Each year as we get older, one more year of gravity takes its toll on our bodies. It seems like Father Time starts at the top with wrinkles and frown lines and mercilessly works his way down to wreak disaster on our bodies, one sagging spot at a time. But nothing is completely irreversible: modern medicine offers some remarkable fixes!

the face
It is one of the most visible, and earliest, signs of aging: Sagging in the face—specifically the cheeks and jawline. But doctors say the methods to address these issues are constantly improving.

nowhere to go but up
“I have so many people who come in and say, ‘I’m doing great in my job but there are so many new, younger people. And I feel young, but my face doesn’t match how I feel,’” reports Dr. Richard Maack, facial plastic surgeon at Synergi Facial Surgery.

There are a few things happening to the lower face as we age, he explains. One is sun exposure: the sun ages the surface of the skin and every layer underneath. In addition, the fat and facial volume over the cheekbones start to thin out, leaving the skin nowhere to go but down. Add loss of collagen and elasticity to the equation, and you’ve got more loose skin gathering around the jawline than you’d probably like.

Just how much skin is there depends on a variety of factors, including genetics, weight loss or gain, and how much exposure to the sun you’ve had over your lifetime. Those factors also play a role in options available to fix the problem. In the most severe cases, the best remedy is a face-lift.

“If you sit in front of a mirror, grab the skin of your neck and pull it back behind your ears to see what it looks like when it’s nice and smooth again, the only thing that gives people a result like that is a trip to the operating room,” says Dr. Joseph Muccini of MidAmerica Skin Health & Vitality Center.

the gold standard
Doctors say the face-lift has come a long way over the years. Some relatively recent improvements include hiding incisions inside the ears and inserting platelet rich plasma (PRP) into the face during surgery to build collagen and speed healing. The procedure also involves tightening the deep tissue to give natural and long-lasting results.

“People are very nervous about face-lifts or surgery because they think they’re going to have that over-operated, pulled look, which they should not have,” says Maack. And while it is the most effective treatment, it is also the most invasive. “It’s the gold standard,” adds Muccini. “It is the thing against which everything else is compared to, but not everyone needs something like that.”

If sagging is not extreme, patients may opt for more interim measures, like laser, ultrasound or radio frequency treatments. When appropriate, these can save a patient money and recovery time. One example, ‘Forever Young BBL with Skin Tyte,’ involves using a deep infrared light to tone the skin, Maack reports. “Both men and women say they really love the results because they feel better about themselves and look the way they used to,” he says.

‘PrecisionTX’ laser treatments also offer a solution by melting fat and tightening the tissue, according to Muccini. “It’s like a very limited, intentional, superficial injury. And your body (sends) a signal to say, ‘repair me.’ So you get some collagen remodeling.”

The only way to know what will work for your individual issues is to go in for a consult, the doctors agree. What’s right for one person may not appeal to another, but beauty professionals are pretty certain there is something for everyone.

the breasts
Breast procedures have been the butt of jokes for decades, but it’s no joking matter when a woman feels her youth, and appearance, slipping away after multiple pregnancies. Or she is self-conscious about the size and shape of her breasts. Breast surgery can boost confidence and let women feel good about what they see in the mirror decades longer.

it’s about feeling good “Breast lift surgery has really great psychological and overall benefits to the people who choose to undergo it,” says Dr. Christina Plikaitis, plastic surgeon with SLUCare Physician Group. “It really boosts confidence and helps them continue to feel great about

Lifts add an element of youth, helping to restore a firmer look to the chest area. But they don’t provide extra volume, which many women also want when they opt for breast surgery. “A lift with augmentation is what restores the fullness of the tissue that sometimes is lost when you have aging of the breast,” explains Plikaitis.

new & improved
As with most cosmetic procedures, the industry is developing new and more effective options, in part to meet demand. “Plastic surgeons are always looking for alternative ways to lift breasts with a shorter scar. And there has been research on different materials placed within the breast tissue to help hold the tissue up,” says plastic surgeon Dr. Michele Koo.

The surgical mesh, which has been FDA -approved, is one possibility for use with breast lifts in the attempt to make lifts work better longer. The ‘internal bra’ is another. Both require introducing a foreign substance to the body, which is why they haven’t been embraced by all physicians. It is thought they might increase the risk of infection, cause an inflammatory reaction in the body and make it harder for doctors to diagnose cancer.

implant debate
Breast implants today are more natural in appearance, especially silicone implants, which are softer and come in a variety of shapes. The other option, the saline implant, is more rounded and gives a fuller, more augmented look. “Depending on patient preference, each is effective,” Plikaitis says.

There’s a difference in their longevity as well. The general lifetime for a saline implant is 10 years, while silicone implants can last 15 to 30 years. Deciding which to use is dependent, in part, “on the woman’s original breast anatomy and her ultimate cosmetic goals,” Koo notes. “Just like a pair of pants that is old and has a hole rubbed through, so can an implant do over years and years of time,” says Plikaitis.

“Breast surgery is not a one and done,” Koo says. “The outcome of a breast lift will depend on the laxity of the woman’s skin and breast tissue, and whether she has major swings in weight gain and loss.” The fitter a woman is, the more likely she will be able to maintain the benefits of surgical lift and augmentation.

the knees
We all know about the common trouble spots—face, breasts, tummy and thighs. but what about knees? Fat pockets and loose skin around the knees are often the culprits when we start noticing that our once-shapely legs suddenly don’t look that great in shorts. Doctors report that cosmetic treatment in this area is becoming more common.

what is going on? 
“It’s a big concern for many, many women,” says Dr. Richard Moore of The Lifestyle Center. “They come in, and they’re happy when they’re sitting and their knees are bent because the skin is stretched. Then they stand up and get that crinkly skin over the knee.”

One reason for droopy skin over and around the patella is the natural loss of collagen and elastin that comes with aging. Moore explains that around age 30, collagen levels start to drop about 1 percent each year. By the time we hit 40, that percentage more than doubles. “You see looser skin,” he says. “There can also be some loss of soft tissue underneath, such as fat.”

A slow decline in muscle mass also begins for women in their 30s, which can add to the problem. For many, the change makes it appear there is more fat around the knee. But experts say that’s not always the case.

what can we do? 
“It’s not so much the fat is getting bigger as it is the muscle mass itself is getting smaller,” says Dr. Lily Bogunovic, a Washington University orthopedic specialist. “So you have a change in the contour of your thighs and knees, and the muscle mass surrounding them.”

The best way to combat the loss of muscle mass is with strength training, which can improve both the appearance and health of the knees, she says.

“If you can maintain and build more muscle mass, I believe that’s the best way to not only have your knees functioning well, but looking good too,” she says.

quick fixes
If strength training is not getting the results you want—or if it’s just not for you—some cosmetic procedures can address the knees, Moore says. Radio frequency treatments, such as BodyTite, can firm the area and generate collagen. His center also uses a biostimulant option called Sculptra in which a substance is injected into problem areas to stimulate the body into producing collagen.

“Historically, it’s been a very difficult thing to deal with and we, to some degree, ignored it,” says Moore of old-looking knees. Women notice when it is happening, he says, but it has never been a top-of-mind issue. Now, with women staying fit longer, they want their bodies to reflect that fitness. “We’ve brought on new treatments to help women deal with it.” He says women today want to look as good as they feel.