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Anti-Aging: Dreams fulfilled...or empty promises?

Article-Anti-Aging: Dreams fulfilled...or empty promises?

Anti-Aging: Everyone is talking about it.

Dr. McDaniel
What is anti-aging really all about? Is it about "age reversal" — using cosmetic surgery to make an older body appear younger, but not necessarily healthier? Is it about aging more slowly and extending longevity — "longevity medicine" without regard to appearance? Is it about "wellness" and optimizing bodily functions so that the body ages at the slowest possible rate based on an individual's genetic makeup? Is it about altering the genetic "engineering" so that one ages more slowly and extends longevity to a greater degree than was originally genetically programmed into the body? Or is it some combination of these?

If you had to choose, would you rather be biologically younger — or look physically younger? Most of us, as cosmetic surgeons, have been grappling with some of these issues our entire careers. Much of what most of us do on a daily basis at present is actually "repair work" to try to mitigate some of the visible effects of aging — or, more accurately for most patients — "premature" aging. This premature aging is frequently the result of lifestyle decisions, such as sunbathing, smoking or lack of exercise.

Some of what we do, however, is reconstructive repair of trauma, surgery, disease, birthmarks and a host of other problems that were not self-inflicted. We also try to give wise counsel to our patients to motivate them to make "more healthy" lifestyle decisions and to avoid or at least minimize the types of environmental exposures that cause premature aging.

Many of these environmental factors have at their core exposure to various types of oxidative stress. One of my cosmetic chemist friends likes to say, "You're not just aging, you are oxidizing." How true! The "rate of oxidation" and the body's inherent defense mechanisms, combined with one's genetic code, profoundly impact the rate of premature aging versus "natural" or intrinsic chronological aging.

Think for a moment about the patients we see who just look younger than their peers — often despite abusing their bodies. Usually we are told "This runs in my family." Likewise, some folks just look old for their age, even with healthy lifestyles.

The outer and the inner

Is outward appearance truly reflective of biological health and aging? Does outer beauty as any culture defines it actually correlate with longevity (not the various sociological benefits such as higher income, etc., of being attractive, which are well-documented). We know "inner beauty," a positive attitude and certain other attributes are correlated with better health and longevity. Are some of our patients "whitewashed tombs"? That is, they look great on the outside due to our cosmetic skills and artistry, but they are "rusting out" on the inside?

What is our responsibility as cosmetic surgeons to provide better advice about these issues? Anti-aging medicine is a very complex and rapidly changing field that is emerging into a specialty of sorts. We live in an age of information explosion. Some days my patients are more challenging than are the residents and fellows — asking me about growth hormone therapy, or showing me their Internet research about new cosmeceuticals or dietary supplements. Our patients are well-equipped with knowledge that rivals or equals our own.

Genetic testing issues are just around the corner. There are many questions — and distressingly few scientifically sound and time-proven answers to many of them. Our patients and the consumer public look to us as physician-scientists-healers for answers. They don't want to age prematurely and they don't want to look older than they feel.

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