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60 is the new 40: Cosmetic procedures for boomers and beyond are on the rise [Pittsburgh Post-Gazette :: BC-SRS-FASH-COSMETIC-PROCEDURES:PG]

PITTSBURGH - If age is said to be a state of mind, then why not match your look on the outside to the way you feel on the inside?

For Lela Covey, 61, who lives near Wheeling, W.Va., that meant treating herself to the occasional skin peel and fillers. A Las Vegas native, she's a former fashion model who graced the runways of Chanel and Dior and the pages of Vogue in her day.

"I've always been interested in health and beauty and fitness. All of those things are intertwined," she says. "It's important that you work on all those aspects of your health. That's the revolution that's taking place."

That philosophy - along with personal tales from friends - motivated her to pursue something more permanent, a minimally invasive QuickLift face lift at The Skin Center Medical Spa in Pittsburgh.

"It's nice to be able to be in my 60s and feel like you're 40 and have the energy and physical and mental health of someone in their 40s," she says.

A rising number of boomers and beyond are trying to achieve just that, with help from cosmetic procedures - especially nonsurgical ones with little or no downtime. In the last five years, nonsurgical cosmetic procedures (think injectables such as Botox and Juvederm Ultra) have increased by 93 percent for those 65 and older, reports the American Society for Aesthetic Plastic Surgery. For surgical procedures, there's been a 58 percent spike. In just two decades, the total number of procedures for this age group is up 1,263 percent.

"People are living longer and working longer. That is what I think really is driving this," says Pittsburgh-based plastic surgeon Leo McCafferty.

Ample information on TV and the internet has helped fuel curiosity, too. Plus, because of selfies, people have a heightened awareness of what they look like as the years tick by - particularly around the eyes and neck. In 2016, eyelid surgery (to correct drooping) and facelifts were among the top three surgical procedures for both the 51- to 64-year-olds and the 65-plus age groups, according to the ASAPS. (The other one was liposuction.) For nonsurgical options, Botulinum Toxin injectables (including Botox, Dysport and Xeomin) and Hyaluronic Acid injectables (Juvederm Ultra, Ultra Plus, Voluma, Perlane, Restylane and Belotero) were popular for both age groups, as well as nonsurgical skin-tightening procedures for 51- to 64-year-olds and skin-rejuvenating chemical peels for the 65-plus demographic.

More research and a better understanding by doctors of how the face ages has allowed for more natural-looking results.

"We used to think gravity was pulling everything down, so we pulled everyone tight. We saw all of the consequences of that - people looked pulled or really tight," says Suzan Obagi, associate professor of dermatology and associate professor of plastic surgery at the University of Pittsburgh. She's also the president-elect for the American Academy of Cosmetic Surgery.

What actually happens with age, she says, is the face loses bone. At the same time, fat tends to diminish around the cheeks, temples and jawline. This combination gives skin a sagging, deflated look and can make the eyes appear more hollow. The key to addressing these features is through a treatment plan that targets multiple areas of the face.

"If you look too full in one area, you'll look out of balance with the rest of the face," Dr. Obagi says. "If things are done correctly, nobody should know what's been done on a patient."

At The Skin Center Medical Spa, which has eight locations across Pittsburgh and one in Columbus, Ohio, hair transplants (particularly for men) and neck tightening with laser treatments are in demand, says founding director and cosmetic surgeon Dominic Brandy. Also popular are collagen induction treatments like micro needling. A handheld pen-shaped device with tiny needles at the tip is stamped across the face to increase the penetration and effectiveness of the topical treatments that are applied. For faster results, platelet rich plasma from the patient's blood is added to the treatment. (The plasma mix also can be added to fat transfer procedures, scalp treatments for thinning hair and even joint therapy to boost effectiveness.)

"That's something that's going to continue to grow and grow as we get more knowledge and research on it," Dr. Brandy says about the plasma injections.

He also sees a lot of clients for what he's dubbed the "grandma makeover" - a combination of tummy tucks, ab etching, liposuction and Brazilian butt lifts. He takes to social media to educate people about the range of procedures at The Skin Center and offers virtual consultations.

Beyond more traditional surgical and noninvasive procedures, one of the fastest-growing fields of surgery for women 50 and older is genital rejuvenation. Using lasers for vaginal tightening has aesthetic and medical impacts, Dr. Obagi says, such as aiding with urinary incontinence.

No matter what procedure a person selects, though, it's important to do your homework.

"It's important that people check credentials and make sure a doctor is board-certified and has privileges in the hospital," even if the procedure isn't being done in one, Dr. McCafferty says. Also, be cautious about receiving nonsurgical procedures at home parties or salons, where it can be more challenging to control the sterility of the environment and how products are stored.

"The key is don't cut corners," Dr. Obagi says. "You have the luxury of electing whether you want to do this or not, so you must do a good job of selecting who does this for you."

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FIVE NATURAL THINGS YOU CAN DO TO LOOK MORE YOUTHFUL

Going under the knife isn't the only way to age gracefully. Here are some steps to incorporate into your daily routine to help keep your body looking and feeling sharp!

1. Practice good posture: Slouching can cause headaches, tension and a slew of other health problems. Hold your head up, roll your shoulders back and face the golden years with a smile.

2. Stay hydrated: Water helps flush toxins, supports healthy cells and helps make your skin glow. Although the recommended amount to drink per day varies per person (depending upon body size, amount of exercise, etc.), a good rule of thumb is eight 8-ounce glasses of fluids each day. Add some fresh fruit such as a lemon or orange slice to a glass of water for an extra jolt of vitamins and flavor.

3. Pamper yourself: Look no further than your pantry for some D-I-Y TLC. For instance, mix 1 tablespoon of apple cider vinegar with a couple cups of water to cleanse and tighten skin after a shower. Another option: unclog pores with a homemade oatmeal mask made with one-third cup of oatmeal steeped in warm water, two tablespoons of honey, a small egg white and some plain yogurt. Mix and apply a thin layer to the face and neck for about 15 minutes.

4. Bend and stretch: Regular exercise - _ even just 20 minutes a day - _ can aid with weight maintenance and reduce aches and pains. Going for a walk, a bike ride or even simply stretching at home in a chair can do the trick.

5. Just breathe: Channel your inner yogi and take some deep breaths. Try inhaling and exhaling for four counts each - all through the nose. Or take air in through the nose and release with a big lion's breath with your mouth open wide and your tongue out and an audible "ha." It might look silly, but the stress will melt away.

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