Anti-Aging Skin Care

Nips, tucks and skin care by decade: Dr. Kim’s guide to looking like a celebrity

By Kim Crawford, M.D. Last updated: November 10, 2017
skin care by decade

Is there a difference between routine skin care and skin care by decade?

In a word-yes. We can guesstimate skin care by decade as well as helpful ways to look younger without plastic surgery decade by decade. And most importantly, if you are indeed going to have plastic surgery, let this article be your guide to getting it done how the celebrities do it. I’ll tackle this topic first.  How old do I look? Is this something you have asked your spouse? Or friends?

I am reminded of Jeff Foxworthy’s routine where the wife asks “Honey do these pants make me look fat?” and the audience laughs while Jeff pauses. He then says “Hell no they don’t. You’re FAT!”

How old to I look seems to me to be one of those questions… Well, if you’re going to ask it I want to make sure you get a great answer.

We now have amazing skin care products, esthetic dermatology lasers, fillers, Botox procedures and plastic surgery nip-tucks. I list all of this hoping you will use each “thing” judiciously. Also, always start with inside out skin care to look younger before anything else. I covered all of that in the eight anti-aging products article which deals just with inside-out skincare. And to jump ahead with skin care products so you’ll have this bookmarked- here is my review of the best anti aging products 2016 which is “all about topical skincare”- nothing else.

First, let’s talk Plastic Surgery:

For those of you who know me personally or professionally, you are likely thinking…”What? Is she talking first about Plastic surgery? Something she says to do last?” Yes, I am because by the time women are thinking “of doing something,” most are making appointments to see Plastic surgeons.

So, while I think this is a terrible way to go about staying young looking, I’m a realist and always want to give my readers the inside scoop on everything. This is why I’ll get this information out of the way so when I discuss skin care by decade, you will know what I’m talking about.

Personally, I’ve been “working on it” with a great anti aging skin care regimen, and adding in Esthetic Dermatology “stuff” the last ten years too. It’s not like one morning I woke up, looked in the mirror, checked the year and decided I needed 5 Plastic Surgery procedures. I get carded sometimes, and THAT always amuses me. Anyway, let’s review what you need to know about plastic surgery. Then, I’ll get into keeping young with, as promised nips and tucks and skin care by decade.

Let’s talk about the “facial zones”:

skin care by decade                                             

This is how you should view your face if you are considering Plastic Surgery. Zone 1 is your forehead. Zone 2 are your eyes and temples. Zone 3 is your “midface.” Zone 4 is your jaw and just above it. Zone 5 is your neck. Remember you want to look younger not tighter. Bad joke but true, right?

When facelifts result in being unnatural, it is from a variety of things. Remember me saying you have to get your skin in shape, get rid of oxidative stress and inflammation and use great skin care products? If not, go back and read that link I gave you when you’re done because that is step 1. Again, if not, you won’t heal “so great.” The next step is to find a great Plastic Surgeon who knows the latest and greatest procedures.

Now regarding the zones, at some point we lose the war with sagging skin with our use of  Lifeline stem cell skincare, botox or lasers. If you can’t stand the sagging, it’s time to judiciously pick “by the zone” and by the specific procedure.

skincare by the decadeThe Zone Rule

Good Plastic Surgeons do surgeries just in one or two zones at a time. Also, they don’t insist you have a full facelift under general anesthesia if you just need 1, 2 or up to 3 “zones” attended to.

The secret that movies stars know is to never have more than two adjacent zones “done” at the same time. Doing so is appearance altering and that is what you want to avoid, right? Who wants everyone saying “OH wow, you’ve had plastic surgery?” You want them to say you look great, look rested, or have a great new hairdo.

So, as an example, you can have an endoscopic brow lift (zone one) and a blepharoplasty (zone 2), but don’t go lower than that. However, you can dip into zone 4 and 5 with a Z-lift and have your jaw and neck “done” at the same time if the surgeon agrees. Got it?

Now let’s talk techniques:

Plastic surgery is forever advancing. Plastic Surgeons, the good ones, will know how to do things like a forehead lift “endoscopically”; being able to make two incisions behind the hairline, so your scar is invisible.

He/she should know how to use lasers for things like jaw tightening and neck tightening-where incisions are tiny, lasers are inserted to basically “shrink-wrap” loose tissue. Gone are the days when plastic surgery will alter the tilt of your eyes or give you huge visible scars. Scars are now minute and become invisible within 3-6 months. The whole how old do I look thing used to involve how many scars can you see- but no more.

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Brow lift

Now remember that each procedure, even if it’s called a “weekend XYZ” means you are up and around but you still look like someone punched you in the face for a 2+ weeks. So it’s down time and weighing the pro’s and cons.

An example of one choice is what to do with upper eyelids drooping and eyebrows appearing to close to the eyes. A blepharoplasty will open the eyes but not fix the brows.

The choice could be getting an endoscopic brow lift or using Ultherapy treatments and Botox®. This is why you need a really good, board certified Plastic Surgeon who specializes in faces. But no matter what, you need to keep your insides healthy and use amazing skin care products to optimize  whatever procedure you have done.

Do More Before Plastic Surgery 

I have discussed lasers, Botox®, and fillers in other articles so make sure you take care of the insides, use great skincare products, use noninvasive techniques well before resorting to plastic surgery, OK? You may or may not have heard of studies where they show people’s facelift b/a pics. The “judgment” was a 2-3 year difference.

IMHO these non-results surgeries happen because the women (and men) don’t do all of the other things they need to do. So, enough of me nagging you to get healthier. And another thing-be realistic about how young you can look.

My Esthetic Dermatologist says that it is unrealistic for most women to look more than 10 years younger than their stated age. Yea, she says that at age 52 while SHE looks 30! “How old do I look?” she asked me last month. I said, “Shawna, you have looked 28 since I met you 10 years ago”. She said, “No, I don’t.” For the record-yes, she does!

Now let’s talk about what your regimen should be for skin care and “tweaks” from girlhood to mature magnificence. I always tell my patients that 60 is the new 40. Further, when they ask how old they look I tell them HONESTLY that they look a good decade younger because if you are my PATIENT or you have gotten a consult from me HERE you take care of the insides!

Skin Care Regimens to Look younger with each decade!

look young each decade

Skin care until age 20

no more acne pitsAt the age of 14-21, your skin is still young, and you still may be experiencing acne (which is best treated with products containing salicylic acid such as a salicylic acid cleanser, hydroxyl acid products, and doing non-abrasive exfoliations 2x weekly. Avoid oral antibiotics or, worse yet, benzoyl peroxide, with actually just traps the bacteria under thickened skin.

To ensure you have a lifetime of great skin, always use sunscreen and safe all natural products. Do not use tanning booths or any sun-tanning. You may not be thinking of the effects now as your skin is still young, but it factors into how your skin will appear as you age. So yes, it DOES matter now.

If you are looking for a tan, look for tanning businesses that use a natural plan based spray tan, and, avoid those rather nasty, UVA-rich tanning beds.

Your skin care regimen only needs to consist of:

Weekly: Exfoliate.

Daily regimen: 1 cleanser, toner (optional), one serum and a moisturizer for acne prone skin. Depending on the acne and oil situation you can add acne product and skip the moisturizer.

Extra procedures: Rarely will you need LED or Fraxel ® for “spots” during this decade but LED and mild chemical peels are great for acne. No Botox® is needed during this time. No one should be obsessing and wondering how old they look or else this is body dymorphia and counseling is needed.

Skin care age 20-30

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If you were exposed to the sun a lot in your teenage years, you might have started to get sun spots or fine lines under your eyes.

  Your skin care regimen:

You might want to add another serum, depending on your current skin condition, such as sun spots.

You can add a night time moisturizer if your skin has started to become dry, otherwise just stay with your regimen and add just one more serum.

You want to do at least a weekly exfoliation and for thick, oily skin-two.

You can add a home micro-current device or home LED device to stimulate collagen and elastin. Also, you can add a derma-roller to Esthetician visits or home use. Inter-change derma-rolling and microneedling for collagen stimulation too. Continue some sort of collagen stimulating technique at home or with an Esthetician or N.P. (for life). I won’t keep mentioning this.

Close to 30– You might consider starting “prophylactic” Botox® for your forehead and crows feet if you “see them starting to appear.” Chemical peels are a good addition, especially if you are acne-prone.

Close to 30– You might consider starting semi-annual laser skin tightening (discussed below) as you are now officially losing elastin and collagen. Don’t scoff at the age group I’m suggesting to “get started” as they will be the ones who will NOT need plastic surgery.

Plastic surgery – Don’t do it!

Skin care and “other” age 30-40

takes bcaa for weight lossDuring this age, you may start to notice some changes, which are nothing to panic over. I am here to help!

Skin care: Assess need for a third serum, but you should be okay unless you are still sun tanning!

Exfoliations: Assess skin thickness and dullness; increase use and variety but don’t fry your skin.

Non invasive Esthetic Dermatology: This is a great time to start a little Botox® and either Titan or Ultherapy laser skin tightening. Titan works; it doesn’t go as deep and you need 2-3 treatments to get started. It’s cheaper than Ultherapy, but not all that much cheaper. Ultherapy is a little painful but wow, it works. It’s once a year on this one. It’s how to tighten skin, in my book. It’s also natural and there is no down time at all!

Fillers in certain areas might be useful, usually the nasolabial lines. The thing about fillers is that they fill in lines and they also stimulate collagen and elastin. There are a variety of fillers, and there is also a product called Sculptra which can be used to fill in where facial fat is lost. Step up the microneedling and/or derma-rolling.

Plastic surgery nip-tucks: During this decade some women have eyelids that disappear, so a blepharoplasty isn’t absurd as you are young and will heal. Warning: DO NOT “get addicted” to plastic surgery!

Skin care and “other” to from age 40-50

what is lean body mass well it's Jennifer! During these years,  menopause is common, mainly around the ages 47-53. Due to hormonal changes with associated loss of collagen, elastin, hyaluronic acid and HORMONES this might be the big intervention decade. If so, here’s what you do:

Weight gain: Start a great program and try to stick to it. Losing and gaining weight is just awful for facial appearance. Add weight training to maintain your lean muscle mass. Use supplements for weight training as needed. Add a natural appetite suppressant as needed.

Skin care regimen: Add serums and moisturizers (as much as you need). If, for some reason you don’t have the Lifeline Proplus duo on board, now’s the critical time.

Esthetic Dermatology: Switch from Titan to Ultherapy, and start using the “correct” fillers to plump and stimulate collagen and elastin.

Continue to use the derma-rolling and micro-needling. You might need LED treatment for sunspots.

Plastic surgery nip-tucks: You might need a neck tightening or endoscopic brow lift. Hopefully not, but you might and if so it’s many “zones” (remember them?) away.

Skin care and “other” from age 50-60

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This is the time when most of the carnage occurs so step it all up! Look at Christie. She sure has got it going on, right?

Skin regimen and exfoliation:

Pull out all stops and use three serums, use the roller, use a home device and fight it, baby, fight it!


This tends to be a decade of high stress for women. Aging parents, college kids, job, “getting older”-you know the drill. Cortisol levels go up, and that is death to collagen and elastin so you must learn how to control your stress. And in many cases, you’ll want to supplement to lower those cortisol levels.


Consult with an Anti-aging M.D.; we can all help! Get educated about the health and beauty benefits of bioidentical hormones.

Esthetic Dermatology: For age spots and fine lines you may consider:

Fraxel® treatments. You can also start to use a very thin hyaluronic acid for under eye filling if you haven’t done this yet. You are looking for Belotero. Continue Botox® and fillers, and consider increasing your Ultherapy to every 6 months. See what your decolletage area needs as you can do Ultherapy here for vertical lines, LED for spots and chemical peels for re-texturizing. You can also do Fraxel for re-surfacing.


As stated earlier, now might be the decade for an endoscopic browlift. See if eyelids and forehead wrinkles can be kept under control with botox. See how neck, jaw, and mid-face are holding up with non-invasive treatments. If they are not doing the job, look at getting  non-contiguous zone nip-tucks.

Thread lifts:

This would not have been something I would have said okay to 5 years ago, but under the right circumstances, yes. If you find someone trained in the latest techniques, they can now use dissolvable sutures which actually stimulate collagen and elastin. So, this can lift up a slightly sagging jawline and even cheeks and a brow quite nicely. I haven’t mentioned this earlier because when you are younger you heal much better from “real” plastic surgery. But, of course, this is an option when you are younger, too.

Skin care and “other” from 60-70 to continue to look young

uses l carnitine bodybuilding supplementsMake sure you are using all of the best anti aging skin care products and ingredients I have listed.

Make sure you also are on the least amount of pharmaceuticals possible and are eating anti-inflammatory and high nutrient, low processed foods and low sugar-crucial at this age. Although this is extremely important at all ages, this is crucial now as health issues potentially increase as we age. (Unless you are seeing an Anti-aging doctor in “real life”).

Continue Esthetic Dermatology procedures that are working for you. Keep up everything discussed previously. You are the new 40, remember?

Nip-tuck mid-face if needed. If jaw wasn’t done when you had your neck done, have that done at the same time, endoscopically with laser assist. If a thread lift can do the trick, try that first. Helen looks better now than in this picture. (She must have had a little nippy tuck done!)

Skin care and other from 70 to 100+

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During these decades, it is clear whether you have been taking care of your insides. If you are not your skin will be thin and plastic surgery will be a “stretched canvas affair” if you are just starting this process.

Inside out: Do not have plastic surgery unless this “thin skin issue” is fixed or your results will not be desirable. Remember, nothing is too late. Don’t worry!

Hormones: If skin is thin and fragile looking you need your consult with an anti-aging doctor first!

Regimen: Use what you have been using; you know now what is best! Keep exfoliating, using collagen and elastin stimulating procedures, and you can liberally use thread lifts now-as often as every one-two years if needed. Actually that is an option at younger ages too-it just can get pricey!

Non-invasive: You should keep all of these up, office and home-based therapies.

Plastic surgery: I am still not a fan of a full facelift. I will always suggest you do things “by the zone”. If you have had a lot of sun damage and are getting skin cancers this is a great time to combine a nip-tuck in different zones with a CO2 laser procedure. Thread lifts are looking like the way to go right now as they have gotten rid of the “broken threads” problem and the results include big time collagen stimulation. If you opt for a full facelift, you get what you pay for. So, make sure you have a very skilled surgeon, and you have seen tons of b/a shots.

1 Comment

  1. Hi: I am a male that is 71 soon to be 72 and I had a facelift about 12 years ago but I need to have something done now to hopefully slow the total aging effect. I realize I will never look 30, 40, 50 but maybe 60. I am not looking at a picture of Brad Pit at 40 and telling the doctor I would like to look like this when all is said and done. It isn’t going to happen even if I was also 40. I try to be realistic.

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