5 Proven Steps TO LOOKING YOUNGER NOW TABLE OF CONTENTS:
Is your face showing your age? ………….…4
STEP 1: Screen Yourself……………….….……..10
STEP 2: Your Surroundings…………….……..14
STEP 3: Feed Your Skin…………………...…....17
STEP 4: Skim Off the Top……………….……..21
STEP 5: Relax Your Muscles …………………24
Getting Started ……………………………..……27 INTRODUCTION Is your face starting to show your age?
Wrinkles around the eyes are often the first signs of facial aging.
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The first signs of aging are subtle but definite. Aging usually starts around the eyes because your eyelid skin is very thin. You may notice that the smile lines or “crow’s feet” radiating from the outer corners of your eyes are just barely noticeable even when you’re not smiling, as if they were faintly etched in your skin.
You might see the same etching on a few other places on your face, including the horizontal lines across your forehead (from raising your eyebrows), the short vertical “11” lines between the eyebrows (from scowling), and the smile lines that run vertically from the sides of the nose to the outer corners of the lips called the naso-labial creases (from smiling).
These creases are the result of the repeated expressions you’ve made over your life. When you talk and laugh your brain sends signals to the muscles in your face to contract in a way that conveys your emotions. The muscles shift, tighten, and relax in a pattern that transmits forces to the skin, pulling it in different directions. There is a fold created at the skin-muscle connection point, and eventually the fold can develop into a fixed crease. There actually is a change in the configuration of the skin layers that represents a wrinkle.
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At what age would you want to freeze time?
If you could pick an age when you looked your best and freeze the clock right then, when would it be? At 20 when your skin was smooth and supple? At 30 when you had some slight expression lines that added some character?
At some point in your life, you will probably feel there is discordance between the way you want to look and the way you actually look. There is nothing wrong with wanting to hold on to that ideal image of yourself, as long as you maintain a realistic self-image (meaning you shouldn’t expect to look 20 when you are 70).
Fortunately, measures can be taken within the framework of natural senescence that can shift your apparent age to the more youthful side of the spectrum. You can adjust your environment, your behaviors, and even the cellular structure of your body to extend your youthful appearance by many years.
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Do you look like your parents?
Photo credit: Sam Beebe
There are other influences on when and how you develop wrinkles. Your genetics determine the basic composition of your skin and the arrangement of the muscles and fat in your face. If one of your parents has a strong smile muscle with tight attachments to the skin alongside the outer corners of your mouth, you may share similar “parentheses lines”.
The same familial traits can determine your body’s response to external forces. Those forces include sun exposure, smoke, toxins, physical forces such as the way your face presses against the pillow at night, dryness, wind, fragrances, the foods you eat, injuries, illnesses, medications, microbes, and other organisms. If you inherited the genes for red hair from your parents, the chances are that you also inherited very light skin which may burn more easily when exposed to sunlight as compared to someone else who inherited darker skin. You can thank your parents for the foundation of your appearance, and then you can take steps to achieve your best and healthiest version of you.
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The Earliest Signs of Eyelid and Facial Aging
Crow’s feet- The wrinkles that radiate from the outer corner of the eyes when you smile
Horizontal forehead lines- The creases across your forehead when you raise your eyebrows
Under-eye shadows- Dark circles caused by bulging lower eyelid fat and upper-cheek hollowing
Loss of cheek fullness- Sunken or deflated cheeks caused by shrinking of facial fat with age
Brown spots- Signs of UV damage
Sagging upper eyelid skin- The thin eyelid skin has an early tendency to stretch
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Graceful aging doesn’t always happen on its own.
Your apparent age (as opposed to your actual age) is partially determined by your actions once you identify some of these early aging signs. If the early stages of wrinkles and sun damage bother you when you look in the mirror, this is the time to act if you have not already done so. Where do you start? The next 5 chapters will get you started.
Page 9 STEP 1: SCREEN YOURSELF (from the sun)
Basking in the sun is one of the fastest ways to age your face. Early and frequent sun protection prevents wrinkles and loose skin.
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The most important anti-aging action you can take is to wear sunscreen every single day.
You should be very diligent about this throughout your life. If you didn’t pay much attention to sun protection in your teens and 20’s, you should start now, even if you have a darker skin type. The ultraviolet radiation emitted by the sun leads to a process called solar elastosis. This consists of degradation of collagen and elastin in the deep skin layer called the dermis. Loss of the building blocks of the skin causes acceleration of wrinkles and sagging.
A 2013 Australian study published in the Annals of Internal Medicine followed 900 people from ages 20-55 to test the effects of sunscreen on facial aging. Half of them were asked to wear sunscreen every day and the other half were asked to just follow their usual routine. After 4 ½ years, the sunscreen users were shown to have halted the appearance of skin aging. UV protection can actually stop your face from aging.
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Sunlight can also cause brown spots, as it stimulates your melanocytes (pigment producing cells) to make more skin pigment. The blood vessels in your skin will also enlarge or dilate, causing more redness. Sun exposure (and tanning beds) can also cause abnormal growth of skin cells, leading to certain skin cancers. Basal cell carcinoma, squamous cell carcinoma, and melanoma can all arise on sun-exposed skin areas. Reducing your cancer risk alone is a good enough reason to be diligent about sun protection.
You should look for a sunscreen that offers UV-A and UV-B protection, and is at least an SPF 30. The American Academy of Dermatology recommends at least an SPF 15, but SPF 30 has been shown to be more effective. SPF greater than 50 does not offer any additional benefit and the FDA has eliminated sunscreen label claims greater than 50.
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Many people forget about the lips, but you can get skin cancer there too. There are lip balms that have built-in sun protection. Sun protection is important year-round, even when it’s cloudy and cold outside. If you stick to only one thing in your looking great plan, this is the one that will be the most worthwhile.
The best sunscreens use physical barrier agents rather than chemical ones. The ingredient to look for is zinc oxide (or titanium dioxide). The micronized forms of zinc oxide in newer sunscreen products allow for a clear application that doesn’t leave you with a pasty, ghost-like appearance. Avoid oxybenzone which has been shown to have hormonal side- effects.
Steps you can take right now An effective routine is to wash your face in the morning, apply any topical creams (like a vitamin C) or moisturizing agents, wait a few minutes, and then apply a broad-spectrum sunscreen of at least SPF 15, preferably SPF 30 with zinc oxide or titanium oxide as the main ingredient. Makeup should be applied last.
Page 13 STEP 2: CHANGE YOUR SURROUNDINGS
To some degree, you have control over your surroundings, and these surroundings definitely influence how you look.
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The sun is one of the most damaging environmental factors from an eyelid and facial aging standpoint. There are other important elements around you that can make you look older.
Do you spend a lot of time around chain smokers? There is a link between cigarette smoke and wrinkles. Smokers also develop sagging upper eyelids and lower eyelid bags earlier in life. A 2013 Ohio-based medical study of twins in which only one of the pair was a smoker showed more pronounced eye bags and wrinkles around the mouth in the smokers as compared to their healthier counterparts. It was clear to observers which of the twins smoked based on the appearance of their faces alone.
Do you spend a significant part of your day driving a car? Drivers tend to get more sun exposure on the left side of their faces and in fact more skin cancers occur on the left side of the face as compared to the right side. UV rays penetrate glass and the only way to deter them is with sunscreen or an approved UV filtering film on your car window.
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Are you a stomach sleeper? Pressing your face against the pillow for the length of the night can lead to sleep lines, vertical wrinkles caused by folding of the skin. Side- sleeping is less likely to cause sleep lines and back sleeping is probably best for beauty. Or you may consider an anti- wrinkle pillow that shifts the pressure points to the periphery of your face where the skin is less prone to pressure-related wrinkles.
Is the air in your bedroom dry or moist? Dry air surrounding you while you sleep can dehydrate your skin.
Steps you can take right now
Take an inventory of your environment. Think about how and where you spend your time and how that may affect the health of your skin. Avoid smoke. Wear sunscreen as part of your daily routine, even while driving. Place a room humidifier in your room if the air is dry. Avoid stomach sleeping- you can even find special pillows that reduce skin creasing during sleep.
Page 16 STEP 3: FEED YOUR SKIN
Photo credit: Gabriel Hess
Vitamins nourish your skin, particularly vitamin C and vitamin A.
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If you were to buy every skin product on the market that claims to make you look younger you would have to take out another mortgage. There is a simple way to cut through the cosmetic marketing noise and develop a skin program that works. Stick with the basic, proven vitamins that promote younger skin; there are 2 that matter.
A proven way to reduce the earliest signs of facial aging is to use a topical vitamin C product every morning. Vitamin C, a potent antioxidant has been shown to reduce wrinkles and repair skin damage. It is a required factor for collagen synthesis and it protects the skin from UVA and UVB damage. Using a vitamin C cream or serum at the beginning of the day will enhance the effectiveness of sunscreen while fighting wrinkles. It also inhibits the production of melanin (pigment) in the skin, so it can reduce the visibility of brown spots caused by sun damage.
There are different forms of vitamin C found in skin products and not all are equal. L-ascorbic acid is a potent form of vitamin C derived from fruit. It is in the majority of topical vitamin C-based skin care products due to its effectiveness and potency. However, l-ascorbic acid is sensitive to heat, air, and light and is subject to degradation. As the product oxidizes or breaks down, it turns brown; a sign that it may no longer be useful. It should be kept in a cool, dark place and once it is turning brown, you should get a replacement.
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Another clinically-proven method of wrinkle reduction is topical vitamin A. Effective forms of this vitamin in skin products are called retinol or tretinoin. It works by increasing glycosaminoglycan production in the skin which acts to retain water and promote hydration and suppleness. Glycosaminoglycans are long chains of sugars that bind water molecules. Vitamin A also increases skin collagen, reducing wrinkles and improving the overall thickness of the skin. Type 1 collagen is the major structural component of the dermis. Generally, having more collagen results in smoother skin.
Topical vitamin A should be applied before bedtime, as it can make the skin more sensitive to light. It can also have a drying effect, and if you experience peeling and flaking, it may be advisable to use a lower strength or reduce the frequency of application to every other night. Some vitamin A products are combined with a moisturizer to prevent the chance of peeling and dryness. Over-the-counter vitamin A creams will be milder than prescription-grade products. Choose based on your doctor’s suggestion and your skin’s tolerance for topical products.
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If you only use two skin products in your anti-aging regimen, for most people a topical vitamin C in the morning and a vitamin A at night will give you the most bang for your buck (in addition to daily sunscreen). There are other products that are appropriate for specific skin conditions, but this is an effective combination to reduce and prevent wrinkles and skin damage.
You can and should use these products on your eyelids, since the skin around your eyes tends to show the first signs of aging. Take special care and apply sparingly around the eyes to prevent products from getting in the eyes. Because the eyelid skin can be more sensitive than the rest of the face you may wish to treat this area every second or third day to minimize irritation. Steps you can take right now
Use a cream or serum containing L-ascorbic acid (vitamin C) in the morning before you apply sunscreen. Start a nightly cream with tretinoin or retinol (vitamin A). If it is irritating to your skin, use every second or third night.
Page 20 STEP 4: SKIM OFF THE TOP (resurface)
Photo credit: Paul Stevenson
The outermost layer of your skin consists mainly of dead cells. Your skin is refreshed after skimming this layer away.
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There are a few gentle treatments that can be extremely helpful at the earliest signs of aging. Exfoliation fits into this category. The idea behind exfoliative treatments is that by removing the outermost layer of skin called the stratum corneum, which mainly consists of dead cells, a smoother surface is created that can be more easily penetrated by the topical products you are using to nourish the skin. Exfoliation treatments also accelerate the natural skin regeneration process, leaving your skin looking more supple. With repeated treatments, there can be some reduction in wrinkles and irregularities.
Alpha and beta hydroxy acids are great ways to exfoliate and they often come in the form of a cream or a cleanser. Alpha hydroxy acids (glycolic acid, citric acid, lactic acid, malic acid) are best for normal to dry skin. Beta hydroxy acids (salicylic acid) are better at penetrating oil so they work best for more oily skin types. These products can be used daily and should be used before your other products. Make sure you are following these with your daily sunscreen.
Microdermabrasion is another way to exfoliate your skin using mechanical forces. It’s most beneficial one or two days before a social event when you want to have some extra glow. Microdermabrasion machines are medical grade devices that use a sandblasting mechanism or a rotating burr to sweep the skin surface.
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Microdermabrasion is not to be confused with dermabrasion, a much more aggressive and somewhat more risky procedure only performed by physicians that grinds away skin to a much deeper level in the dermis, often to the point of bleeding. Microdermabrasion and facial scrubs are gentler and much safer.
Some of the handheld brushes (like the very popular Clarisonic) that can be purchased for home use can also do a great job. Cleansing scrubs are another way to get a similar result. Some products will use sugar grains to rub away the unwanted surface skin debris. Mechanical exfoliation is only necessary about two times per week for most people.
Steps you can take right now
Invest in an exfoliating scrub or home-use cleansing brush and use 2-3 times per week. Start using a hydroxy acid cleanser. Consider a medical-grade microdermabrasion treatment a few days before a special event.
Page 23 STEP 5: RELAX YOUR MUSCLES
Lines and wrinkles around your eyes are caused by repeated muscle contraction. Targeted muscle relaxation softens these wrinkles.
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At the earliest signs of aging around the eyes, topical creams, sunscreen, and exfoliation can go a long way. The movement lines however, may require more than home maintenance if they are starting to become visible when your face isn’t making expressions. This is especially true when it comes to the vertical lines between your eyebrows, the horizontal lines across the forehead, and the crow’s feet. These lines are caused by frowning, smiling, and raising your eyebrows; the normal expressions you make during conversations. Deep lines in these areas can convey a harsh, tired, or angry look.
The best way to reduce these lines and prevent them from getting deeper is with a purified protein called botulinum toxin, most commonly known as Botox (also Dysport or Xeomin). Botox placed in the proper locations will relax the frowning muscles around the eyes and forehead, softening the unwanted creases and preventing their progression. There is a perception that Botox creates a frozen appearance, but when it is expertly administered, the result is a natural, softer look instead of a frozen look.
Before and After Botox for crow’s feet
Page 25 5 Steps to Looking Younger Now The benefits of Botox generally last about three to six months, and while the treatment reduces harsh creases, it can also give you a flattering lift to your eyebrows. Many people who have a tendency to get frequent headaches find significant relief after undergoing this treatment, especially if muscle tension is their headache trigger.
Botox is both a preventive treatment and an aging- reversal treatment. If you have fine expression lines it can eliminate them and at the same time it can stop them from becoming worse.
Botox is currently the most popular cosmetic procedure in the world. Why? Because it is extremely safe, extremely effective, it has no downtime, and when done by an expert it is natural- looking. Steps you can take right now
If you wish to reduce frown lines and crow’s feet lines and prevent them from getting worse, schedule an appointment with a cosmetic eyelid and facial specialist.
To schedule a personal consultation with Dr. Kotlus, click here.
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Now is the time to
Photo credit: Lindsay Sherbert
You are never too young to start thinking about wrinkle prevention, because your expressive eyelids frame your glimmering eyes and your skin is the beautiful wrapper that packages your beautiful body. Why wouldn’t you want to take care of them? I have a lot of patients in their 70’s and I never heard one say they took too much care of their skin. I have heard many of them say they wished they protected themselves better from the sun and maybe they wouldn’t have so many wrinkles or occurrences of skin cancer. The days of slathering baby oil on your face and laying out in the sun with a reflector are over. If you start an effective anti-aging plan today, you may avoid or postpone a surgery or laser procedure many years from now.
A youthful face is attractive. Studies have shown that attractive people are more successful in business. People who feel attractive tend to have more self-confidence. Now is the best time to look and feel healthy.
Page 27 If you’re interested in looking younger now with the assistance of an expert cosmetic eyelid and facial surgeon, request a personal consultation with Dr. Kotlus.
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About Dr. Kotlus:
Dr. Kotlus is certified by the American Board of Cosmetic Surgery, the American Society of Ophthalmic Plastic and Reconstructive Surgery, and the American Board of Ophthalmology
His offices are in New York City and Westchester, NY
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