September Wellness

Tag: Botox

  • 55 Then vs. 55 Now: What Happened to Aging?

    55 Then vs. 55 Now: What Happened to Aging?

    Put a 55 year old celebrity from 1985 next to one from today and you’d swear somebody mixed up the birth certificates. Are we actually aging better than our parents, or have we just gotten extraordinarily good at looking like it? The science has a few surprises, and one of them is a little rude.

    I saw a TikTok the other day that made me stop scrolling.

    It was one of those side by side comparisons of celebrities at the exact same age, decades apart. Michael Caine at 51 next to Leonardo DiCaprio at 51. Bette Davis at 57 next to Jennifer Lopez at 57. Gene Hackman at 45 next to Ryan Gosling at 45.

    The difference was startling. Not because the older celebrities looked bad. They didn’t. They just looked like grown ups. Proper, established, middle aged adults who paid their mortgages on time, knew their insurance agent by first name and owned very sensible luggage.

    The people photographed today? Some of them look like they haven’t decided what they want to be when they grow up.

    Here’s my favorite example. When The Golden Girls premiered in 1985, Rue McClanahan, who played the gloriously flirty Blanche, was 51 years old. Fifty one! Picture Blanche’s shoulder pads, the floral caftans, the wicker furniture. Now picture a 51 year old woman you know today. It’s practically a different species.

    I’m 52. And when I look around at my friends, I genuinely think we look younger than people our age did when we were growing up. Is it because we dress younger? Take better care of ourselves? Get a little help from Botox and lasers? Or is something actually different about how we’re aging?

    Turns out, it’s a little bit of everything.

    And buried in the research is one deeply uncomfortable discovery: we may look younger on the outside, but some scientists are finding evidence that newer generations could be aging faster on the inside.

    Which feels like a particularly cruel joke after all the money we’ve spent on skincare.

    First, Those Celebrity Comparisons Are Playing Tricks on You

    Let’s start with the obvious. Comparing two celebrities at the same age is not exactly a controlled scientific experiment.

    One photo might be a grainy screenshot from a 1983 talk show. The other might come from a movie premiere with professional lighting, professional makeup, a tailored tuxedo and a photographer whose entire job is making famous people look fabulous. We don’t know what treatments either person had, how much retouching happened, or how they’d look standing side by side in the fluorescent light of a grocery store.

    And then there’s who gets picked. Jennifer Lopez is not the average 57 year old woman. Neither was Bette Davis. If you go hunting for the most dramatic comparisons, you’ll find them. That’s how a viral TikTok carousel works.

    But I don’t think it’s all an illusion. Part of what we’re seeing has to do with how our brains decide how old someone is.

    Apparently, Hairstyles Have Birthdays

    Look at a photo of someone in their 50s from the 1980s. The hair is enormous. The makeup is unmistakably of its era. The clothes have structure. Sometimes shoulder pads big enough to qualify as protective sports equipment.

    And somehow, all of that makes them look older to us.

    Here’s why that’s fascinating. When we were kids, those were the hairstyles and clothes worn by adults: our parents, our teachers, the anchors on the evening news. So our brains learned to file those looks under “old.” Now we see that same perm on someone who was 45 in an old photo, and our brain reads them as 65. It’s not necessarily their face. It’s the whole package.

    Meanwhile, a 55 year old today might have long, loose hair, jeans, sneakers and the exact same haircut as her 30 year old daughter. We’ve mostly stopped following the old rules about how a middle aged person is supposed to look.

    I can’t remember the last time someone told me a woman over 50 shouldn’t wear her hair long. And if they did, I’d have a few suggestions about what they could do with that opinion.

    A hairstyle can’t reverse biological aging, of course. But it can completely change how old we think someone is. So some of those viral comparisons are showing us changing fashion as much as changing faces.

    The Cigarette Smoke We Forget Was Everywhere

    Now for something that genuinely changed: smoking.

    In 1965, 42.4 percent of American adults smoked cigarettes. By 2022, that had dropped to 11.6 percent, according to the CDC. That’s an enormous shift. And cigarettes don’t just wreck your lungs and heart. They wreck your face.

    Researchers have studied this using identical twins, which is a brilliant setup: two people with nearly identical genes, but different exposure to one major aging factor. In a 2013 study of 79 pairs of identical twins where one smoked more than the other, the smoking twins showed noticeably more aging around the eyes and mouth. Smoking damages skin through oxidative stress and by breaking down the collagen and elastin that keep it firm and bouncy.

    Unlike the hairstyle theory, this isn’t about seeming older. It’s actual damage.

    So when we compare a 55 year old from 1985 with a 55 year old today, we may also be comparing two generations with very different lifetime exposure to cigarette smoke. Not every older celebrity smoked, and plenty of people still do today. But it’s a huge population level change that almost never comes up in those TikToks. Back then, you couldn’t even sit on an airplane without breathing someone else’s Marlboro.

    We Also Used to Cook Ourselves in the Sun

    I remember when having a tan was practically a personality trait. We went to the beach with baby oil, not sunscreen. Some people used aluminum foil reflectors to make sure no ray went to waste. The goal was to look like you’d spent the entire summer on a yacht. And if you burned first? That was just part of the process.

    Today we’re having serious conversations about SPF 50, UVA protection, mineral versus chemical filters, and whether our sunscreen was formulated in Korea or reformulated for the American market. It’s a whole new world.

    And unlike a lot of skincare claims, the evidence that sunscreen prevents visible aging is unusually strong. In a randomized Australian trial published in 2013, researchers followed adults for four and a half years. One group used sunscreen every day. The other used it whenever they felt like it. The daily sunscreen group had 24 percent less skin aging according to the researchers’ measurements. That’s a real result from a controlled study, not a before and after photo in an ad.

    The catch: sunscreen you start wearing at 52 can’t erase 30 years of baby oil and beach towels. Prevention and reversal are two very different things. But if younger generations protect their skin earlier, there’s a solid biological reason to expect less sun damage at the same age. That’s a real change in how skin ages, not just in how it’s photographed.

    Botox Changed the Rules. Then Everything Else Joined the Party.

    Now for the part everyone’s thinking about but nobody wants to say too loudly: cosmetic treatments.

    Facial aging changed dramatically once wrinkle relaxing injections went mainstream. Then came fillers. Lasers. Radiofrequency. Microneedling. Chemical peels. Prescription retinoids. Better facelifts. Better eyelid surgery. Hair transplants. Veneers. The list is getting ridiculous.

    According to the American Society of Plastic Surgeons, about 28.2 million minimally invasive procedures were reported in the United States in 2024. That includes everything from injectables and skin treatments to certain other nonsurgical services. And that’s procedures, not people. Plenty of folks come back for more.

    Whatever way you look at it, the business of changing how we look has become enormous.

    And these treatments do very different things. Botox temporarily relaxes the muscles that create certain lines. Fillers add volume and reshape contours. Resurfacing treatments improve texture and sun spots. Retinoids help with cell turnover and collagen. Surgery repositions tissue. And a great dentist can change the way your entire face looks.

    That’s not one anti aging technology. It’s an entire industry devoted to editing the features we associate with age.

    But here’s the important part: making a face look younger isn’t the same as making the body underneath biologically younger. If Botox softens the lines around your eyes, that’s a visible improvement. It doesn’t mean your arteries, immune system or kidneys just got younger too.

    That doesn’t make cosmetic treatments silly or dishonest. If someone wants to look fresher, feel more confident or simply enjoy what they see in the mirror, I’m all for it. I just think we should be clear about what we’re buying. Sometimes we’re repairing damage. Sometimes we’re reshaping structure. And sometimes we’re just becoming extraordinarily good at hiding the evidence.

    Why Two People Can Age Completely Differently

    Here’s where the science gets really interesting. Even people born on the same day with the same genes can end up looking surprisingly different.

    A 2009 study of identical twins found that smoking and sun exposure were linked to older looking faces, no surprise there. But it also found something unexpected: among twins over 40, the one with a higher body weight sometimes looked younger.

    Before anyone celebrates by canceling their gym membership, the explanation is simple. A little facial fullness softens wrinkles and hollows. Lose a lot of facial fat in midlife, and your cheekbones may look fabulous while the rest of your face suddenly looks exhausted. There’s a reason the old saying goes that after a certain age, you have to choose between your face and your figure.

    It’s a balance between body composition, facial volume, skin elasticity and the bone structure underneath. Genes matter enormously. But they’re not the whole story. A Danish study of more than 1,800 older twins found that lifestyle and social factors were linked to how old people looked to others.

    The face we see at 55 is the result of far more than the number of candles on the cake.

    Menopause Changed the Conversation for Women

    When we compare women across generations, there’s one more piece we can’t skip: hormones.

    Estrogen plays a big role in skin thickness, hydration, collagen and elasticity. As it drops around menopause, many women notice their skin changing faster than it did in their 30s and early 40s. It gets drier. Fine lines get louder. Skin can feel thinner and less resilient. And the facial fullness that once kept everything comfortably lifted starts to shift.

    It’s not your imagination.

    But it’s worth separating what we know from what the skincare industry would like us to believe. Yes, hormones affect skin. No, that doesn’t mean every woman needs a $200 “menopause” face cream. Researchers are studying hormone related approaches to skin aging, but whether a specific treatment is safe and effective depends on the formula, the dose, how it’s used and your personal medical history. Hormone therapy is never a casual cosmetic shortcut.

    What has changed is the conversation. Our mothers mostly suffered through menopausal skin changes in silence. Today, women in their 40s and 50s are walking into their doctor’s offices with detailed, sophisticated questions.

    And frankly, it’s about time.

    Are We Even Comparing the Same 55 Year Old?

    Here’s what bugs me most about these celebrity comparisons. We’re comparing famous people from different decades, under different expectations, and then acting like their faces represent millions of regular people.

    They don’t.

    Money matters. Healthcare matters. Diet, work, stress and environment matter. Someone who spent decades working outdoors without sun protection has had a very different life than someone who works in an office and sees a dermatologist twice a year. And someone with money for great dental care, preventive medicine, a personal trainer and regular treatments has advantages that aren’t available to everyone.

    There’s also a selection problem. We notice the celebrities who look unusually young. Nobody makes a viral carousel of perfectly ordinary celebrities who look exactly their age. So the internet keeps showing us the exceptions until we start believing they’re normal.

    Remember that the next time someone announces that 60 is the new 40. Maybe for some people. But I suspect it depends rather heavily on your genes, your bank account, your health and how flattering the lighting is.

    Now for the Rude Part: What If We’re Aging Faster on the Inside?

    This is the finding that completely changed how I wanted to write this article.

    In June 2026, researchers published a study in Nature Medicine looking at biological aging across generations. They analyzed data from more than 154,000 people in the UK Biobank, plus a separate group of Americans. Instead of wrinkles or gray hair, they looked at blood and health markers tied to how fast the body is actually aging.

    And they found something unexpected. People born in more recent decades tended to have worse biological aging scores than people born earlier, even after accounting for their actual age.

    In one comparison, people born between 1965 and 1974, which is my generation, scored 23 percent higher on a standardized measure of biological aging than people born between 1950 and 1954.

    Before anyone starts checking their expiration date, that doesn’t mean we’re 23 percent older on the inside. It’s a statistical measure, not actual years added to our bodies. But the researchers also found that higher biological aging scores were linked to increased risks of certain cancers diagnosed before age 50.

    So here’s the picture. On the outside, we’re armed with sunscreen, lasers, injectables and ten step skincare routines, looking younger than any generation before us. On the inside, researchers are seeing signs that some of us may be experiencing more biological wear and tear.

    The study was observational, so it can’t prove that every system in the body is aging faster or explain exactly why. And biological aging clocks are useful research tools, not perfect measurements of how old your whole body really is.

    Still, the contrast is striking. We may be getting better at looking younger without actually becoming younger. And that raises a question the beauty industry rarely wants to discuss: what exactly are we trying to slow down?

    Your Face and Your Body Don’t Always Agree

    We tend to think of aging as one big process. You get older, your skin wrinkles, your hair goes gray, your joints complain, and eventually you start making little noises every time you stand up.

    But aging isn’t nearly that coordinated. Different organs and tissues age at different speeds. Your skin might show plenty of sun damage while the rest of you is in excellent health. Someone else might have flawless skin and serious heart or blood sugar problems. And a person who looks older than their age might be strong, active and thriving.

    There is research linking how old a face looks with certain health outcomes. But your face is not a medical test. You cannot look at a celebrity photo and know how their arteries are doing, let alone how long they’ll live.

    That’s why the whole “looking young” conversation can be a little misleading. We’ve turned a youthful appearance into shorthand for wellness. Great skin? Must be healthy. Toned body? Must be aging beautifully. Looks 40 at 60? Must have found the secret.

    That’s just not how biology works. And the better our cosmetic tools get, the less useful our appearance becomes as a clue to our actual health. Which is wonderful if your goal is to look good. Less wonderful if you start confusing your reflection with a full medical report.

    So Who’s Aging Better, Us or Our Parents?

    I don’t think there’s one simple answer.

    In some ways, we have real advantages. Far fewer of us smoke. We understand sun protection. We have treatments for visible aging that didn’t exist decades ago. Dental care, dermatology, cancer screening and cosmetic techniques have all improved enormously.

    But some of the difference is purely cultural. Hairstyles changed. Clothes changed. Our expectations of what 50, 60 and 70 should look like changed. And today’s photos are picked, styled and edited in ways that make fair comparisons nearly impossible.

    Then there’s that new biological aging research, which pokes a hole in the idea that modern life has improved every part of getting older.

    So no, I don’t think we can confidently say today’s 55 year olds are aging better than their parents across the board. But we’ve made dramatic progress in managing how aging looks. And maybe that’s the real story.

    The Part I Actually Find Encouraging

    I don’t actually want to look 35 again. I liked 35. I just don’t need a repeat.

    What I love is that turning 50 no longer comes with a mandatory rulebook. You don’t have to cut your hair short. You don’t have to stop wearing jeans. You don’t have to give up fitness, fashion, dating, travel, adventure or anything else that lights you up.

    You can do skincare because you enjoy it. You can get Botox if you want. You can skip all of it. And none of those choices decides whether you’re aging well.

    To me, that’s the most meaningful change of all. Maybe the goal isn’t to look younger than our parents did at 55. Maybe it’s having the freedom to decide for ourselves what getting older is supposed to look like.

    Blanche Devereaux would approve.

    THE SEPTEMBER TAKE

    I’m still obsessed with those celebrity comparisons. And I’m not going to pretend I don’t enjoy that today’s 50 year olds seem younger than the ones I grew up with.

    But after digging into the research, I think we’ve gotten remarkably good at changing how aging looks, while scientists are still figuring out what’s happening underneath.

    I’d love to look wonderful at 75. But I’d also like my heart, brain, bones and everything else to be doing reasonably well when I get there.

    Looking younger is lovely. Actually aging well is the bigger accomplishment.

    And if I can pull off both? I’m certainly not going to complain.

    Do This Week

    1. Find an old photo of someone at your age.

    A parent, an aunt, an uncle, or even yourself years ago. Look past the wrinkles and notice the clothes, the hair, the makeup and the photography. How much of what reads as “older” is actually just a different decade?

    2. Take sunscreen seriously.

    Of everything marketed to prevent visible aging, daily sun protection has some of the best evidence behind it. Use a broad spectrum sunscreen every day, and remember that shade, hats and protective clothing count too.

    3. Keep your skincare grounded in evidence.

    Before adding another expensive product, ask what it’s supposed to do and whether real human studies back it up. Prescription retinoids, for example, have far more evidence for sun damage than most trendy ingredients.

    4. Don’t confuse cosmetic wins with health wins.

    Enjoying skincare or cosmetic treatments is great. Just remember that fewer wrinkles tell you nothing about your blood pressure, cholesterol or blood sugar.

    5. Rethink what “looking your age” means.

    Long hair at 60? Wonderful. Jeans at 75? Why not? There’s no biological reason to adopt a certain style just because you had another birthday.

    6. Take care of the parts nobody sees.

    Exercise, good nutrition, avoiding tobacco, regular checkups and managing your health risks aren’t as exciting as a laser treatment. But they matter enormously for how you’ll feel at 75.

    7. Stop using celebrities as your aging benchmark.

    Enjoy the photos. Be curious. But a professionally styled red carpet portrait is never a fair comparison with your bathroom mirror.

    The goal isn’t to look like somebody else at 55. It’s to take care of the person you’re going to be at 75.

    September Wellness provides educational information about skin aging, cosmetic treatments and longevity research. Visible appearance is not a reliable measure of overall biological age or health. Cosmetic procedures and prescription skincare treatments involve individual benefits, limitations and risks. Consult qualified healthcare professionals for personalized advice about skin treatments, cancer prevention and age-related health concerns.

    Sources & Further Reading

    1. Hughes, M. C. B., Williams, G. M., Baker, P., and Green, A. C. Sunscreen and Prevention of Skin Aging: A Randomized Trial. Annals of Internal Medicine, 2013. The Australian study finding that daily sunscreen use reduced measured skin aging by 24 percent over four and a half years.

    2. Okada, H. C., Alleyne, B., Varghai, K., et al. Facial Changes Caused by Smoking: A Comparison Between Smoking and Nonsmoking Identical Twins. Plastic and Reconstructive Surgery, 2013. Uses identical twins to show how differences in smoking exposure are associated with visible facial aging.

    3. Guyuron, B., Rowe, D. J., Weinfeld, A. B., et al. Factors Contributing to the Facial Aging of Identical Twins. Plastic and Reconstructive Surgery, 2009. Examines how smoking, sun exposure, body weight and other lifestyle factors relate to differences in facial aging between twins.

    4. Rexbye, H., Petersen, I., Johansens, M., et al. Influence of Environmental Factors on Facial Ageing. Age and Ageing, 2006. A study of more than 1,800 older twins examining environmental and lifestyle factors associated with how old people appear.

    5. Centers for Disease Control and Prevention. Notes From the Field: Tobacco Product Use Among Adults — United States, 2017–2023. MMWR, 2025. Documents changes in tobacco use, providing context for the dramatic decline in cigarette smoking since the 1960s.

    6. American Society of Plastic Surgeons. 2024 ASPS Procedural Statistics Release. Plastic and Reconstructive Surgery, 2025. Provides national estimates of cosmetic surgical and minimally invasive procedures, showing how much aesthetic medicine has grown.

    7. Tian, R., et al. Biological Aging and Generational Shifts in Early-Onset Cancer Risk. Nature Medicine, 2026. Examines biological-aging measurements across birth cohorts and their associations with certain early-onset cancers. The findings complicate the assumption that looking younger necessarily means aging more slowly.

    8. Dart, A. Accelerated Ageing Confers Early-Onset Cancer Risk. Nature Reviews Cancer, 2026. Explains the newer biological-aging research and what the findings may mean for understanding early-onset cancer risk.

  • Everyone Wants to Look Younger. Nobody Wants to Look Like They Tried.

    Everyone Wants to Look Younger. Nobody Wants to Look Like They Tried.

    In Orange County, a great facelift can make you the envy of the dinner table. An obvious one can make you the evening’s entertainment. Somewhere between aging gracefully and trying too hard, we’ve invented an entire rulebook for looking younger, and I’m beginning to wonder why any of us agreed to play.

    I’m 52, and I’ve never had plastic surgery. And I’ll confess something slightly embarrassing: every so often, I’ve been rather pleased with myself about that.

    Someone compliments my skin, and before I can stop myself, I’m volunteering information nobody requested. “Oh, thank you! You know, I’ve actually never had any work done. I haven’t even had Botox in almost a year!” I say it as if I’ve just accepted a lifetime achievement award.

    An award for what, exactly? Good genetics? Being lucky enough not to have felt the need for surgery yet? Having a face that’s been relatively cooperative for five decades? Congratulations to me, I suppose.

    The more I think about it, the sillier that little flash of pride seems, especially because I’m not remotely opposed to plastic surgery. I’ve used Botox. I love good skincare, smart aesthetic treatments and pretty much anything that helps us look and feel our best. If someone offered me the chance to look like an even better version of myself, I’d absolutely be interested. So why am I so eager to announce that I haven’t needed much help getting here?

    Maybe because, somewhere along the way, we created one of the strangest competitions in modern life. We all want to look younger. We just want everyone to believe we did it naturally. And nowhere is that contradiction more entertaining than in a certain sun-drenched corner of Orange County, where cosmetic procedures are practically on the social calendar, everyone knows someone who’s had a facelift, and a good surgeon’s name travels through a dinner party faster than the juiciest piece of gossip.

    The facelift everyone admires. Until dinner.

    There’s a peculiar little ritual that unfolds when someone walks into a room looking noticeably younger than she did six months ago. It comes in four acts.

    First, admiration: She looks incredible. Then curiosity: Who did her face? Then the financial audit: I heard it cost an absolute fortune. And finally, if the evening runs long enough, the verdict: Don’t you think she was a little young to have that done?

    What’s remarkable is that all four reactions can come from the very same person, sometimes within the same conversation. And somewhere between the second glass of wine and dessert, that same person is quietly saving the surgeon’s number in her phone.

    I don’t think any of this is truly malicious. It’s human nature, especially in communities where appearance carries real social currency. We notice attractive people, compare ourselves to them, admire them, envy them, question their choices, and reassure ourselves we’d have done it differently. But plastic surgery adds a strange new twist to the game. It’s not enough to look good. Apparently, you also have to have gotten there the approved way. A beautiful result earns admiration, but the decision to get there can still earn judgment. Those are some very peculiar rules.

    Apparently there’s an acceptable amount of vanity

    Consider how strange our standards have become. A woman spends years exercising, eating beautifully, investing in skincare, booking facials and buying serums that cost more than a car payment. We applaud her. She’s disciplined, she takes care of herself, she’s aging beautifully.

    Then she decides she’d like a facelift, and suddenly someone wants to know why she can’t just accept herself.

    Excuse me? We were perfectly comfortable with her spending time, money and effort on looking better yesterday. What changed? The scalpel? The price tag? The fact that the results might be more dramatic than any serum could deliver? Or does surgery make us uncomfortable because it exposes something we’d rather not admit: there are limits to what healthy eating, exercise and a very good moisturizer can do.

    I love all three, and they matter for reasons that go far beyond appearance. But no amount of kale is going to recreate the structural lift of a facelift, and I don’t understand why we’re all supposed to pretend otherwise. We happily accept braces, laser eye surgery and all sorts of interventions that improve our lives. Yet when the improvement is mainly aesthetic, we suddenly need a philosophical debate about vanity. Maybe, sometimes, people simply want to look better. That seems like a perfectly reasonable explanation to me.

    THE NUMBER THAT GOT OUR ATTENTION: 9.9 MILLION

    According to the American Society of Plastic Surgeons, roughly 9.9 million neuromodulator injection procedures, the category that includes Botox, were performed in the United States in 2024, alongside nearly 1.6 million cosmetic surgical procedures. (Those are procedures, not individual people.)

    For something we still whisper about as if it were a scandalous little secret, aesthetic medicine is about as mainstream as it gets. Millions of treatments, endless social judgment. Apparently we’re very comfortable having work done. We’re just not quite as comfortable talking about it.

    And here’s a fun twist: Botox didn’t even begin as a beauty treatment. It was originally used for medical conditions involving the eyes. In the 1980s, a patient being treated for eyelid spasms pointed out to her ophthalmologist, Dr. Jean Carruthers, that her frown lines were disappearing. That observation helped launch an entirely new chapter in aesthetic medicine. Botox received its first U.S. medical approvals in 1989 and its cosmetic approval in 2002. One of the world’s most famous beauty treatments owes its popularity, in part, to a patient who happened to notice her wrinkles disappearing. You really can’t make this stuff up.

    The strange virtue of having done nothing

    Here’s where I have to turn the mirror on myself, because I know exactly how this game works.

    When someone compliments me and I cheerfully announce that I’ve never had surgery, what am I really saying? That I’m fortunate? That I’ve taken excellent care of myself? Or, tucked somewhere underneath, that I deserve a little extra credit because I didn’t need professional help? It’s not a particularly flattering realization. My genetics aren’t an accomplishment, and neither is the fact that I happen to be happy with my face right now. If I decided next year that I wanted a procedure, would that erase whatever imaginary points I thought I’d earned? Of course not. And yet we keep treating natural beauty as if it were a moral achievement.

    There’s also an inconvenient question hiding inside the phrase aging naturally: what counts as natural anymore? Is Botox natural? No. What about laser resurfacing, prescription retinoids, hair color, porcelain veneers, a touch of filler, or that very expensive facial involving a machine nobody can quite explain? We’ve invented an entire sliding scale of acceptable intervention, and, rather conveniently, most of us draw the line just a little beyond whatever we’re personally doing. Everything I’ve done is maintenance. Anything you’ve done beyond that is excessive. Funny how that works.

    Korea, California and the two faces of beauty culture

    I was born in South Korea, though I left when I was three. I’ve been back to visit several times, and what has always fascinated me is how differently Korea approaches cosmetic enhancement.

    There, aesthetic treatments can feel far less secretive than they do here. People talk about procedures openly. Double-eyelid surgery and rhinoplasty are familiar dinner-table subjects, and an entire stretch of Seoul’s Gangnam district is famous for its density of cosmetic clinics. Men’s skincare and grooming have a genuinely visible place in the culture. In some settings, seeing someone recovering from a procedure isn’t an invitation to analyze her character. She had something done. Life goes on.

    I don’t want to romanticize it. Korean beauty culture can create enormous pressure to meet very particular appearance standards, especially for young people, and openness about surgery doesn’t automatically mean freedom from judgment or insecurity. Research on South Korean young adults has documented the weight of appearance expectations, the influence of family and peers, and the widespread belief that looks can affect social and professional opportunities. Openness comes with its own complications.

    But on my visits, I’ve also been struck by how often the preferred result is understated and harmonious rather than obviously altered. Of course Korea has its dramatic transformations, just as Beverly Hills has surgeons doing breathtakingly subtle work. There’s no single Korean face and no single Orange County face. Still, the contrast is fascinating. In one culture, procedures are openly acknowledged, but the pressure to participate can be intense. In the other, procedures are everywhere, yet the ideal result is one that convinces everyone nothing happened at all.

    I’m not convinced either side has it figured out. Perhaps we could borrow a little of the openness, a little of the restraint, and leave the pressure behind. Wouldn’t that be refreshing?

    And then there are the men

    Some of the most entertaining double standards show up when men enter the picture.

    A man in his 50s starts lifting weights, loses his stomach, upgrades his wardrobe and begins taking care of his skin. Fantastic, we say. He gets a hair transplant. Interesting. He gets a facelift, and suddenly, depending on the crowd, people start drawing conclusions about his masculinity, his marriage, his dating life or his midlife crisis.

    Why? When a woman maintains her appearance, we might call it self-care. When a man invests heavily in his, we’re tempted to write him an entire psychological profile. I’ve noticed how quickly people link a noticeably younger-looking older man with the assumption that he must be chasing younger women. Maybe he is. Maybe he isn’t. But isn’t it revealing that we assume his appearance needs any explanation beyond simply wanting to look better? We’re far more used to discussing women’s efforts to hold onto youth, so perhaps men’s cosmetic choices still challenge our expectations of how an older man is “supposed” to behave.

    Meanwhile, aesthetic medicine has gone global, from hair transplant clinics in Turkey to meticulous facial work in Seoul. When a man flies across the world for a procedure, is that vanity, practicality, or simply taking advantage of options that have become more accessible? It depends entirely on the person, which makes the automatic judgment all the more unnecessary.

    When did looking your age become a problem?

    Here’s the part of this conversation that bothers me more than plastic surgery ever could. Somewhere along the way, we started treating looking your age as something that needs explaining.

    A beautiful 60-year-old is praised for looking incredible for her age. A 65-year-old celebrity is celebrated for looking 45. Someone who looks 65 at 65 is said to have aged badly, and someone who looks 45 at 65 is immediately suspected of having had work done. The goal, apparently, is to look younger while proving you’re far above wanting to. How exhausting.

    And when did attractive aging come to mean only looking younger? I know plenty of people whose appeal has very little to do with whether they could pass for a certain age. There’s confidence, energy and style. There’s the way someone carries herself, the spark in her eyes, the ease of a person who knows exactly who she is. Those things matter enormously.

    But I also refuse to pretend physical appearance stops mattering at 50. Wanting to stay attractive, desirable and youthful isn’t automatically a sign of insecurity or an inability to accept aging. Sometimes it’s simply a preference. We’re allowed to have it.

    Does plastic surgery actually make people happier?

    This is where the conversation deserves some real science.

    Cosmetic procedures can genuinely improve how people feel about their appearance. A systematic review and meta-analysis of 35 studies on surgical and nonsurgical facial procedures found improvements in patients’ satisfaction with their faces across a wide range of treatments, and some studies also reported psychological and social benefits. That’s worth saying out loud. We often talk about cosmetic work as if it must spring from deep insecurity, but plenty of people are perfectly content with their lives, choose to change something about their appearance, and are simply delighted with the result.

    At the same time, being happy with a result isn’t necessarily the same as being happier overall. A 2025 systematic review found some psychological and body-image benefits after cosmetic surgery, but noted that the research quality was limited and long-term outcomes remained uncertain. In other words, a facelift can change a face. It can’t guarantee a change in someone’s relationship with herself.

    That distinction matters. If there’s a particular feature you dislike, changing it may bring genuine, lasting satisfaction. But if you’re hoping a procedure will fix your marriage, restore a lost sense of purpose or make you immune to comparing yourself with everyone at the table, that’s an awful lot to ask of a surgeon. A good cosmetic procedure can help you feel better about how you look. It shouldn’t have to fix everything else in your life.

    Let’s talk about going too far

    Of course, no honest conversation about cosmetic surgery can skip the results that simply don’t work. We’ve all seen the celebrity photos: faces pulled too tight, features that no longer move, proportions that drift further and further from the person we remember. And yes, people talk. I’ve done it too.

    But I’m beginning to think there’s an important difference between deciding a result doesn’t appeal to you and deciding the person who chose it deserves ridicule. You can dislike an aesthetic outcome without condemning the human being. You can question whether repeated procedures are wise without making assumptions about someone’s entire personality. And you can believe wholeheartedly in personal freedom while still recognizing that surgery carries real medical risks.

    This isn’t the same as choosing a new haircut. Surgery can involve anesthesia, bleeding, infection, scarring, nerve injury and complicated recoveries, and injectables have their own risks too. Many people are thrilled with their outcomes, but research also highlights how important it is to evaluate expectations and emotional well-being beforehand. A responsible surgeon should sometimes say no. Not because an adult is too old, too young-looking, too vain or too interested in beauty, but because a procedure may not be safe, appropriate or likely to deliver what she’s hoping for.

    That’s the kind of restraint I can get behind. Not society deciding how much attractiveness anyone is allowed to pursue, but sound medical judgment, realistic expectations and the wisdom to recognize when enough is enough.

    Maybe the best version of yourself takes a little help

    I don’t believe healthy aging has to be an either-or proposition. You can take beautiful care of your skin and consider professional treatments. You can work out, eat well and still admit that exercise won’t address every aesthetic concern. You can appreciate the face you inherited and still decide there’s something you’d like to refine. None of those ideas cancel each other out.

    Wanting to look good doesn’t mean you’re refusing to grow older. You’re still aging. You’re still collecting experiences, relationships, wisdom, humor and, hopefully, enough confidence to care a little less about what everyone else thinks. You’re simply choosing how you’d like to look while you do it.

    Nor should anyone feel obligated to pursue every enhancement on the menu. If you’re happy with your appearance, wonderful. If you’d like Botox, wonderful. If you’re considering a facelift, take your time, do your homework, understand the risks and make the decision for yourself. And if you’ve had absolutely nothing done, maybe resist the urge to announce it as though you’ve completed aging on the hardest difficulty setting.

    I’m talking to myself here. Because I’m starting to suspect that the most attractive part of growing older might be getting comfortable enough with ourselves to finally stop keeping score.

    THE SEPTEMBER TAKE

    We’ve turned looking younger into a competition, then awarded bonus points for pretending we never tried. A great facelift earns admiration, an obvious one earns gossip, and doing nothing somehow earns a medal.

    Maybe the real vanity isn’t wanting to look younger. It’s believing our own way of getting there makes us better than everyone else.