Has She or Hasn’t She? by Dr. Vivian Diller

Editor’s Note: Vivian Diller is the author, with Jill Muir-Sukenick, of Face It: What Women Really Feel as Their Looks Change.

Let’s start with the good news: When it comes to aging gracefully, there is a plethora of products and procedures available for women seeking ways to "update" their appearance, without making radical changes. These are short-term solutions for those who don’t yearn to look 20 years younger, but want to look the best they can at their own age. They are for women who would like to take control over the kind of uneasy feelings recently described by Sheila Nevins on this site.

Some women say they simply want to look as good as they feel (a demographic that seems to be getting alarmingly younger and younger). Just as we have come to color our hair routinely, many women regularly seek solutions to revitalize other aging parts. And there are countless options to choose from: creams, lotions, facials and spa treatments, and of course an increasing number of non-surgical procedures like Botox, laser resurfacing, dermabrasion, collagen and filler injections, to name a few. Most offer immediate, short-term results that are less expensive, and for some, comfortably, less dramatic than plastic surgery.

But now for the bad news: Many women are reaching for these solutions impulsively and compulsively, rather than thinking them through carefully. They are acting out of fear, as they anticipate living well into their 80s, even 90s, in a youth-obsessed culture. With few role models for how to age with grace and poise, women dread the notion of looking like their mothers and grandmothers — or worse, becoming invisible. Eager to do whatever it takes to avoid that destiny, they often don’t consider the slippery slope on which they embark.

More bad news? Most of these non-invasive products and procedures require constant upkeep. They take time and cost money that some women don’t have. I have yet to meet a woman who hasn’t wanted to continue, once she likes what she sees. Not only do most want more of the same, but one procedure often leads to another. Just as a newly painted room makes the furniture look older, so does a wrinkle-free forehead make crow’s-feet seem more pronounced. Wrinkles return, along with a woman’s original face/neck/body — and after the "work" wears off, she notices them more than ever.

Click the play button below to watch Diller and Face It co-author Jill Muir-Sukenick on the "Today Show":

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"Does she or doesn’t she?" — the question asked furtively by women just a few decades ago — has now shifted to "has she or hasn’t she?" Does this shift derive from greater comfort with new cosmetic options, or have we started down a slippery slope? Perhaps the answer depends upon how thoughtful we are about the long-term impact these options have on us — not just medically, but psychologically as well. Look at it this way: Would you go up a mountain and ski down without knowing the terrain, without knowing if there is an end in sight or if you can make it down safely? What about women who start these "non-invasive" procedures at age 30, or even 20? We have heard of Botox injections being offered to teenage girls, who are excited by the possibility they can avoid wrinkles altogether by never getting them in the first place. But do we know yet if healthy skin has enough elasticity to tolerate repeated dermatological procedures — or if they potentially create the opposite effect over the long term?

We clearly don’t have the answers yet (after all, we are just beginning to see the impact on our hair from the years of dye we have used). But we know we need to be asking the right questions: What does this all really mean and for whom are we doing it? Remember, no procedure stops the clock. Aging is a process that begins the day we are born and continues for the rest of our lives. The key is how we care for our aging appearance and resolving our ambivalence about the whole topic.

So before you reach for that expensive new jar or spend $1,000 on the next injection, be thoughtful and be careful. We use the acronym, S.A.F.E. to help women make good choices, encouraging them to ask these four questions: Are these procedures (1) Safe, (2) Affordable, (3) For You and (4) are your Expectations realistic? The many new options may bring you great pleasure, just as that mountain might for a skier who knows how to make good choices. But one who plans to ski a lifetime thinks carefully before going down a dangerously slippery slope. When it comes to your face, your body and your aging process, be as thoughtful as you are in other aspects of your life. You will feel, and ultimately look, far more beautiful.

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