

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look drastically better,
or be protected forever.

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And it just doesn't work that way. And it,

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and it's very much like dental cleaning.

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You could have the best
cleaning from your hygienist,

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but if you're not brushing
your teeth at home,

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your teeth are going to be
in trouble fast. Likewise,

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you could be brushing your
teeth really well at home,

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but if the hygienist doesn't
occasionally come in and clean off any

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buildup that you're not
able to get at home,

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you're eventually going to get in trouble.

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That makes sense.

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I know we all wish there was this magic
wand that we could wave and somehow

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magically turn into our 20 year old
self. But for now that doesn't exist.

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So overall Dr. Bass,

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what should we remember to stay looking
our best and make 50, the new 30?

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So like every other aspect of our
health care and maintenance has to start

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when we're young. And that makes
a huge difference. You know,

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you can't wait till you're sick to
start taking care of your health.

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You need to be doing sensible things when

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you're young. So start early.

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Do as much as you comfortably can do.

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Most of us don't want to play
with our skin three hours a day,

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but even some skin care
is better than none.

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When you accumulate that over decades,

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you're gonna be in a much better place
if you've been doing something than if

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you just let it go,

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do something that's meaningful for
where you are in the aging process. So,

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you know, if you're in your twenties,
very simple things may be meaningful,

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a little bit of a medicated
moisturized product, uh,

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and a little bit of sun avoidance or
sunscreen use. But as you get older,

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you have to pick other options
to really be having an impact

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on anti-aging, you know, on
prevention and maintenance.

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So this starts with, with
skincare in small ways,

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but increasingly it becomes medical.

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It needs to be managed in
partnership with a professional.

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Eventually you get to a stage of aging
where surgical treatments are going to be

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needed to look your best.

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But these occur later in age and much
later than they used to with good

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skin health and prevention activities.

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Thank you for sharing your
insights with us. Dr. Bass,

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I learned a lot about how modern aesthetic
medicine has provided us with a huge

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repertoire of tools and
techniques to delay aging.

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If you think of other exciting
developments in plastic
surgery that you would

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00:16:13,561 --> 00:16:16,680
like us to discuss in upcoming
episodes, please reach out.

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We'll see you next
time. This is Doreen Wu,

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thanking you for joining Dr. Bass and
me for this discussion of different

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aesthetic treatments designed to
delay the effects of facial aging.

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Be sure to join us next time. And don't
forget to subscribe to our podcast,

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00:16:31,000 --> 00:16:34,260
to stay up to date with all of the
exciting content that is coming soon.

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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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00:17:05,060 --> 00:17:05,893
in this podcast,

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00:17:06,150 --> 00:17:10,200
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
be sure to subscribe to our podcast on

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Apple Podcasts, Google, Spotify, Stitcher,

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or wherever you listen to podcasts.