As we age, looking younger becomes a choice, just as doing nothing is a choice.

This of course, begs the question of ‘when does the aging process starts?’


However, before we address the when, let us talk about the what. Aging is a gradual, continuous process of physical and physiologic changes. There is no specific designated age when people become old; however, the United Nations designates ageing based on people’s chronological age, defining older persons as those age 60 or older.

According to the National Institute of Aging, there are currently over 49-million Americans ages 65 and older, a number that is expected to grow as more Baby Boomers (individuals born between 1946 and 1964) reach retirement age. 


Beauty and physical attractiveness are constantly emphasized as desirable and admirable characteristics in Western societies. In general, beauty and youth are revered and are also significant determinants of economic security. As people age, they are seeking ways of enhancing their appearance for personal and professional reasons. Therefore, to remain viable in the workplace, a significant number of middle-aged women and men are seeking increasing number of aesthetic medical services.

As people age, their concern about their appearance increasingly focuses on the face concentrating specifically on wrinkles and drooping skin, as compared to younger women and men who are mostly concerned about the shape and appearance of their bodies.  

We all agree that chubby cheeks in toddlers and preschoolers are adorable. However, part of maturing and getting older is getting a leaner, more sculpted face and body, as most people lose fullness in their face in their early 20s.

From this point on, one starts noticing the signs of aging due to loss of facial volume as expected from reduction in muscle, fat and bone leading hollow cheeks and temples, thinning and sagging skin, a lined forehead, drooping brows, with a hooded appearance to the lateral upper lid, deep nasolabial folds, sagging neck lines, loss of chin definition, and wrinkling of the skin around the mouth, with thinning of the lips.

 And the pigmentary changes of the skin including sun/age spots and overall uneven pigmentation are also contributing to an aged appearance.

From around age twenty, we start losing essential structural proteins in the skin including collagen and elastin. However, the aging signs may not start to show until the 30s, with the biggest changes typically occurring when people reach their 40s and 50s, as fat atrophy and bone loss also develop. External factors, including but not limited to sun exposure and smoking, further damage the dermis, by affecting collagen and elastin fiber production.

Aging is an integral part of life, and we need to embrace and celebrate it. While we may be at peace with our age, keeping intact our physical characteristics is most people’s ultimate desire. From an aesthetic point of view, this is no longer an unattainable dream. Indeed, aesthetic medicine has made immense progress and, today it is able to reverse most visible wrinkles and signs of aging.


Aesthetic medicine, also known as “rejuvenative” is performed mostly on the face to modify the signs of aging for those who wish to have their appearance restored to what it was previously. Some refinement of features may also be undertaken at the same time.

While some beauty enthusiasts believe that ‘rejuvenative’ aesthetic results can be obtained at any time by just doing perhaps “a little more”, the reality is that the best anti-aging results are obtained with early implementation, and consistent and long-term care.

Therefore, at what point in life, and at what chronologic age should one start accessing some of the aesthetic procedures? That decision of course becomes an individual one and, one that should be discuss with your aesthetic physician based on most recent clinical and scientific information.  However, knowing what we know now about the aging process and how we can arrest and reverse those signs, getting an earlier start is recommended. This represents a change in the doctrine of even a decade ago, to where one would consider starting the use of Botox and/or dermal fillers at age 50!

Going back to our initial question ‘…when does the aging process starts?’, most of us will be surprised by Professor Dino Giussani from the Department of Physiology Development and Neuroscience at Cambridge findings, who determined that “… the ageing clock begins ticking even before we are born and enter this world.”

In future blogs, I am looking forward to introducing and detailing for my audience different non- and minimally invasive procedures used in aesthetic, anti-aging/’rejuvenative’ medicine.