Special to the Maine Sunday Telegram

Who hasn’t looked in the mirror and hardly recognized the person looking back?

As we age, our skin tends to sag and wrinkle, our teeth to yellow and our muscles to lose tone. Energy levels decline and hormonal changes make it harder to maintain an ideal weight.

These changes are, of course, natural. However, they may not be inevitable, thanks to the availability of a wide range of facial, dental and body treatments.

Mainers may not talk openly about anti-aging treatments.

“It’s more accepted in urban areas,” says Michele Smith, physician’s assistant with Plastic and Hand Surgical Associates in South Portland. “In Maine, people are more private generally. They may (get treatments) but keep it secret.”

Smith is happy with — and comfortable talking about — the work she herself has had done, including a chin implant, upper eyelid lift and regular facial injections.

Just recently, she got Botox injections throughout her face, including the forehead, frown lines, corners of the eyes and the chin-lip area, along with wrinkle-filling injections of Juv?rm (hyaluronic acid).

“My husband says it’s taken 10 years off my face,” she says of the results — including lifting her forehead and mouth and opening up her eyes — which are similar to possible surgical results.

“It was getting time to do my eyelids again, but then I thought I’d try Botox instead. It can be more cost-effective” than surgery, she says, even though Botox lasts only a few months.

Smith acknowledges that Botox can be overdone, leading to lack of facial expression. Properly done, it relaxes — not freezes — the muscles, for a subtle effect, “so that you look not different but better,” she says. “That’s what plastic surgery is all about.”

Before choosing a procedure, it’s important to discuss goals with a professional.

In initial consultations with potential clients, “once I see the skin, I can give them realistic expectations,” explains Kathy Leighton, lead aesthetician with Plastic and Hand. “Then we’ll analyze their options. Sometimes people ask for a treatment that they may not need.”

Sydnee Zisumbo, aesthetician and patient coordinator with York Plastic Surgery and Aesthetic Center, sees patients who seek surgery when less drastic measures would suffice. “Good skin care can reverse damage, when you get your collagen stimulated and working again,” she says.

“You might not need that facelift down the road,” adds Peggy York, site director of Spa Tech Institute in Portland. “A huge part of looking youthful is having glowing, supple skin,” which she says sustained skin care, especially with the right essential oils, can provide.

Skin care starts with the basics: cleanse, tone and moisturize, with high-grade products. (Percentages of active ingredients in over-the-counter products are often too low, says York.)

Professional facials involve deeper cleaning and moisturizing, plus facial massage and application of masks and sometimes serums. The massage is important, York explains, to exfoliate and stimulate circulation. “It also gives stress relief, which can help balance hormones,” she adds.

Facials are preventive by nature, with cumulative anti-aging effects, while peels and other more intensive treatments reverse wrinkling, pigmentation and other damage more dramatically.

Centers like Plastic and Hand and York Plastic Surgery offer facials and peels, microdermabrasion or vitamin A (retinol) treatments to “retexturize” the skin and Intense Pulsed Light therapy to stimulate collagen and reduce pigmentation and capillary damage.

At a higher level (of both intensity and expense), laser therapy is used to “remodel, tighten and regenerate” collagen, smoothing fine to medium wrinkles. “As we age, our collagen fibers stretch,” explains Leighton.

Injections are the next step up, and Zisumbo has seen them rise in popularity in the last year, as people learn about other measures to take before resorting to surgery.

Both Botox and Juv?rm help eliminate wrinkles, one by relaxing the muscles and the other by filling in the lines. Both provide instant results, without surgery’s recovery time.

The most difficult problem to treat nonsurgically is sagging. Some people really won’t get the results they want without a facelift, Leighton says. “It’s important for us to be honest about that,” she adds.

Facelifts are offered at different levels, depending on the degree of facial laxity (sagging) and wrinkling. They don’t necessarily cause extreme appearance changes, like those we see (and may ridicule) on some celebrities. The results “depend on the doctor and on the patient’s preferences,” says Zisumbo.

Eyelid lifts require less recovery time than facelifts and may not require general anesthesia. Lower eyelid lifts are useful for under-eye bags, while upper lifts handle drooping (and may be covered by insurance, if vision is obscured).

For the body, tummy tucks and liposuction are popular. Both men and women choose tucks after weight loss. Men often opt for liposuction for “love handles,” while women tend to target the thighs and abdominal area.

Liposuction isn’t a weight-loss procedure, Smith emphasizes. “It’s for fat that won’t go away, even with exercise and diet,” she says. For liposuction to be effective, the skin needs enough elasticity not to sag after fat removal.

Cosmetic dentistry is another option for turning back the clock. Kelly Lynch, office manager for Gentle Dental Care in Arundel, has seen powerful results in patients who received veneers or crowns.

She recalls a woman in her 50s who recently had a complete smile makeover, with a dramatic anti-aging effect. “Now, her smile is as beautiful as she is, inside and outside,” she says. “It’s a natural smile, and nobody would know that work had been done.”

When the teeth are in good shape otherwise, bleaching can reverse the yellowing that occurs naturally with age. Gentle Dental Care offers both single in-office treatments and custom-made trays and gel to use at home over the course of a couple of weeks.

Some procedures may be health-oriented, not overtly cosmetic. For example, many people receive crowns or dental implants for health reasons, but enjoy side benefits of improved appearance and self-esteem.

York notes that more global measures can have a powerful anti-aging effect. Expert in skin care, massage and polarity therapy (all taught at Spa Tech and offered in its student clinics), she considers each helpful for looking and feeling youthful.

Massage, yoga and other stretching “help keep the body healthy, allowing tissues to stay nourished,” she says, and “increase circulation, for a positive effect on the firmness and glow of the skin.” (There are even special exercises just for toning the face and neck.)

Polarity therapy, with components of yoga, nutrition and emotional balance, “opens up energy systems,” York says, giving what she calls a “polarity glow or facelift.”

Simply eating right can make us look younger, she adds. “Drink plenty of water, and don’t cut out the good fats. EFAs (essential fatty acids) make a big difference to your skin.”


Jennifer Brewer is a freelance writer who lives in Saco.


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