The face in the mirror becomes all too familiar with each passing year.  The nose… the eyelids… the wrinkles – increasingly recreate the image of your mother.  You loved your mother, but you’re not sure you want to look like her as you get older.

Welcome to “Looking in the Mirror”, a new column that focuses on you.  What you look like, how you age, and what you can do to rejuvenate your appearance.  We’ll talk about skincare – what works, what doesn’t, and what is downright fraudulent.  We’ll investigate all of those “noninvasive” procedures (hard to justify 300 needle jabs as being noninvasive, though) that paralyze, fill, shrink, and tug your skin.  And when little procedures no longer can suspend sagging skin, we’ll go into the operating room and literally under the skin to obliterate turkey gobblers, jowls, and crow’s feet.

Arthur Perry, MD, FACS

I’m a plastic surgeon. One of the rarest of specialties, but certainly the most mentioned on the Internet and on TV.  I heal with steel (as they say) savoring the privilege of operating on my patients.  I’ve been around the block a few times, garnering wisdom from a few decades of learning what procedures stand the test of time and which ones cause headaches down the road.  My medical degree was awarded with distinction in research from Union University’s Albany Medical College.  From there, I trained in general surgery at Harvard’s Beth Israel Hospital, in burns at Cornell/New York Hospital, and in plastic surgery at the University of Chicago.  I teach at 2 medical schools – Columbia University in New York, and Rutgers in New Jersey – and have a unique perspective as the judge of thousands of complaints against doctors and the creator of the regulations that govern them during my decade as a member of New Jersey’s State Board of Medical Examiners.  Most importantly, however, I love helping people look and feel better.  Unlike many plastic surgeons who feel small procedures are beneath them, I’ve turned the science of wrinkle fillers into an art form, and have injected tens of thousands of patients, never having (knowingly) created a set of duck lips!

I believe that plastic surgery is useless unless your skin is healthy, and unlike almost all plastic surgeons, I studied skincare and have created a unique line of scientifically based products.  While some skincare programs are as complex as astrophysics, I believe regimens need to be simple enough for people to stay on them long enough to see results.

As you read my columns, you’ll understand why I worry about the “entertainmentizing” of plastic surgery – turning a serious clinical discipline into 30 second internet videobites.  You’ll benefit from my healthy skepticism – not performing procedures until they are proven effective…and safe.  I want you to be able to assess whether those hyped procedures are worthwhile…or worthless.

Let’s start by talking about aging skin. We can’t deny our destiny – despite Martha Stewart’s contention, we all age.  And it shows not only in our overall health, but in our skin.  That’s our packaging.  It’s what makes us look pretty or unattractive.  It keeps environmental toxins from killing us and contains all the chemicals that our body has manufactured to keep us healthy.  It’s largely collagen – that’s a protein that holds us together (it’s what leather is made of).  And collagen begins to thin by 1% every year after age 30.  So, by the time we’re 70, you can see the blood vessels and muscles right through our skin.  The same happens to our elastin – those stretchy fibers in our skin.  Just pinch your grandchild’s skin and it snaps right back, but your skin may take a while to settle back into place.  As if that’s not enough, our hyaluronic acid levels also decrease as we age.  That’s the chemical that attracts water – youthful skin looks dewy and healthy – aged skin looks dry.

As these changes occur, we wrinkle and sag and generally look…old.  At some point (every day?) we look into that mirror and make the decision to see a plastic surgeon.  To begin the process of looking better…looking younger.  We spend a fortune on skincare, we paralyze the muscles that literally fracture the skin into wrinkles, and we plump up crags and folds and sagging tissues with…yes – collagen and hyaluronic acid.  Then we torture the skin by pricking it with microneedling and burning it with lasers or electric current or even high energy sound.  All these techniques stimulate the formation of collagen, hopefully recapturing our youthful appearance…and hopefully not slipping into the syndrome of the all-too-common overdone plastic surgery.

A good place to start our journey together is with an honest discussion about skincare, the foundation for looking good.  We’ll explore what works, what’s fantasy, and what’s downright harmful.  In next month’s column, we’ll get into the nuts and bolts of skincare – guaranteed to save you money as you discard much of what you’re slathering on your skin.

Arthur W. Perry, MD, FACS is a board-certified plastic surgeon with offices at 1021 Park Avenue in Manhattan, NY and Somerset, NJ.  He is the author of “Straight Talk about Cosmetic Surgery” and host’s WOR radio’s “What’s Your Wrinkle” show every Saturday evening at 6 pm.  His website is www.perryplasticsurgery.com.  He can be reached at (212) 753-1820.