Life Stage Personal Enhancement:

Avoiding smoking and sun exposure does a lot to help keep a woman's skin healthy -- but the impact of menopause on a woman's internal skin anatomy is often overlooked

By Dr. Robert T. Grant, MD, MSc, FACS

Did you ever wonder why certain celebrities and other high-profile people seem to age better than your average baby boomer or Gen-Xer?

Never underestimate the impact of professional assistance with diet, exercise and fashion -- these folks get plenty of sleep, avoid excess sun exposure and don’t smoke. But what role does plastic surgery play in their aging success?

Women face certain biological realities you should consider when thinking about how you want to face the aging process, foremost among them being the impact of menopause.

Female sex hormones are responsible for much of what is thought to be attractive about skin and its youthful appearance -- smoothness, texture and elasticity. The changes brought about by menopause affect a woman's hormone levels and, consequently, can affect the way her skin looks.

Many of us are aware of how hormone replacement therapy can make women look and feel better inside and out -- but there are real health risks associated with long-term use of hormone replacement therapies.

Yes, avoiding environmental toxins like smoking and sun exposure does a lot for keeping skin healthy, but women considering surgical and minimally invasive procedures to address signs of aging need to think about the impact of menopause on their internal skin anatomy.

What do I mean by this?

Well, the elasticity and ability of the skin to bounce back after being stretched during childbirth, or if one’s weight fluctuates significantly, depends on having normal and appropriate levels of hormones circulating through one’s bloodstream and being delivered to one’s skin. When those hormone levels start to decline, so does a women’s appearance. That’s why a woman's 40s is when she begins to see the changes associated with aging start to accelerate.

This period of time is known as the "perimenopause." Even Oprah Winfrey has taken notice of this phenomenon in women’s aging, noting on her Web site: "If you’re a woman who is planning to live past the age of 35 at some point you are going to face hormone imbalance."

One significant consequence of waiting until your circulating hormone levels have dropped before having plastic surgical procedures is that the skin isn’t as resilient as it was when you were younger – so the results of the surgery may not last as long. In addition, you may require more nipping and tucking than if the same kind of procedure was done when you had a higher level of circulating female hormones.

Fullness of the tissues under the skin of the face also decline as a woman’s hormone levels decrease in the perimenopause. Pulling or tightening skin across a face with lesser amounts of youthful plumpness underneath the surface can sometimes lead to a result that some describe as "overdone."

Modern plastic surgery has responded to the realities of perimenopause by initiating less-aggressive corrective procedures sooner on women before they go through menopause. In addition, an increased role has developed for the use of injectible fillers like Restylane or Juvederm to build up and enhance the fatty tissue layers of the face.

The good news is that many of these "age-maintenance procedures" -- a term I like because it truly reflects what is being done, rather than saying they are "anti-aging procedures" -- utilize techniques that are less invasive, not too pricey and easier to recover from quickly.

I believe one of the reasons high-profile celebrities look so good for so long is that the ones who understand the concept of age maintenance don’t wait to get started. Those who don’t pay attention to caring for their appearance over time look unnatural when they try to play catch-up and have more extensive procedures done all at once later in life. We’ve all seen examples of this: The operations may be a technical success, but the results are so obvious a change that the patient becomes a poster child for excessive or overzealous plastic surgery.

The procedures area of this site offers a sample Life Stage Personal Enhancement program – including the incremental steps that help one avoid the tendency to look overdone.

To summarize: Incremental treatments and procedures done today can help you maintain your best look over time and while you counter the known aging effects associated with perimenopause and beyond. Waiting until your late-50s and into your 60s can result in both sticker shock and a visual shock you may not find appealing.

You have plenty of options, so don’t hesitate to get advice from a board-certified plastic surgeon. Your doctor will partner with you to choose the most appropriate course of action that will help you look and feel your best -- at any age.

To schedule a consultation appointment with my office, please call 212.832.6182 or e-mail inquires@robertgrantmd.com -- we look forward to hearing from you.