‘To get back my youth I would do anything in the world, except take exercise, get up early, or be respectable’
If we cannot be immortal, can at least our youthful looks be maintained? Almost everyone wants to look reasonably young while still living to a respectable old age without serious disabilities. Youth’s attraction is no mystery: evolution wants us to reproduce and so has selected us to find young people attractive, since they are the best reproducers. The same principle has resulted in us finding old faces unattractive. What could we do to avoid changes in our appearance with age? Having the right genes is a good beginning, as is keeping fit and active, and eating the right foods—staying slim is one of the key factors to looking young, but it does not hide wrinkles.
Efforts to hide and prevent ageing are far from being a modern obsession. In Ancient Egypt cosmetics were applied to the face and eyes, and cosmetic implements, particularly eye-makeup palettes, have been discovered in the earliest graves. Honey as well as various herbs and plants were used in an attempt to devise anti-ageing treatments. The aloe plant was commonly used as an anti-wrinkle treatment and is still with us today. Cleopatra is known to have used lactic acid in order to peel her skin, believing it made her appear more beautiful. The arid desert climate of Egypt led to the widespread use of body oils as moisturisers. It is believed that all classes of Egyptian society were concerned with their appearance, both men and women.
This pattern is repeated throughout the ancient world. As now, the focus was on the youthful beauty of women rather than men. The Roman poet Ovid despaired of time’s encroachments: ‘The years will wear these charming features; this forehead, time withered, will be crossed with wrinkles; this beauty will become the prey of the pitiless old age which is creeping up silently step by step.’ Other writers saw the comedy as well as the pathos of the situation. ‘The Man and His Two Mistresses’ is one of Aesop’s Fables, written around 600 BC:
A man of middle age, whose hair was turning grey, had two mistresses, an old woman and a young one. The elder of the two didn’t like having a lover who looked so much younger than herself; so, whenever he came to see her, she used to pull the dark hairs out of his head to make him look old. The younger, on the other hand, didn’t like him to look so much older than herself, and took every opportunity of pulling out the grey hairs, to make him look young. Between them, they left not a hair in his head, and he became perfectly bald.
In a recent survey many men and women said that they are, will be, or were, at their physical peak not during their youth but during their early middle years around the age of 40. Those aged 65 and over said 46 was their personal best age. But in terms of appearance, youth remains the golden age. Marie Helvin, at 54 still a supermodel, said: ‘Please shoot me if I’m doing this in my 80s. Anyway, one day I won’t be able to. My mother always said that Japanese women look youthful for years and then one morning they wake up and they’ve aged like 100 years. And she’s right. It happened to her when she was 79.’
Celebrities and many others have fallen prey to the cloned-youth look. The American anti-ageing magazine New Beauty offers articles on how to get flawless feet, and lists the top ten wrinkle reducers. However, the treatment needed to achieve this youth has, it is claimed, made many women look like waxwork escapees from Madame Tussaud’s. Many have had their faces injected with a filler to remove the creases while others have plastic surgery. In a survey 20 per cent of men said they thought that cosmetic surgery for their wives could save their marriage; it seems no one asked the women whether they would like the pot bellies of their husbands reduced.
Currently the global anti-ageing market for cosmetic products and treatment is estimated to be worth approximately $57 billion, a figure that is expected to grow at breakneck speed in coming years. In the UK cosmetic surgery has tripled in the last five years. Britons are spending nearly £500 million a year on cosmetic procedures, said Which? magazine, more than any other European country. A total of some £673 million a year is spent on skin care, and these figures are dwarfed by figures from the US. Of course not all this money is spent by the old, but anti-ageing products are the largest growing sector. An article in Time magazine in early 2009 introduced the concept of ‘amortality’ when referring to the current attempts to avoid ageing and achieve a leap in life expectancy. Age-appropriate behaviour, it claimed, will be relegated to the past, like black-and-white television. Amortals do not dread extinction—they deny it.
Surveys exploring attitudes towards ageing, beauty and cosmetic surgery can yield varying results. In one survey of some 2,000 Americans aged over 18, as well as 500 who have had cosmetic surgery, almost all of those interviewed were satisfied with the way they look for their age, and over half felt that inner beauty is more important than physical appearance—this was particularly true for the old. Just one in three said physical beauty counts most. More than half believed that men and women age gracefully, and only a quarter of women felt that maintaining an attractive physical appearance was important for them. Most of the women were satisfied with their appearance. After 45, women were more interested in looking good for their age than in trying to look a different age. Agony Aunt Virginia Ironside has commented, ‘I want to look good at my age, but I also want to look old enough for people to open heavy doors for me.’ She also very much appreciates being offered a seat on a crowded bus.
But in another survey, almost three quarters of women cited body shape as a ‘major concern’. Meanwhile, men are also taking more time over their appearance. About 20 per cent said they would consider getting cosmetic surgery in the future, while about 22 per cent were unsure if they would. Those under the age of 40 were nearly twice as likely to consider having a procedure in the future. A study by Which? magazine found that Botox treatments are seen as a desirable Christmas present by 50 per cent of people aged between 16 and 24, and 45 per cent of those aged 55 to 64. A survey of schoolchildren found that 18 per cent of all boys and 25 per cent of all girls declined to imagine any form of enhancement because they saw it as unnatural or simply unnecessary. One girl commented, ‘I wouldn’t want an upgrade because I wouldn’t want to be different. I like being who I am.’
Despite people’s professed opinions, however, cosmetic surgery in general has been growing in popularity in Britain, with a threefold increase in the first decade of the twenty-first century. According to figures released by the British Association of Aesthetic Plastic Surgeons, only 10,700 procedures were performed in 2003, but by 2009, this figure had risen to 36,482. One of the biggest growth areas was in people in middle or late middle age. These figures do not include non-surgical interventions like the use of Botox, which has been increasing even more rapidly. The most common procedures were breast enlargement, liposuction, and eyelid and facial surgery.
In the US, over 10 million surgical and non-surgical procedures were performed in 2008, costing over $11.8 billion. Men had over 800,000 cosmetic procedures. Strikingly, people aged between 54 and 61 had about a quarter of these procedures, and people over 65 much fewer. Over half were for breast augmentation and fat reduction. Plastic surgery of the face can help you feel better, but does not affect what is going on inside the body. Anti-ageing surgery procedures are widely advertised on the internet with the injunction to ‘Get expert free advice’. These include Eye Bag Removal, which can restore a youthful look through the removal of fat and excess skin from both sets of eyelids, and the Brow Lift is a procedure that concentrates on restoration in the upper part of the face, correcting drooping eyebrows and loose skin in that area. Facelift surgery challenges the most visible signs of the ageing process: loose facial and neck skin is removed to produce a smoother, fresher appearance. The operation can take between two and three hours and it is recommended that patients spend at least one night in the cosmetic surgery clinic after the procedure. Liposuction entails the removal of fatty deposits from any part of the body, a process usually taking no more than one and a half hours to complete. The recovery time involved is minimal, with most patients getting on with their lives again within a few days.
Those undergoing or planning to undergo cosmetic surgery still constitute a distinct minority, but the numbers would increase if it could be done safely. As with any surgery, there are some risks associated with these procedures. And not every procedure will have the desired results, as the case of the unfortunate American Jocelyn Wildenstein, who allegedly spent $4 million on facial plastic surgery to please her husband, illustrates. She has been unkindly dubbed ‘The Bride of Wildenstein’, and her horrified husband apparently commented, ‘She seems to think you can fix a face the same way you fix a house.’ But the emotional benefits of plastic surgery results can be many times greater than the physical rewards. If you have felt bad about the way you look, plastic surgery can make you feel better about yourself.
Treatment based on Botox injections is probably the most popular cosmetic surgery worldwide. The adverts refer to the frown lines, crow’s feet and wrinkles around the mouth that can cause a person to look worn out, tired and old. Botox treatments were first approved by the FDA in 1990 for the treatment of eye muscle spasms for those under 65; however, its cosmetic value was quickly realised. Botox cosmetic is an approved trade name for botulinum toxin, produced by the bacterium Clostridium botulinum. When injected in small doses in designated areas, Botox blocks nerves activating muscles responsible for the repetitive action that causes fine lines and wrinkles, and literally paralyses the area. Normal Botox treatment with a doctor will cost about £400, and results can last up to eight months. But it doesn’t always, of course, have the desired effect, and can lead to a face that looks angry as well as to headaches. One actress claimed that it made her look like an extra from the Planet of the Apes.
A multitude of wrinkle creams and lotions sold in chemists and department stores promise to reduce wrinkles and prevent or reverse damage caused by the sun. At the top end of the market, Oro Gold Cosmetics has introduced a set of anti-ageing products (including eye serums, bionic facial treatment and skin moisturisers and other products) infused with 24k gold—which, they claim, but without reliable evidence, has many properties that induce rejuvenation in the skin. But do any of these products actually work? Some research suggests that wrinkle creams do have ingredients that may diminish wrinkles. But according to Mayo Clinic physicians, many of these ingredients have not undergone scientific research to prove their benefit. Creams and lotions may slightly improve the look of your skin, depending on how long you use the product and the type and amount of the active ingredient, but any effects from non-prescription wrinkle creams will not last very long. You’ll have to dab on wrinkle creams once or twice a day for many weeks before noticing any improvement. And once you stop, your skin will very likely return to its original wrinkled appearance, according to dermatologists. Studies have confirmed that more expensive wrinkle face creams work no better than cheaper products.
Which? magazine decided to put anti-ageing creams to the test. It selected 12 ordinary moisturisers and 12 anti-ageing creams. Groups of four women tested each product for four weeks. None of the 96 women knew which product they were using and at the end of the trial they were asked to guess whether they had been using a moisturiser or an anti-ageing cream. Three quarters chose moisturiser. Most had not noticed any difference in the look or feel of their skin, and of the 48 women who had been using an anti-ageing cream, only 10 reported any improvement.
Which? concluded that ‘some of the claims made for the ingredients of anti-ageing creams can be substantiated but, with the low concentrations used in the creams, they are unlikely to do more than moisturise your skin’. There is more support for this view from a beauty-industry insider: ‘There is no miracle ingredient that will take years off your appearance,’ says Gisele Mir, a cosmetic scientist and founder of the holistic skincare range Mir. ‘The only miracle is that the cosmetics industry has managed to persuade us otherwise for so long. In my opinion you can harm your skin by using anti-ageing products. I believe many of these products accelerate ageing rather than prevent it.’ Tretinoin, a derivative of vitamin A, is the only topical medication that has been proven to improve wrinkles.
The advertisements and publicity seem endless. A full-page advertisement in several UK newspapers proclaims: ‘Is your skin ageing too fast? Our scientists definitely think so… Inspired by 25 years of groundbreaking DNA research, Estée Lauder now innovates anti-ageing skincare…’ In the US: ‘Discover the FIVE SECRET RITUALS from a Hidden Himalayan Monastery that Make You Look 30 Years Younger—In Just 10 MINUTES A DAY! $39. This unique complex of Bio Enhanced trans-resveratrol and potent polyphenols and anthocyanins is formulated specifically to fight ageing at both the genetic and metabolic level.’ It is claimed that CoverGirl Simply Ageless Foundation significantly improves skin condition in just four weeks, and super model Christie Brinkley’s affiliation with CoverGirl was a huge success. She said: ‘CoverGirl is part of my DNA and I’m thrilled to be back with my family. I’m excited to promote a new product developed specifically for women like me, who want flawless coverage combined with the latest science in skincare. I’m looking forward to working with the brand at a time when there is so much innovation.’ But there is as little real evidence for the benefits of agents that prevent facial ageing as there is for medical treatments.
In April 2009 there was a report that a new product from the chemist Boots, which works by stimulating the production of a protein that promotes skin elasticity, made a significant difference to the wrinkles of 70 per cent of volunteers aged between 45 and 80. This was a properly conducted trial by the University of Manchester and so seems an important advance. It led to a stampede to Boots’ shops which is still continuing. In one month, February 2010, Boots sold more than 700,000 anti-ageing creams. However, other experts say that only one in five users will get something more than from using common moisturisers. A new product of a quite different nature is a device that electrically stimulates the muscles in the face; there are claims that it is safer and more effective than plastic surgery, and acts due to stimulation of the facial muscles, but there are no reports of proper trials.
The links between ‘expert opinion’ and the commercial interests behind a product are always worth considering. A recent report in the Boston Globe said that when a 73-year-old patient recently asked a prominent dermatologist how she could look more youthful, he had a ready answer. He suggested she visit a drugstore across the street to shop for a specific brand of anti-ageing, wrinkle-fighting, and lip-plumping creams. The products were part of the doctor’s own line of cosmetics.
The use of wrinkle creams twice a day can plump up the skin temporarily, which causes the wrinkles to be less visible. These creams may also be excellent moisturisers, and they may smell and feel good. But no matter how expensive they are and no matter what they claim to do, they won’t turn back the clock. An important way to avoid wrinkles is to practise sensible sun avoidance and use sun screen. Yet are wrinkles really such a terrible sign of ageing compared to certain other indicators?
Weight and other factors can affect how one looks. A study in the USA of the photographs of 186 pairs of identical female twins together with detailed interviews showed surprising results. One twin aged 70 could look six years younger than her sister if she had more weight, as this filled in the wrinkles on her face. Antidepressants and alcohol made a twin look older, as did suntan and cigarettes. Before 40, the lighter twin looked younger and more attractive, but over 40 the heavier twin looked younger, the weight difference being about 24 lbs. So it may well be that what you eat has a more beneficial effect than what you dab on your skin in the war against wrinkles. But being overweight, of course, can have many ageing effects on one’s health.
There are studies that suggest that hair is more important than wrinkles in judging someone’s age—it can make a differences of 4 to 5 years in one’s appearance. Also important is the fullness of lips, which makes a face appear much younger and is almost entirely determined by a person’s genes. This accounts for the large number of cosmetic surgery procedures for lips, some leading unfortunately to ‘trout pout’.
It is reassuring to learn from the attitude surveys that many think real beauty comes from the inside, not the outside. And in spite of the enormous amounts of facial treatments to avoid looking old, there are those who argue that we should learn to live with this universal process. Anne Robinson, a well-known TV presenter in her 60s, had a facelift at 61 and currently uses Botox. An article in the Daily Mail recognises that it is tough to still be a TV presenter at her age; but would it not be better, it argues, for someone like Robinson, who is a role model for women, to champion the rights of women as they grow old? When women like her resort to cosmetic surgery it puts unwelcome pressure on women of a similar age. As a cosmetic surgeon comments, facelifts are dangerous, and he is dismayed that injectible fillers for wrinkles are advertised on TV.
All these procedures can lead to an obsessive desire to achieve an ideal beauty. An article in the London Evening Standard offered ten tips to make ladies look ten years younger: remove dead cells from your skin using a wrung-out face cloth every night; fill out the volume of your face with injections; get baby Botox to get rid of embedded frown lines; wear sunscreen every day; use an expensive serum to exfoliate; get rid of uneven skin tone using a light concealer; get made up by an expert; get advice on hair colour and shape; tint eyelashes and eyebrows; make sure your teeth are a harmonious shade of pale. How much time will be left in the day for life’s other pleasures?
Oscar Wilde found a way to prevent the signs of ageing in The Picture of Dorian Gray. Dorian is a cultured, wealthy, and exceptionally good-looking young man who has his portrait painted. He curses his excellent and attractive portrait, which he believes will one day remind him of the looks he will have lost as he ages. In a fit of distress, he pledges his soul if only the painting could bear the burden of age and infamy, allowing him to stay young for ever. This wish is fulfilled and he does not show signs of ageing, but the portrait does. Only when he dies does the portrait turn back to a youthful image, while his body show all the wrinkles. A well-known quotation from the book says: ‘The tragedy of old age is not that one is old, but that one is young.’
Perhaps Lucille Ball got it right: ‘The secret to staying young is to live honestly, eat slowly, and lie about your age.’