Genes vs. Behavior: What Makes Us Age?

Study Shows Behavioral Choices Are the Real Culprits of an Aging Face

Reviewed by Louise Chang, MD on February 04, 2009
From the WebMD Archives

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."

Guyuron says these factors include smoking, alcohol consumption, and food intake. Depression also can lead to lines and wrinkles, even if people with that condition take antidepressants.

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."

Weight and Facial Aging

Genetics, Yellin tells WebMD, "is only one component of aging. You have a great deal of control over how you will look at 45, 55, or 65. If you eat well, maintain a good body mass index, don't smoke, wear sun protectant, and keep yourself fit, then you're going to look better than your genetic identical twin who makes bad decisions, eats high-fat foods, ignores admonitions about [too much] sun, and goes to a tanning bed."

Yellin says that after age 40, people with "higher than normal weight are going to look younger because fat is going to stretch the skin," lessening the appearance of wrinkles, but no one should gain weight to keep from looking old.

Researchers looked at identical twins because they are genetically programmed to age in exactly the same way. But Guyuron says the study shows "you can cheat your biological clock" by making smart choices, such as not smoking.

"Some patients, particularly those who have eating disorders, feel they will look younger if they lose a lot of weight after 40," he says. "But actually that will make you look older."

He says he doesn't recommend that people in bad marriages stay together, but faces of twins in the study suggested that those who'd divorced looked nearly two years older than siblings who hadn't.

In twins younger than 40, the heavier ones were perceived as being older, but in those over 40, the lighter ones looked older, says Guyuron.

"The research is important for two reasons," Guyuron says. "First, we have discovered a number of new factors that contribute to aging, and second, our findings put science behind the idea that volume replacement rejuvenates the face."

Show Sources


News release, American Society of Plastic Surgeons.

Guyuron, B. Plastic and Reconstructive Surgery, April 2009; vol 123.

Bahman Guyuron, MD, University Hospitals, Case Western Reserve University, Cleveland.

Seth A. Yellin, MD, chief of facial plastic surgery, Emory Healthcare, Atlanta.

Richard Winer, MD, psychiatrist, Atlanta.

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