Davis

Most of us are super-tuned-in to the first signs of aging on our faces. (Isn’t that why the mirror was invented?!) All the while, the hands are more likely to betray our ages.

Just like the face, the soft tissue in our hands that gives them volume gradually diminishes as we age, which makes the veins, tendons, and bones much more prominent.

Our hands also see as much sun as our faces, sometimes even more. The face is the first place we’ll apply sunblock, in large part because we’re so sensitized now to the sun’s aging effects, but who thinks about protecting their hands? We really should, because all that exposure can lead to hyperpigmentation as we age.

Hindsight is 20/20. Fortunately, there’s a range of remedies that’ll undo the ravages of time and leave your hands looking as young as you feel.

Hyperpigmentation treatments

Topical skin care products for home use are the least aggressive track to help combat hyperpigmentation.  We know there’s no shortage of over-the-counter serums, peels, and creams that treat sunspots and pimple marks, but if you’re truly bothered by those dark spots, the best thing you can do is see a board-certified plastic surgeon because they’re all far more effective after a plastic surgeon’s been able to lift and lighten the brown with professional-strength chemical peels and calibrated lasers.

A plastic surgeon with lots of experience in treating hyperpigmentation will know to be very careful with their approach. Even a well-meaning laser can ignite pigment rather than extinguish it. The least aggressive tack by a plastic surgeon or medical aesthetician is usually a series of mild chemical peels. For dense spots, lasers are more effective, such as IPL – intense pulsed light.

Dermal filler

Restylane Lyft, a hyaluronic acid filler, made headlines last year when it became the first injectable of its kind to be approved by the FDA for use outside of the face.

An injection underneath the skin on the back of the hands but above the connective tissue that covers the tendons, bones, blood vessels, and nerves has been shown to improve age-related volume loss for up to six months.

There may be some mild swelling, tenderness, or itching afterward, but it’s typically short-lived.

Fat transfer

An autologous fat transplantation, or, simply, a fat transfer, is a cosmetic surgical procedure where your own processed fat is used to re-contour and smooth your hands.

Fat cells are removed by liposuction—usually from around the belly button or the thighs or buttocks—with a small needle attached to syringe. They’re then sterilized and processed and injected into the back of the hands.

Generally, the results from fat transfer is about 50% permanency, and you could possibly want a second treatment to reach your desired look.

A topical or local anesthesia is applied to the area where the fat cells are taken from and the backs of the hands. The procedure should only take an hour or so, about 10 to 15 minutes to remove the fat cells and then another five to 20 to inject them into each hand. The results can last up to several years.

In an earlier post, I discussed how to go about restoring a more youthful appearance to aging eyes through cosmetic surgery. Here, I’ll get into a less invasive approach: under-eye dermal fillers.

As we age, those dark circles under our eyes become more pronounced. Doctors call them tear troughs. The skin around your eyes is thinner and paler and lacking the proper fat restores, so the indentations grow a little deeper, giving the eyes a more tired appearance, even if you feel as vibrant as you did 20 years ago.

It’s a pretty common issue. Everyone has a natural indentation above the rim of the bone that encircles the eye, but some are deeper than others. Thank your parents. Those dark circles can also be affected by sun exposure, allergies, dehydration, and insufficient sleep. So there are natural ways to stave them off, like wearing sunblock, staying hydrated, and getting enough sleep, but dark circles will still worsen as we age.

The wonder that is hyaluronic acid

Enter under-eye dermal fillers. They’re injectable treatments of hyaluronic acid—the most common brand names are Juvederm and Restylane —that stimulate the appearance of thicker fat pads under the skin.

Hyaluronic acid is a natural part of the skin’s dermis, but it diminishes as we age, which causes the undesired hollowing effect under the eyes. The hyaluronic acid in fillers helps pull water to the site of the injection, creating a plumper under-eye.

A series of injections are placed under your eyes. A topical numbing agent can be applied beforehand to ease any discomfort, but the injections are virtually painless. (It’s a very small needle.) In all, the procedure should only take about a half-hour. The cost starts around $300 with individually tailored treatment plans, and the results last up to a year.

The recovery is minimal: You’ll need to avoid intense exercise for the first 24 hours, and you may need to ice your under-eyes if you start to feel any discomfort around the injection sites. That should be the full extent of it.

Experience still matters

As simple as the procedure may sound, it’s important to find a board-certified plastic surgeon that has lots of experience injecting under the eyes.

No two fillers behave exactly the same way. So it’s crucial that the injector understands the differences between the products and the areas where they’re most appropriate. Use the wrong filler in the under-eye area and you’ll run the risk of creating an unnatural look or creating an even bigger problem.

The right product in the right hands, however, could restore years to your appearance in less than an hour.

As we anxiously await some more pleasant weather, it feels like the right time to discuss updating your skin protection regimen. It turns out, the sun isn’t the only threat, and you don’t even need to set foot outside to feel the effects of another.

I’m talking about blue light. The main source of our exposure to it is the sun, but we’re also getting our fill of it from our screens and indoor lighting. It’s been garnering increasing attention over the last few years after a few small but potentially groundbreaking studies came to light.

One found that exposing skin to the amount of blue light we get from the sun caused more pigment, redness, and swelling than when the same person’s skin was exposed to comparable levels of UVA rays. Another suggested that blue light might stimulate the production of free radicals in skin, which can speed up the appearance of aging.

Let’s unpack that and discuss what you can do about it.

How damaging is blue light, exactly?

Blue light isn’t all bad, actually. It helps regulate our natural sleep-wake cycle, for one. (Though, too much of it may make it more difficult to fall asleep.) It’s also been found to elevate mood and help memory and cognitive function.

But that early research I referenced doesn’t paint such an inviting picture. A lot more research still needs to be done before we can draw any meaningful conclusions, but the evidence so far does seem to suggest that it has the potential to be damaging to our skin.

Some of that has found that as blue light penetrates the skin, it leads to DNA damage, which spurs inflammation and the breakdown of healthy collagen and elastin, along with hyperpigmentation.

It’s still hard to say whether our screens produce enough blue light to cause serious skin damage. Though, it’s not hard to envision a scenario where the longer we spend on our devices, the worse off our skin might be. And make no mistake; we’re spending a lot of time on our devices. A 2016 report found that adults log more than 10 hours of screen time a day.

At least one prominent dermatologist has been quoted as saying, “Spending four eight-hour workdays in front of a computer screen exposes you to the same amount of energy as 20 minutes in the midday sun.”

What can you do about it?

Before we discuss your skin protection regimen, find the “night shift” (or “night mode”) setting on your phone and tablet and set it to run all the time. That’ll effectively disable the blue light emissions from those devices.

Now, as for your regimen, a quick search will yield lots of new topical antioxidants that are designed to boost our skin’s natural defense system against blue light and environmental stressors. I offer what I believe to be the most effective formula on the market, SkinMedica’s LUMIVIVE. It’s billed as “full atmospheric protection against blue light and pollution.”

LUMIVIVE is a two-step system. The Day Damage Defense Serum provides protection all day long while the Night Revitalize Repair Complex enhances the critical sleep-repair cycle. Together, they can offset the 10 hours, on average, we spend in front of a screen each day and restore your skin’s radiant glow within 14 days.

In time, it may become as essential as your broad-spectrum SPF.

The face you see looking back at you in the mirror as you remove your makeup each night, does it look tired?

Inside, you may feel as vibrant as you did in your twenties. But your eyes are telling a different story to everyone you come in contact with.

Cosmetic eyelid surgery is a way to align those two versions of yourself. It restores a more refreshed and naturally youthful appearance to aging eyes.

Here’s what eyelid surgery, or blepharoplasty, can treat:

• Loose or sagging skin that creates folds around the upper eyelid
• Fatty deposits that appear as puffiness in the eyelids
• Bags under the eyes
• Drooping lower eyelids
• Excess skin and fine wrinkles of the lower eyelid

What’s eyelid surgery like?

Eyelid surgery can be performed on your upper eyelids, lower eyelids, or both. Your plastic surgeon will determine how much skin, and/or fat to remove based on a thorough pre-operative evaluation.

From there, your surgeon will make precise markings to indicate where the excess tissue will be removed. In the upper eyelid, the incision will be hidden in the natural fold of the upper eyelid. In the lower eyelid, it’ll be hidden just below the lower lashes. When excess fat is removed, the incision can also be placed inside the lower eyelid, in which case a laser is sometimes used to tighten the lower eyelid skin.

The excess tissue will be removed with scalpels, surgical scissors, radiofrequency cutting devices, and, sometimes, cutting lasers. Less tissue will be removed if you have dry eyes because exposing more of your eyes to air could worsen your symptoms.

Fat is sometimes redistributed in the lower eyelids to eliminate puffiness or bulges. In the process, your surgeon may also make adjustments to correct special issues, like muscle laxity.

Sutures or glue are then applied to smooth and reconfigure the areas around the eyebrows and eyelids. The sutures are invisible to the eye and usually self-dissolving. In most cases, there are virtually no detectable scars. A laser may also be used to resurface skin and smooth wrinkles in and around the eyelids.

The surgery is performed as an outpatient procedure and usually lasts between 45 minutes and two hours. Depending on the extent of yours, you’ll be given either general anesthesia or local anesthesia with IV sedation.

Eyelid surgery alone can significantly rejuvenate your appearance, but it’s also commonly combined with other complementary procedures, such as a facelift, brow lift, or both. A brow lift will address the sagging skin and deep furrows above the eyes, while a facelift will resolve jowling, sagging, and wrinkles on the cheeks and neck.

How about the recovery?

During the first few days to a week following eyelid surgery, it’s common for patients to have some visible bruising and swelling. Their eyelids may also feel unusually tight and more bothersome than normal. This can often be relieved with cold compresses.

Most are fit to return to work within five to seven days. For the first few weeks back, you can expect your eyes to get tired a little more quickly than usual. You’ll also need to avoid lifting, straining, and bending down to pick things up for about two weeks. And it’s critical that you protect your eyes from the sun and wind.

The effects of your eyelid surgery, with a healthy lifestyle and a good skincare regimen, should last for years. Nothing stops the aging process, but your results will age naturally with you.