Lip Rejuvenation: How to Use Fillers to the most Natural, Youthful Appearance

Dr Day demonstrates symmetrical beauty
Nefertiti is a perfect example of “phi,” the golden ratio of balance and proportion

Lips send a message even when they’re not moving. To create beautiful natural lips I often combine devices such as lasers and radiofrequency or ultrasound, products that contain antioxidants, neuromodulators such as Botox, Dysport or Xeomin and hyaluronic acid fillers. And, of course always, always, always use sun protection to defend against collagen breakdown and damage to this very delicate area of the face. Before I address the lips I evaluate the face as a whole and the teeth and area around the mouth, including the chin in particular.

Considerations: For beautiful lips take into account: Your Genetics, Your Age Group , Your Personality & Life Style, Your Race – Culture – Gender. It’s About Attention to details – It’s the little difference that makes the big difference.

Nefertiti is a perfect example of “phi” the golden ratio balance and proportion.

The green line that goes from one inner eyelid to the other is called the intercanthal distance, it is unique to you and it stays the same from 9 months to 90 years. It determines the perfect balance and proportions for the rest of your face, including your lips.

Start with the area around the lips:

I always start with looking at the teeth. Very often when lips are flat or uneven, it’s due to the lack of support of underlying teeth. I often see a strong overbite, crooked teeth or teeth that are angled inward and therefore not supporting the overlying lip. We can try to correct the lips, but the results won’t be as good or as long lasting if we don’t address the underlying cause distracts from the area.

Gummy Smile: I always study the lips at rest and the lips in animation. Some people have beautiful full lips at rest but they become small and flat or roll under when they smile, exposing their gums. This can be corrected with a neuromodulator like Botox and the results are fantastic. It is an area of advanced injection technique because there are different types of gummy smile causing the changes you see and also because the treatment can affect the way you speak and pronounce certain sounds like the letter ‘p” or “o”. The results are fabulous when done well and unfortunately last too long when not done correctly. The basic rules for the lips is that the left and right sides should be identical. In white skin people the balance of the upper to lower lip is 1:1.618. The center “bow” to the outer lip should also be 1.1.618. The majority of the product should fit in the areaas wide as the sides of the nose (see image below).

Dr Day explains how lips benefit from fillers
The center “bow” to the outer lip should be the correct ratio.

Consider the image below as being like the frame  of a painting. The upper white roll is more pronounced, the lower white roll is more subtle.
Vermillion: This is the red and main part of the lips. There are different products we use for different purposes and sometimes we layer product for best effect. The most common product used for lip filler is hyaluronic acid, but there are many different types and brands and it can make a very big difference in how the end result looks and how long the results last. Some fillers are thicker and give more of a fill or augmentation while others are softer and more flexible and help enhance.

Dr Day lip illustration after fillers
The most common product used for lip filler is hyaluronic acid, but there are many different types and brands and it can make a very big difference in how the end result looks and how long the results last.

 

Steps

Step 1. The doctor may apply a topical anesthetic to help minimize discomfort.

Step 2. They may use a needle or a cannula (blunt needle) to inject the proper product into the lips to augment
(make bigger) or enhance (make more beautiful and balanced).

If you have relatively smaller lips be prepared to be patient and allow for several sessions with small amounts of a more robust filler to reach the final result and avoid having too much projection and that dreaded “duck lip” look.

After desired volume is reached the doctor may use a softer filler to enhance and balance the lips and surrounding area. It takes time for the product to settle and there may be swelling for a few hours to a few days after the treatment. There can also be bruising, which can be treated with a laser to speed healing if needed.

Dr Day explains lip anatomy

The majority of the lip product should sit between the nasal ala one side of the nose to the other as in the photo above.

Dr Day demonstrates intercanthal distance

Lower lip: The lower lip should be slightly larger than the upper lip, except for African American and Asians where the natural proportion is for them to be the same size. Also, the bulk of the filler should be within the lines that would drop straight down from one inner eyelid to the other (called the intercanthal distance as seen in the photo above).

Oral Commissure (aka corners of the mouth): as we age the corners of the mouth can drop and droop and give the appearance of a frown even though you’re not sad or angry!

A firm filler can give an excellent lift to this area and instantly reframe the lips. A little Botox into the muscles along the jawline that pull the corners down can also have an excellent impact in helping to lift the corners.

Dr Day before and after dermal fillers photo
As women age, our chin recedes and gets smaller. By adding a filler right into the center of the chin, we can help bring this area back into balance and change the look of the lips before even injecting any product there at all.

Chin: As women age, our chin recedes and gets smaller. This can make the lower lip slip back and look smaller and it can make it more difficult to keep the lips together, which forces us to use the muscles that surround the mouth more to push our lips together. This ends up creating those dreaded upper lip lines. Filling the lower lip without addressing this area makes the lips look unnaturally larger and out of proportion to the face.

By adding a filler right into the center of the chin, we can help bring this area back into balance and change the look of the lips before even injecting any product there at all. This has to be done carefully in order to create the proper look. Injected too low it can make the face longer, injected too high and it will look like a bump. There is a sweet spot to inject that looks beautiful and natural and gives lasting results.

Upper lip line creases: These are usually caused from sun exposure over years, from repetitive motion of the area and from volume loss. It is best addressed with a softer more flexible hyaluronic acid filler to give support to the delicate skin around the lips and to stimulate collagen production. Sometimes a laser treatment, radiofrequency or other in-office treatment along with topicals containing retinol and growth factors are also needed to help restore and enhance the skin around the lips.

The best way to proceed is to see a board certified aesthetic physician like a dermatologist or plastic surgeon so you get a proper consultation and the right products are chosen for you. It often takes 2-3 sessions for optimal results and to avoid getting that over projected “duck lip” look.

Tools: There are different ways to deliver the filler. The doctor may use a needle directly into the area or they may use a blunt needle called a cannula. Both are excellent options. The cannula lowers the risk of bruising and is becoming a more popular technique for injections.

Bottom Line: The goal is to have balance and harmony of the lips and the face. A proper aesthetic evaluation along with using the right filler for the right area is very important to restore, reflate and rejuvenate this very sensitive and important part of the face. There is a science to the art of lip injections and for beautiful lasting results see a doctor trained in aesthetics, such as a dermatologist or plastic surgeon.

Birthdays are for Celebrating

Dr. Day family photo

Birthdays are for celebrating, even if the ones we cherish are not here to blow out their own candles.
I would give anything to have had more time with my sister; her birthday was last week. All the heartache and pain of missing her will always pale in comparison to the love and joy of the time we shared together in her 14 years on this earth. I love reliving the beautiful memories of the time we had and I love dreaming about what might have been if we had more time. She accomplished so much in the time she was here. Her energy still lives on and inspires me every day to be a better person, to help others any way I can, to love with all my heart and to not take a moment of this life for granted.

Dr Day with her father as she graduated from Medical School

My dad’s birthday is today. I think of and celebrate him as well. I am so proud to be his daughter and that I was able to share the sweetest goodbye and watch him transition as he passed on to begin his next adventure.

He left me with a lifetime of memories from his 92 years here in this world. I love sharing those stories and wise words of wisdom with you, here, and on my radio show.

Dr. Day and happy monk Tenzin Jampa

It meant so much to have the blessings and incredible positive energy of the “happy” monk, Tenzin Jampa, during his recent visit to my office. The timing, between my sister and dad’s birthday was absolutely perfect and made his presence even more meaningful.

3 Top Tips To Save Your Skin This Winter

Winter is approaching and for most of us that means it is time to tackle our changing skin needs. As the air outside gets colder and the humidity decreases, indoor heat gets hotter and drier, which can lead to skin that is parched from moisture as the air around us, indoor and out, selfishly steals our reserves. Rosacea, which is commonly triggered by extremes in temperature, can flare more easily.  Eczema and psoriasis can flare too, and those with acne-prone skin may even start to see an increase in breakout.

Another tricky aspect we are presented with these days is that while winter weather may be imminently approaching, temperatures can range widely from day to day or week to week. One day it can be cold and blustery and the very next temperatures can soar into the 60’s, making it difficult to know what coat to wear let alone which moisturizer to use.  Wool and coarse fabrics can irritate your skin and add to the problem. Here is the solution to your winter skin woes:

1. Listen to your skin: It will always tell you what it needs, and what it doesn’t like. If your rosacea is flaring or you’re breaking out like you haven’t in a while, there is still hope. Try to pinpoint any triggers, avoid them when possible and be sure to stick to your skin care routine especially when you’re under stress. Perhaps you are overdue for a maintenance treatment or a visit to your dermatologist for a peel or skin care assessment? Did you run out of a skincare product that you love? Your skin will need different ingredients and products as weeks, months and years go by, but a common thread of consistency in your daily routine- cleansing, hydrating and sun protection- is important to prevent flares and keep your skin looking it’s most beautiful radiant best.

2. Check the weather: Just like you think ahead for seasonal weather changes, you should also prepare for the effects the changes in season will have on your skin. Learning to layer the right products and adding or subtracting ingredients throughout the year will lead to happier, healthier, more beautiful skin. Warmer days tend to be a bit more humid, so layers of antioxidant serums, hyaluronic acid serums and lightweight sunscreens may do the trick for you. Colder days, especially when it is dry and windy, may require a moisturizer designed to help seal in precious moisture. The body is drier than the face, and all skin loses water as you sleep and your body repairs damage from the day, so be sure to add a richer layer of hydration at night and find an easy to maintain humidifier to use in your bedroom as you sleep, allowing your skin to protect, replenish and restore its moisture bank.

3. Have the right skin care products ready in your arsenal: Key pieces are critical. Once you know which products you love and what works best for you,  make sure you have them supplied and available to use on the fly as needed. Once you learn to listen to your skin and remember to routinely think of your daily skincare as you would your outfit selection for the day, you will start feeling and seeing more consistency in your skin health. See below to learn how to select the best products for your skin needs.

If all your efforts still only get you so far, trust the experts- after all it is what we are here for!

Skincare products that help you cope:

Facial Serums with Hyaluronic Acid

Depending on how prone to dryness your skin is,  the cold air will quickly steal moisture from your skin. Layering serums, thinnest to thickest, under lotions and creams, helps to infuse your skin with deeper hydration. Topping off with the right lotion or cream will seal in all the good stuff so you’ll be best prepared for blustery, cold days.

I like to think of using Hyaluronic acid, which is a humectant, helping to pull in and hold water in the skin, as an ingredient that helps to fill the well. HA attracts water from the air around you and holds onto it, up to 1,000 times its weight, and is part of how your skin hydrates itself naturally. After a week or so of consistent HA use your skin’s moisture well will be replenished so you have better defense against dryness. As we age, we lose our reserves of naturally occurring HA so it’s important to supplement with it topically. Not only will it help you feel less dry but your skin will also plump up and the appearance of fine lines and wrinkles will soften.

A few favorites: SkinCeuticals H.A. Intensifier, Skin Medica HA5 and PCA Hydrating Serum

Facial Antioxidant Serums

Using antioxidant serums year round is a must. In the summer, we tote antioxidants for their protective qualities when layered with sunscreens and the same is true in the winter months. Some of us can upgrade to more emollient formulas in the winter for an extra boost of hydration. If you don’t already have a facial antioxidant you love, Alastin Skin Nectar, SkinBetter Alto, SkinCeuticals CE Ferulic and Skin Medica TNS Essential Serum are all highly recommended!

Super Gentle Exfoliants

You might notice that treatment ingredients and acne medications  suddenly begin to irritate your skin as the weather gets colder. This is because as your skin loses moisture and naturally occurring protective oils, active ingredients penetrate more deeply. To counter this, use actives less often and sandwich them between serums and moisturizers. If they still irritate you, switch it up and try these clever products from RestorSea, which exfoliate without any irritation and help to enhance skin function and barrier repair. RestorSea Intensive Treatment 10x is a safe and non-irritating alternative to retinols. Apply RestorSea Rebalancing Lotion on top for additional hydration.

Facial Moisturizers

Your moisturizers will never work better than they do when layered over your favorite Hyaluronic Acid and Antioxidant Serums. And for some of us, these layers of serums might be enough, especially when topped in the day with a protective sunscreen. For those who need a bit more, we recommend finding a formulation designed for your specific skin needs. Drier skin types can use moisturizers morning and night. For combination-to-normal-to-dry skins, we say sleep in one that you love, remembering to slather your neck and chest too.

Dry Skin: Skin Medica Dermal Repair, MD Rejuvena Ultra-Rich Hydration, Neutrogena Hydro Boost Gel-Cream (for extra-dry skin)

Normal-to-Dry Skin: Epionce Medical Barrier Repair, SkinCeuticals Triple Lipid Restore, Sente Dermal Repair Cream, Skin Medica Total Defense and Repair SPF

Oily or Combination Skin: SkinCeuticals Physical Fusion SPF 50, NeoCutis MicroDay

Hydrating Masks

1-2 nights a week you can apply a hydrating mask. For very dry skin, apply a cream or gel based mask like SkinCeuticals Phyto Corrective Masque  for 10-20 minutes, tissue the mask off and then apply your regular nightly routine. For normal to dry skin, apply your evening skincare and then a sheet mask over the products, wearing the sheet mask, like SkinCeuticals Biocellulose Restorative Masque for up to an hour or even overnight. Make sure you’ve got a good humidifier going while you sleep, too. Certain essential oil diffusers also infuse the air with moisture with the adding bonus of sleep-enhancing essential oils like Lavender or Chamomile. In a pinch, take a tip from our grandmothers and great grandmothers and place a bowl of water by your bed- it doesn’t work nearly as well as the other options but it’s certainly better than nothing.

Lips, Hands, Feet, Body

Dry, chapped skin can start to appear on the hands, legs and body as soon as the weather starts to change. Keep a bottle of liquid coconut oil (Nutiva Organic Cold-Pressed Liquid Coconut Oil) in the bathtub and apply it to your whole body while the water is still running. A little coconut oil goes a long way and the warm shower water helps you spread it evenly over your whole body (do not apply to feet while standing in the shower and be especially careful not to slip getting in or out!). Before drying off, try applying 1-2 pumps of an exfoliating, hydrating body lotion. Some of my favorites are: PCA Body Therapy, AmLactin Hydrating Body Lotion, SkinFix Extra Strength Soothing Body Cream and Theraplex Emollient for Severely Dry Skin.

Replace hand soaps with richer moisturizing formulas and keep hand lotions next to your sink in the bathroom and kitchen and apply after every hand wash and in your purse for when you’re on the go. Pro tip: If you don’t like your hands to feel greasy, just apply the formula to the back of your hands from time to time. Keep your hands covered with gloves or mittens on especially cold days to protect them from cold, dry air.

To better manage dry cracked feet, begin by exfoliating regularly. Most of us get pedicures less frequently in the winter but when you do, skip the exfoliating callus remover and more aggressive exfoliation methods offered at spas as they can go wrong, making you more prone to cracked heels. Instead, when you step out of the shower, apply an exfoliating serum designed specifically for the feet, then apply something rich like Aquaphor and put on your socks. For less dry feet use a milder exfoliating and hydrating formula when you get out of the shower and before you go to bed.

Lips need love too! Physically exfoliate them gently with your toothbrush then apply a hydrating lip serum. Top off with something more occlusive and reapply it throughout the day. Keep it easy by having a travel version in your bag at all times.

Hands- Dr. Day’s Handle With Care, Neutrogena Norwegian Formula Hand Cream, Aquaphor

Feet– Clarisonic Pedi-System, Clarisonic Pedi Boost Renewing Peel, Isdin Podos

Lips-RestorSea Lip Magic, EpiCeram Lipcare, Aquaphor

For questions about how to best treat your skin, please call us. We can help answer your questions over the phone or in person during a consultation with Dr. Day or myself (Holly Montgomery).

Many of these products are available on our online store! If you’re not yet signed up for access please call us at (212) 772-0740 and we will happily register you! Access allows you to store our recommendations and other favorites so you can order them as needed or have them shipped automatically, making life that much easier.

 

The following in-office treatments are some our favorite skin savers in maintaining glowing skin during the winter months:

 

Hydrating Facial Peels

Dermaplaning

Clear and Brilliant

Fraxel

Hyaluronic Acid-based Filler

Botox

Impact of Air Pollution on Your Skin

The world we live in is rapidly changing. Our body, starting with our skin, is under ever greater assault from pollution and toxic elements in the environment that it has not yet evolved enough to neutralize on its own. The consequences can range from irritation and premature aging, to organ damage and at worst, cancer. This is mostly from oxidative stress, which is defined as an over production of destructive reactive oxygen species (ROS) and an inability of the body’s natural antioxidant network to neutralize them before they do damage to skin and other organs. The generation of ROS is initiated by three major components relating to pollution: particulate matter, ozones and aryl hydrocarbon receptors (AhR). The good news is that there are ways to protect against the damage and repair at least some of the damage done.

The Facts

Let’s look at some recent numbers issued by the World Health Organization (WHO):

92%-that’s the percentage of people around the world who live in cities that do NOT comply with WHO air quality standards.

6.5 million- that’s the combined number of deaths (11.6% of all global deaths) associated with indoor and outdoor air pollution. That number has more than doubled since 2012.

Life expectancy – In Europe, one year of life expectancy is lost for every person due to exposure to particulate matter (PM) from air pollution. This is mostly due to the increased risk of heart and lung diseases. The effects of pollution on skin are also profound, seen as increased risk of skin cancer, skin sensitivity, premature skin aging, discoloration, dryness, dullness and roughness.

Pollution is in fact a mix of many, many components which makes it difficult to say exactly which one of the different elements are responsible for the skin changes we see. In the laboratory, it is possible to expose cultured human skin cells to certain pollutants one at a time. A few examples of specific pollutants tested include Benzo-a-pyrene, urban dust, ultrafine dust, and diesel exhaust.

Surprisingly the real threat often doesn’t come from these particles themselves, it comes from the chemicals that find a way to attach to them. Urban dust for example, contains a cocktail of 224 toxic chemicals – from polyaromatic hydrocarbons to pesticides and heavy metals. And, while the particles of pollution are usually too large to penetrate skin themselves, many of these chemicals attached to them are not. Cigarette smoke is another major pollutant, and that has been shown to consist of over 6,000 chemicals!

The laboratory tests are able to measure not only how the cells react to different pollutants, but also which ingredients can protect them against the negative effects caused, for example, inflammation. From there, products can be developed to protect against the damage and repair the damage done as much as possible.

The relationship between air quality and skin conditions

There is a clear correlation between spikes in air pollution and increases in the number of people suffering from skin problems such as acne, hives and eczema. It is clear that air pollution is not just affecting skin on a cosmetic level, but also poses a real threat to skin health.

A recent study done in Korea evaluated the clinical effects of outdoor air pollutants in patients with chronic eczema. Researchers measured daily outdoor concentrations of PM, nitric oxides and volatile organic compounds to estimate each patient’s exposure to air pollution. They found a direct correlation between outdoor particulate concentration and presence of symptoms, showing that ambient air pollution was an aggravating factor for these patients.

Those living in highly polluted areas have significantly worse skin hydration than subjects living in the cleaner suburbs despite making better lifestyle choices (such as cleansing routines, water consumption and greater skin care product usage). In addition, compromised skin barrier function were found in the urban dwellers. While there is sadly a lack of in-depth research in the area of air pollution and skin health, there is clear scientific evidence that skin barrier function and skin hydration are among the most immediate and significant threats air pollution imposes on our skin.

Anti-Pollution Measures To Protect and Restore Your Skin

Cleansing: I was intrigued by the numbers showing how many different chemicals are attached to pollution particles. I recommend a two-step process for cleansing, the first using a cleansing wipe or makeup remover pad and a second pass or wash with a cleanser to remove any remaining makeup, dirt, grime or pollution left on the skin. Cleansing brushes work better than just using your hands to wash your face.

Niacinamide (Vitamin B3): Orally in doses of 500 to 750mg twice a day or topically in brands such as Olay, Nia24, Skin Medica, SkinCeuticals and others, is one of the hardest working ingredients and is at the top of the list in being able to successfully reduce the negative effects of urban dust, cigarette smoke, diesel dust and benzo-a-pyrene, found mostly in urban living environments. In all these tests, it significantly reduces the damage caused to the skin cells, protecting them and helping them to recover better. It also strengthens the skin barrier and actively repairs UV damage – giving your skin all-round protection against environmental stresses

Superoxide Dismutase (SOD): One form I often recommend to my patients is GliSODin. This is an oral supplement containing melon SOD combined with wheat gliadin, and has been shown to increase the body’s antioxidant defenses and also has anti-inflammatory properties.

Hydration: both by drinking water and from using excellent products on your skin is key in making sure your skin functions at its best in protecting and strengthening the natural skin barrier.

UV Protection: still one of the biggest environmental stressors. An SPF product should always be part of your daily skin care routine.

Antioxidants: both topical and by mouth. These include Vitamin A, C, D, B-complex and B3 as noted above.

Adaptogens: These are natural ingredients that help balance out and modify the effects of stress on the system. These include Superoxide dismutase, CoQ10 and Resveratrol, ashwaganda, curcumin, and ginseng, among others. The best way to incorporate these into your regimen is through fruits and vegetables and spices. They are also available in supplements such as Nutrafol, which was designed for hair growth, but is one I often recommend to my patients as an anti-pollution supplement.

Protect Your Skin

The threat from pollution is real and it is not getting any better any time soon. Protect your skin and your health by eating a high antioxidant diet, adding in select supplements, properly cleansing your skin and using products with ingredients specifically tested against the most common toxins in pollution. And, do what you can to re-use and re-cycle so we can restore our planet while we still have time.

 

In Defense of Beauty

Use one word to describe any of the following people: Christie Brinkley, Halle Berry, Marilyn Monroe, Raquel Welsh, or Sophia Loren. The number one answer will always be “beautiful.” This makes us all judges and for this we feel we have the right to also judge how they become or stay beautiful as they age. Everyone has their own sense of how far is acceptable to go to maintain or attain beauty, and, of course, there are those among us who impose their views on others. A friend innocently posted an article on their Facebook page announcing Christie Brinkley’s partnership with  Merz in which Christie discussed certain aesthetic treatments she’d chosen to have, using their products of course.  I wish I could say I was shocked by some of the vicious and woefully uninformed comments that followed. I won’t mention them here, because they are not deserving of repeat, but you can probably guess what they were. It was especially upsetting to see this since I had the pleasure of having worked with Christie early on on her skin care line and found her to be not only stunningly beautiful but also one of the nicest people I’ve met and a great mom to boot! Sure she has great DNA but you don’t get to where she is, especially at her age, without also being smart and working very hard.

Hardest on ourselves vs. others

In some cases, we are hardest on ourselves. In others, we impose our views on those around us, especially celebrities and models. There are a few women who beat the system and are recognized and celebrated for their beauty even as they age. My hope is they will set the tone for the rest of us. One example that comes to mind is Jane Fonda who looks beautiful for any age, and just like herself, even if she’s had the help of some very talented aesthetic physicians along the way. I met her once. Ok, not actually met, but used to see her way back years ago in the late 1970’s at a gym called the Manhattan Cardiac Institute. It was in the time before there was a gym on every corner. You were assigned a trainer and needed a doctor’s note to attend.

I was there because my dad wanted me to lose weight and Jane was probably there because it was the best place in town, known for no-nonsense, intense work outs. Jane was on the mat next to me, stretching and doing our standard 100 sit-up warm ups, and then she went to work with her trainer and I went with mine. I was 17, she was… not. I couldn’t help but notice her workout kicked my workout’s butt! She also took great care of herself over the years and so have most, if not all, of the women you see who look great as they age.

Aging has its challenges

Up to 90% of how your skin ages is from sun exposure and other lifestyle choices  you’ve made over the years. The skin thins, discolors and wrinkles and genetics also kick in and kick out hormones of youth and reproductive potential. Thick flowing hair thins and grays. The brows and corners of the mouth drop and lines and wrinkles settle in. As words on paper, that doesn’t conjure up the ideal image of beauty. To make matters worse, most of us did not win the DNA beauty-queen lottery at birth, but we all have beauty and it’s normal to want to make the most of it and to hang on to what we have. Sadly, it’s sometimes even harder for those very few who did win the genetic beauty-lottery. Many of these women end up being commoditized and unable to see their own beauty because it’s always defined in comparison to others and is eventually in comparison to a younger version of themselves.

Beauty in Aging

Embracing aging does not mean letting your hair go gray or avoiding aesthetic treatments any more than It means letting go of a healthy lifestyle, including proper diet and exercise, sleep and sex. There is also no aesthetic treatment that will recreate the beauty of a life fulfilled, but it can enhance and more accurately reflect it.

Beauty and the word “beautiful” change as we age and take on richer meaning as the years add on.

There is no greater beauty than the beauty of a life lived, love had, love and loss, gratitude and inner peace and of a satisfaction that you made it this far and are still here to tell the tale.

For many women, aesthetic treatments help them look as good as they feel, or sometimes as good as they want to feel.  Treatments can help repair the damage of indiscretions from earlier years when the lack of sunscreen and sleep may have seemed like a small price to pay for a good time at the time, but accelerated the aging process and added artificial and distracting layers to aging skin years later. 

Bottom Line: it’s no one’s business what you or anyone else does, or how much you choose to tell or not to tell. You have options – enjoy what you see or turn the page.