Growing old is mandatory, but looking old is optional! — our twist on a quote from Walt Disney in reference to growing up.

The American Society for Aesthetic Plastic Surgery (ASAPS) reports “non-surgical skin tightening” rose 15.1% in 2017 with Botox being the most common course of action with a 5.1% increase in 2017 over the prior year and a 40.6% increase in the past five years. Additionally, ASAPS reports women comprise 90% of the reported cosmetic procedures.

But, do you really need Botox? What are the alternatives?

Carol Langsdon — a nurse practitioner specializing in facial plastics and procedures, business partner at The Langsdon Clinic since 1986 and wife to Phillip Langsdon, MD, FACS and President of the American Academy of Facial Plastic & Reconstructive Surgery (AAFPRS) — reveals alternatives and offers practical advice with regard to aging gracefully. One of the reasons Carol was chosen for this interview is her willingness to forego profits for proper procedure. Recently, a StyleBlueprint staff member sought consultation for Botox, and Carol told her, quite simply, she did not need it. The Langsdon team is an impressive duo, not only for their highly esteemed accolades in the field of facial plastics and procedures, but also for their honesty, practicality and interest in each patient.

Carol Langsdon (left) is a nurse practitioner specializing in facial plastics and procedures at The Langsdon Clinic, where she is business partner and wife to Phillip Langsdon (right), MD, FACS and President of the American Academy of Facial Plastic & Reconstructive Surgery (AAFPRS).

Carol Langsdon (left) is a nurse practitioner specializing in facial plastics and procedures at The Langsdon Clinic, where she is business partner and wife to Phillip Langsdon (right), MD, FACS and President of the American Academy of Facial Plastic & Reconstructive Surgery (AAFPRS).

Supporting the findings of the ASAPS, Carol notes more and more women are seeking Botox and, alarmingly, beginning in their 20s. There is a trend to push Botox as an intervention to wrinkles, but Carol posits the opposite effect to be most likely. The earlier you begin Botox, the more likely you may be to create more wrinkles. Carol describes the anatomy of the face as a structure of muscles with each muscle affecting the next muscle. Botox, a neurotoxin that inhibits nerve cells from communicating with the skin muscle, prevents movement of the skin muscle. Thus, the paralysis of one group of muscles may increase the work of the surrounding muscles and increase wrinkles.

The move to push this form of early intervention may also be driven by professionals seeking to increase profits. This is why, when considering cosmetic procedures, it is important to seek professionals who have been practicing for a long time and are at a high level in their careers, such as with Carol and Phillip Langsdon.

So, what are the alternatives? When is Botox the right choice? What does the journey of aging entail for the average person? Below are some of Carol’s suggestions with regard to appropriate procedures and aging gracefully.

Alternatives to Botox

Topical Treatments:

  • A daily medical-grade skin-care program
  • A daily topical exfoliation cream such as:
    • Retin-A — A Vitamin A retinoid acid cream or gel, Retin-A is a topical chemical peel. Initial use may result in excessive skin peeling, which may give the impression of getting worse, but you’re really getting better.
    • Fruit acid cream — a glycolic acid cream that provides exfoliation of the face
    • Hyaluronic acid cream — a natural constituent of human tissue that binds to specific receptors to promote stimulation of cell movement and growth
  • Vitamin C serum — repairs damaged skin and protects against free radicals

It’s important to note three of the best things you can do to prolong youthfulness is drink plenty of water, eat fresh fruits and vegetables and get seven to nine hours of rest every day!

RELATED: We’re Obsessed with The Jade Facial Roller — Here’s Why

Chemical & Laser Peels (or skin ablations)

  • Fractionated laser treatment, also known as Fractional CO2 laser — This treatment is meant to reduce wrinkles, tighten the skin, strengthen the skin and improve elasticity. This is an intense treatment involving a conscious IV sedation.
  • Subtle chemical peel — This treatment is designed for improving fine lines as well as repairing sun-damaged skin. The recommended treatment is three to four peels at four- to eight-week intervals.

Aging Gracefully: What To Do & When

In Your 20s

So, you’re 20-something … now you’re starting to think about your skincare, and you may notice the trendy enhancements of celebrities. Says Carol, “Botox is not the best course of action for most in their 20s, and I especially do not recommend starting Botox before you have wrinkles.” As a preventative measure to the onset of wrinkles, Carol says to avoid tanning, adding, “Sunscreen on the face is a must!” She recommends a well-rounded daily skin routine that includes:

  • Exfoliation cream with glycolic acid
  • Vitamin C serum
  • Sunscreen
  • Retin-A cream, if you have acne

In Your 30s

Thirty-something? You might be thinking it’s time to start Botox just because you’re in the BIG 3-0s. Nope, not necessarily — if you aren’t seeing wrinkles, it’s not time. As Carol reminds us, “Botox is not a preventative treatment.” Preventative treatments include the exfoliation of the skin, continuing the same routine as the 20-something, but now it’s time to add Retin-A, regardless of acne.

Beginning in your 20s, your skin care routine should include and exfoliation cream with glycolic acid, a vitamin C serum, sunscreen and, if you have acne, Retin-A cream, which should become routine in your 30s.

Beginning in your 20s, your skin care routine should include and exfoliation cream with glycolic acid, a vitamin C serum, sunscreen and, if you have acne, Retin-A cream, which should become routine in your 30s.

In Your 40s & Beyond

We can’t help but hear Buzz Lightyear saying, “To infinity and beyond!” But the 40s are the time to consider kicking things up a notch. You might incorporate glycolic acid peels, laser treatments (ablation of the skin), Botox and perhaps hyaluronic acid injections. “At some point, there are not a lot of alternatives to Botox,” says Carol, adding that her oldest patient is 93.

Many people seek treatment for the neck and hands as well as the face. Carol does not recommend treating the lips as the inhibited movement may affect speech and mouth functioning. The main areas where Botox is most appropriate and beneficial are for chin dimpling, crow’s feet and forehead lines.

Research indicates that while more middle-aged women across all cultures are seeking facial treatments, more are also choosing a conservative approach that allows for some movement and facial expression with more frequent treatments.

The way to avoid or put off Botox is to care for your skin throughout your life. Exfoliants and skin peels are a great way to keep the skin fresh, but if you’re at a point in your aging journey where you are ready to consider more intense treatments, seek the advice of a licensed professional who has a focused career on facial skin treatments with significant experience. And work with someone who will focus on a customized protocol for your specific needs and desires.

Looking and feeling like our best selves is an important piece of our quality-of-life puzzle. Also, facial movement is natural, and animation and smiles create connection. So it’s important to strike a healthy balance in order to feel your best and make meaningful connections with others.

P.S. — Winter is a great time of year to repair summertime skin. Follow some of Carol’s tips to see that fresh, luminous glow in your skin!

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