October 7, 2010

USA: "Aging Gracefully Is Both an Art and a Science"

LOS ANGELES, California / The Los Angeles Times Magazine / Health / October 2010

The Way Back

AGING GRACEFULLY is both an art and a science
by ALISON SINGH GEE /illustration by DAN WINTERS

I’ll always think of it as the moment when everything changed—when I crossed the line from young and alluring to middle-aged and invisible. I was in my office at the magazine where I worked, when I found a favorite photo from my recent past: me in India, dressed in a sari, smiling and shielding my eyes from the sun. I placed the picture on my desk, and my colleague—a rogue of a guy so handsome that Hollywood publicists I’d never even met would call trying to get the scoop on his relationship status—came in.

“Wow!” he said, gazing down at the photo.

“Oh, yeah—in India,” I said, trying to disguise my blush.

“Yeah, wow...So, who is that?” He asked, eyes gleaming.

“What do you mean, who is that?” I snapped. “It’s me.”

Silence. I was positive he would backpedal with platitudes such as, “Oh, of course it’s you. What was I thinking?” Instead, he cleared his throat and said, “Gosh, uh, how long ago was that?”

“Seven. Years. Ago,” I said, silently willing him to disappear. I glared at him, but he was too busy wondering what the hell happened to that luscious girl in those seven years.

I passed from my rose-still-in-bloom thirties into my petals-suddenly-falling-off forties, that’s what happened. I gave birth, endured a two-hour commute for six years, gave up facials and the Stairmaster for playdates and preschool co-op meetings and lived my life on six hours of sleep a night. I gained 20 pounds, developed a constellation of age spots, lost my cheekbones, stopped bothering with mascara and developed an amorphous jaw line. I transformed from a Miss into a Ma’am. I undeniably lost the heat.

And now I want it back.

As we cross from our thirties to our forties, the levels of hormones that once regulated our skin tone, muscle mass, libido and brain function begin to decline. Our reservoir of enzymes, which helps us digest food and transform vitamins and minerals into nourishment, may start to diminish. As a result of shrinking muscle tissue, our resting metabolic rate becomes slower. We can no longer eat the same amount and expect to maintain the same figure.

Women lose muscle tone in their arms, legs, abs and buttocks and start to pack on some fat, while our skin becomes slow to regenerate. Even our hair—the essence of femininity—thins and loses its ability to grow long, turning gray and brittle. Gravity pulls at everything, leaving us looking like exhausted versions of our younger selves. The G-force works its voodoo on our spines as well, causing us to compress and stoop. Not exactly the most captivating look.

Men in their forties go through the male midlife shift—andropause. Testosterone levels decline, which leads to muscle loss and fat gain. Many a formerly fit guy transforms into a pear- or apple-shaped frump. Add to that a blurring jawline, male-pattern baldness, dilated blood vessels and hormone-induced midlife depression, and you’ve got a guy who’s gone decidedly tepid.

Want more good news? In our forties, both men and women start to see their libidos fade. “At this age, you have to work hard to create the magic,” says Dr. Karlis Ullis, medical director of the Sports Medicine, Anti-Aging & Preventive Medical Group in Santa Monica and author of Age Right: Turn Back the Clock with a Proven, Personalized, Anti-Aging Program. “You can’t just schlep around. If you want to be hot again, now’s the time to get it back.”

But how? I want to look like the me in that India photo, not a shiny, synthetic caricature. So plastic surgery is definitely out. At the same time, I don’t want to erase the 10 years of inner growth I’ve already experienced.

I know it is possible. After all, Sophia Loren at 76 and Catherine Deneuve at 66 both capture a timeless sex appeal. Closer to home, Demi Moore, 47, hit her forties looking hotter than ever. On the cover of a recent Vogue, Gwyneth Paltrow, 38, looks as though she is aging in reverse.

“Gwyneth does an amazing amount of physical activity,” explains Dr. Oz Garcia, the author of Redesigning 50: The No-Plastic-Surgery Guide to 21st-Century Age Defiance, who teaches people—including Paltrow—how to maintain and enhance their bodies. She is a living testament to the powers of self-maintenance through education and application. “Everything flies off of being fit, having food intelligence, getting adequate sleep and understanding your hormones. When things start to shift in your forties, you can’t toss in the towel.”

"You can't just schlep around.

If you want to be hot again,
now's the time to get it back."
But how, I wondered?
I wanted to look like me
in that India photo,
not a shiny, synthetic caricature."

So, will it ever be possible for me to get the looks and allure of my thirties back? I ask Garcia. “You can...” he says with a pause, “but you have to earn it back.”

I can earn my hotness back—six words have never sounded so good. But just how much currency—meaning time, money and effort—will it take? I embark on a one-month quest to find out...

Even if we labor over our skin as adults, there’s no escaping the damage we might have done when we were young. I, for one, have taken scrupulous care of my skin since my late twenties. But even my costly, focused and commitment-heavy routine seems to have failed lately. Gone are the days when I can roll out of bed and start the day without makeup.

“At this age, your skin becomes a journal of your life,” says Dr. Jessica Wu, a Harvard-trained dermatologist who treats many boldface names in her West L.A. office. “You know those summers you spent tanning on the beach? That’s those dark spots right there. I’d say you have mild to moderate sun damage.” For the crow’s feet and forehead wrinkles, she recommends Botox, “to soften you up and make you look less tired.”

As for the fat pockets forming on my jawline? Losing weight, as is my plan, might make those disappear, she says. Otherwise she recommends artificial fillers to even out my visage. She teaches me her favorite facial exercise for firming the muscles under the chin: Curl the tip of my tongue up and back and press it against the roof of my mouth, then hold for five seconds; repeat five times. I now do the maneuver whenever I’m at a red light or trawling through emails.

I’m not interested in Botox—it seems half of Hollywood are frozen-faced Stepford Wives. As far as treating my fine lines and age spots, she tells me I have options. The first is a fractionated laser treatment (between $1,000 and $2,000), which evens out skin tone. The laser drills thousands of tiny pinholes into the skin, shrinking and tightening the epidermis while stimulating new collagen. The downside? “After the treatment, you look like you have a sunburn,” says Dr. Wu.

I look up photos of laser-treated patients, and it’s not a pretty picture. The sunburn looks more like a second-degree scorch, and the ensuing “crusting”—as the peeling of the scalded skin is called—can last up to 10 days. “But afterward, you look like you’ve turned back the clock about 10 years,” says the doctor...which almost makes it sound worth the pain.

Another option is decidedly less radical—a series of three LHA (lipo-hydroxy acid) peels, with roughly the same benefits as a laser. Most patients go back to work the next day. The best part: Even a series of three peels (at about $300 per peel)—costs less than even one fractionated laser treatment.

Because both treatments should be done when you won’t be in the sun at all—and that is not something I’m ready for—my skin-renewal process will start with a prescription for Renova, which company literature says helps replace damaged skin with new skin.

Within two months, I supposedly will see wrinkles soften. After six months, I should expect a reduction of fine wrinkles and a fading of brown spots. The downside? I have to wear a strong sunscreen and a hat, or the spots might come back even darker. And no facial waxing, Dr. Wu cautions: “You’ll rip the skin right off your face.” Sounds fair. I start the prescription that night.

But Renova won’t erase my jowls. My chicest friend, Coralie, tells me of Arcona Studio’s “signature” facial contouring massage. “The next day your cheekbones are out to there,” she coos. Sounds intriguing—and it doesn’t involve knives or syringes.

It is a workout my face won’t soon forget. Priming her hands with an emollient made of naturally active ingredients, Chanel Jenae, the spa’s lead aesthetician and a woman known to Hollywood cognoscenti as the Sculptress, attacks my cheeks, lips and forehead with a series of upward strokes. Company theory is that these actions counteract the aging forces of gravity.

“It’s like sending your face out for a Pilates class,” she says. Die-hards book facials (about $85) weekly, and Jenae says the more you have it done, the better the results: “Just like going to the gym.” Still, even one treatment releases tension, “and tension affects how we look and relate...We don’t make any claims, but if people weren’t happy, they wouldn’t come back. And they’re definitely coming back.”

The next day, I notice something is happening, however subtle. My visage looks like a cubist painting, all angles and shadows. My eyebrows seem raised, making my eyes look more alive. Somehow my cheekbones have come home—hurrah!—and my skin glows. I make a mental note to apply moisturizer religiously to my face in upward strokes. And then I walk to Starbucks without makeup.

Sports Medicine, Anti-Aging & Preventative Group’s Ullis is a former UCLA physician trained in regenerative medicine. Treatments can include hormone-replacement, prescribed supplements, nutrition plans and posture and fitness routines.

From the photos of high-profile actors and sports stars lining his office walls, I realize a steady stream of this town’s youth-obsessed citizens have probably come here. “My focus is the whole person,” he says.

If I submitted to blood work and a full-spectrum diagnosis, Ullis says he could determine my biological age (which can differ radically from chronological age), how efficiently my body is absorbing vitamins and how the chemicals in my body are affecting my weight and muscle mass.

“He runs his hands along my sides.
‘You still have a smallish waist,
but you’ve got to knock this out.’
He reaches around and jiggles my belly.”

Today, he simply examines the way I hold myself and walk. He looks at me head to toe and notes from my posture—and not the loaf-size roll of flab around my middle— that I’ve been through childbirth.

“Muscles disconnect from the brain to accommodate the baby,” he says. “Your stomach sticks forward, your rear end is tucked in. This makes you look perpetually three months’ pregnant.” Okay, posture not attractive—I get it.

Does the way I stand age me? He notes that my left knee turns out, which could lead to hip problems, and my Achilles tendons are especially tight, which means a decreased range of calf motion. He runs his hands along my sides. “For women, the key to looking young and vital is a low waist-to-hip ratio. You still have a smallish waist, but you’ve got to knock this out.” He reaches around and jiggles my belly. “You have a little bit of this, too,” he says, shaking the flab on the back of my arms.

Once I’ve regained my powers of speech, I ask how I can take 10 years off. He says my routine—30-minute walks four times a week and 20 minutes of Tae Bo videos two times a week—doesn’t build enough muscle, and at this age, the only way I’ll get my body back is to strength-train hard several times a week. “You have a lot of body parts to work on.”

To that end, he sends me to his associate Michael Greenspan, a neuromuscular therapist who works with sports stars and regular folks who, because of posture issues or injuries, find themselves in intense pain. His brand of healing is a growing industry—“Bill Gates put me in business,” he says with a smile. The desk worker of today’s society spends his days sitting—in the car, at the keyboard and on the couch. This limited employment leads to the weakening of essential muscles and poor circulation.

Optimal circulation is one of the keys to anti-aging, Greenspan says. “Without blood flow, toxins remain in the muscles.” He teaches how to strengthen and support the load-bearing joints; the goal of these physical routines is to realign the body to its natural posture, thus increasing circulation.

“Aligning your posture by exercising your antigravity muscles is the most anti-aging thing you can do for yourself,” Greenspan says. “That allows you to stay active and pain free, even as you age chronologically.”

He prescribes 10 exercises to “rebuild the integrity” of my pelvic floor, strengthen my back and correct my posture—all repairs that will keep me from stooping.

I decide to take action—literally—and redeem a gift certificate for Curves, the women’s gym that devises 30-minute cardio and strength-training workouts. After moving from machine to machine and prancing in place to a Michael Jackson compilation tape, I feel like I’ve awakened long dormant muscles. It’s also fun—I end up working out five times in my first week.

“Exercise is the best fountain of youth we have found,” says Dr. Eva Ritvo, a South Beach–based psychiatrist and, with Beverly Hills dermatologist Dr. Debra Luftman, coauthor of The Beauty Prescription: The Complete Formula for Looking and Feeling Beautiful. She says to find a form of exercise I love—and look forward to each day of it.

Throughout this month-long quest, I realize there’s one aspect of myself I rarely complain about: my hair. Instead of losing hair when I was pregnant nine years ago, my mane actually got thicker and wavier. And thanks to genetics, I have never had a gray hair.

But when a stylist recently assessed my locks and noted, “It has started to thin,” I reeled. My sisters have all suffered noticeable hair loss, but I foolishly thought it wouldn’t happen to me.

Researching female hair loss, I come across Dr. Alex Khadavi, associate professor of dermatology at USC and the creator of Revivogen, a line of products based on natural ingredients that purports to inhibit hair loss in men and women.

When we meet in his Santa Monica office, Khadavi explains a widely shared medical theory on hair loss: As men and women age, testosterone combines with an enzyme called 5-alpha reductase (5AR) and transforms into dihydrotestosterone (DHT), a hormone that binds to hair follicles and causes hair to morph into finer, thinner strands—a process called “miniaturization.” Younger women are protected from the effects because their bodies still produce estrogen, but when a female crosses into her forties, those levels plummet.

In Khadavi’s experience, hair-recovery products that contain minoxodil do stimulate hair growth. “But once you stop using it, your hair falls out,” he warns. Another treatment for male-pattern baldness, the once-daily, FDA-approved pill Propecia—which specifically should not be taken, or even handled, by women—has been proven to reduce DHT. Company literature says 9 out of 10 male users reported visible results, but rare side effects could include a lowered libido, erectile dysfunction and decreased semen production.

Khadavi says his Revivogen works in the same way as Propecia, inhibiting production of DHT, but it is applied to the scalp and does not bring about the same side effects.

When I ask what is going on with my hair, he says, “Well, I can see the miniaturized hairs all over your scalp,” he says. “You actually have classic female-pattern hair loss.” The room starts to spin, and I clutch my locks, barely stifling a gasp.

“If you start addressing the problem now, you have a chance of restoring your hair to where it was one to three years ago,” he says. “You won’t ever return to where your hair was 10 years ago—no product can do that—but you probably will be able to maintain your head of hair.”

I weigh the pluses and minuses. At $119 for a three-month supply, Revivogen usage will make a serious dent in my budget. And applying it nightly is messy, odorous and laborious. But even though I won’t see any visible results for at least three months, I decide to give it a go.

So, how do I feel a month after embarking on my quest to return to the thinner, prettier, hotter me? Well, strength-training has flattened my abs, tightened my thighs and defined my arms. I have lost about six pounds, and my clothes are fitting great.

My new skin regimen—Renova and a light antioxidant-fueled program from Arcona’s line—has left me glowing. My age spots have faded, and the fine lines on my forehead seem to be softening. My cheekbones are more prominent and my jaw is less flabby—but whether that is from my DIY daily facial massage or my weight loss, I can’t be sure. As for the posture-aligning exercises and attempts to stem my hair loss, the jury is still out.

Something about me is surely shifting. At a press trip a few days ago, I noticed a hot young journalist following me from event to event, and lately retailers and waiters have started to address me as “Miss” again. Even my daughter has noticed. “Mommy,” she says, as I emerge for the day, “you look really pretty.”

The biggest change has happened within—my confidence is back. I no longer feel I am aging uncontrollably. After a month of intense self-focus, I’m not back to where I was a decade ago, but I believe I can get there. Perhaps best of all, rather than feeling ravaged by time, I now feel I’ve merely been kissed by it.

is an award-winning journalist and author.
Her India-based memoir,
The Peacock Cries for Rain,
is due out in 2011.


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