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Turn back the aging clock

In "Absolute Beauty," plastic surgeon Gerald Imber shares how to keep looking young as you get older. Read an excerpt.

There is no fountain of youth, however staying young-looking can be as easy as taking care of your skin and finding the right advice to follow. In his new book, "Absolute Beauty: A Renowned Plastic Surgeon's Guide to Looking Young Forever," plastic surgeon Gerald Imber shares his knowledge of the aging process and advises people on the variety of ways to look as young as you feel. Read an excerpt.

Chapter one: Revisiting the Youth CorridorOver the last decade we have come to understand a great deal about the cellular biology of aging. Aging of the skin, so obvious on the macro level, is also particularly easy to study on the micro level, due to the rapid turnover of cells and their easy accessibility. Coordinating the findings of facial aging with degeneration at the cellular and tissue level is, for these reasons, obviously an easier task than making similar observations about the liver, or bones, or brain. As cells reach senility, in this sense meaning aging, cell division slows down, tissues made up of cells degenerate, and the tissues, the organ, and the organism age.

A marker in the observation of this process is the telomere, a tail present on all chromosomes, which shortens each time the chromosome replicates itself. So each cell division results in shortening of the telomere. The number of cell divisions appears limited by the presence of the telomere. When it disappears, cell division stops and the cell cannot replicate itself. The opposite of this occurs in cancer. Cancer cells possess an enzyme called telomerase, which protects the loss of the telomere during cell division. With the telomere protected, cancer cells retain the ability to replicate themselves indefinitely without wearing out. Knowing this, scientists have attempted to introduce telomerase to cell cultures to extend the healthy life of cells, and in some circumstances they have been successful.

This phenomenon has been studied extensively in the skin, both for its accessibility and the rapid turnover rate of skin cells. Some of what has been learned has been applied to rare skin diseases, with remarkable results. These successes have encouraged investigators to study normal skin, its functions, and its longevity. We know that young skin exhibits a rapid cell turnover rate, and we know that cells have a finite number of divisions written into their genetic code. The goal is to increase the number of possible cell divisions by preserving the essential telomere. It can be done, and it will be done in the not-too-distant future. That will signal a major change in how we perceive and deal with aging of the skin.

Today we must continue to deal with today's reality, using today's science. Hence, the energy lavished on the problem of facial aging over the last ten years has been well spent. If we haven't truly overcome the problem, we have certainly made great progress in our approach and our thinking. Not only can we recognize cellular changes resulting in the signs of facial aging, but we can easily follow the progress of various therapies designed to combat them. We recognize the problem and can actually see if we are winning or losing the battle. Because of this, numerous effective treatments have been proposed and either adapted or discarded, depending on their efficacy, and not what some advertising campaign promises. The key to making use of this knowledge lies in dealing with the control of the predictable changes, and they are predictable, instead of relying solely on cosmetic surgery after the fact.

The art and science of plastic surgery arose from the hospital wards of World War I. It has come far, and changed considerably along the way. We plastic surgeons have been specifically trained to undo damage inflicted upon the human body by genetic accidents, the assault of war, disease, trauma, or the slow ravages of time. Ours has not been a world of prevention. And so our thinking has always been skewed toward the big change, the transformation.

The world of antiaging surgery is no exception. The big change, the transformation, prevails here as well. Enter the consulting room old and wrinkled, and leave the operating suite rejuvenated. That is how we all think of plastic surgery, or at least how we thought in the past. I was as guilty of this telescopic blindness as anyone. But my thinking changed. What if we could push the need for that day of major transformation off into the future? Perhaps we could manage aging with self-help, maintenance, minimal intervention, and small changes. If this approach could be realized and the issues dealt with in a timely fashion, these major transformations would become unnecessary, and so many good years would be enjoyed beautifully instead of waiting for things to get bad enough to be dealt with.

The concept of the Youth Corridor germinated from the seed of this idea. It means, simply, an extended period of years through which one might maintain a thoroughly youthful appearance, an appearance at once at peace with, and appropriate to, the general well-being and success of those very important years from thirty to sixty and beyond. During those thirty years much can be done to keep one looking, if not unchanged, certainly youthful, vital, and of indeterminate age. That is the Youth Corridor.

Beyond sixty the rules apply as well. New treatments, injectables, and surgical procedures have further blurred the lines of age. But much depends on the level of maintenance one has made use of to this point. Often the surgical solution is the proper one. But even then our procedures are less invasive than in the past, and the results far more natural.

The plan for maintenance has evolved successfully through bits and pieces and thousands of patients over a number of years. This book will explain it all to you. But take warning! Don't expect a generalized do-it-yourself book, or some New Age paean to positive thinking, though much of both are actually a part of the plan. There is a great deal you can do for yourself, much you can do with a bit of professional help, and some that is purely the result of professional help. You can accept or reject its elements as you wish ...

The foregoing is excerpted from "Absolute Beauty: A Renowned Plastic Surgeon's Guide to Looking Young Forever," by Gerald Imber. All rights reserved. No part of this book may be used or reproduced without written permission from HarperCollins Publishers, 10 East 53rd Street, New York, NY 10022