Feb. 5, 2009 -- Genes play a role in your appearance as you get older, but the real villains of the wrinkles of aging involve behavioral choices such as smoking, eating, and sun exposure, a new study shows.
The study is published online in Plastic and Reconstructive Surgery, the official medical journal of the American Society of Plastic Surgeons.
Environmental factors and personal lifestyle choices more than genes can add years to a person's appearance, study researcher Bahman Guyuron, MD, chairman of the department of plastic surgery at University Hospitals, Case Medical Center in Cleveland, tells WebMD.
The study involved 186 pairs of identical twins. During the study, researchers obtained comprehensive questionnaires and digital images from all the twins. An independent panel reviewed the images and recorded perceived age differences between the siblings.
Guyuron says the study suggests that non-genetic factors may be major culprits for wrinkles, lines, and blotches. But anything that fills your life with stress, such as a job you hate or too much debt, can also draw lines all over your face later in life, he says.
"Identical twins, unless they behave exactly the same, will exhibit their different lifetime experiences on their faces," he says. "If the biological clock is designed to make you age in a certain way, you can alter that by eliminating some of the external factors that make you age faster."
He tells WebMD that relaxation of facial muscles due to use of antidepressants might be why more sagging was recorded in twins taking such medications. But it's not a "might," he adds, that stress is "a common denominator" of looking older.
Richard Winer, MD, an Atlanta psychiatrist, says in his 24 years of practice, he's noticed that people who take antidepressants soon look better and develop fewer lines as they age.
"When people are depressed, there is a tendency not to take care of yourself, and maybe to smoke and drink more," he tells WebMD. "Generally speaking, when people are happier, they tend to look younger. Colleagues have noticed the same thing."
Also, aging reduces hormones, and "if they are replaced judicially under medical advice, that will delay aging," Guyuron says. "Estrogen has a significant effect on the elasticity of the skin." To look younger, overweight people shouldn't try to lose a lot of weight quickly, he says.
Seth A. Yellin, MD, chief of facial plastic surgery at Emory Healthcare in Atlanta, says everyone loses "facial volume" with age and "gets a loose neck. If we replenish facial volume, it can make an older face look more youthful."