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Aesthetic Medicine and Anti-Ageing Medicine: The Right Synergies
Professor Meningaud - Maxillofacial Surgery at Paris Est Créteil
Appearance may seem like a trivial concern. In fact, many intellectuals, psychologists, organ specialists, religious figures, and educators consider physical concerns to be frivolous.
As a specialist in facial surgery, I have seen how much my patients can suffer, whether it is from a face mutilated by an accident or simply affected by the passage of time. Aesthetic medicine and surgery aim to help people better manage their physical appearance and health without dogmatism. I remain convinced that the beauty of people comes from their diversity.
An appearance correlated with our chronological age
We have the age of our arteries, our mental performance, our hormonal balance, our chromosomes, but also our external appearance. The appearance, especially of our face, is closely correlated with our chronological age. My team has verified this in a recent study. Unconsciously, most people can estimate a person’s age with reasonable accuracy.
Moreover, with minimal training on the objective criteria of facial ageing, this precision increases exponentially. From this, we can deduce that an effective anti-ageing treatment must eventually favourably modify appearance. If the treatment is effective, it will not only alter biological or tension-related parameters but will inevitably impact our outward appearance.
Aesthetic medicine and surgery interventions positively influence health
Conversely, it has been widely demonstrated that interventions on appearance can have a positive effect on health in very concrete areas: posture, chronic pain (neck and back), smoking cessation, lifestyle improvement (weight loss, diet, physical activity affecting blood sugar levels), respiratory function, and visual field. The psychological benefits of aesthetic surgery and medicine are well established: anxiety, quality of life, self-esteem, confidence, and sexuality.
But one might also wonder if a direct action on appearance, and therefore on the psyche, could influence the biological parameters of ageing. Is a direct intervention on our physical body a form of “cheating” or does it trigger a positive feedback mechanism, reinforcing overall health? Several arguments support this positive feedback theory.
Indirect influence of aesthetic medicine and surgery interventions
First, it is a general rule that life consists of multiple systems that remain in equilibrium for extended periods. At the molecular level, this translates into biochemical equations allowing slight reversals through negative feedback (braking mechanism) or positive feedback (reinforcement mechanism). The hypothesis of positive feedback from appearance on biology aligns with natural laws.
Moreover, it has been shown that improving psychological dimensions such as anxiety, self-confidence, and self-esteem affects the secretion of stress hormones. It has even been suggested that body posture can alter hormone secretion. A team from Columbia University found that a simple change in posture could increase testosterone and decrease cortisol levels within two minutes. This team measured saliva testosterone and cortisol levels in a group of volunteers when they moved from a submissive posture (hunched, arms and legs crossed, head down) to a more confident posture (arms open, head up, straight back, etc.).
Although these studies have been methodologically contested, it is plausible that medical or surgical procedures that restore long-term self-confidence could affect the chronic production of these hormones and, consequently, other biological processes involved in ageing.
Direct influence of aesthetic medicine and surgery interventions
Finally, it is now known that many new aesthetic medicine and surgery techniques have a positive biological effect on the treated tissues. For example, a simple injection of hyaluronic acid has a local tissue-inducing (regenerative) effect, leading to increased collagen synthesis. In surgery, lipofilling techniques (injecting the patient’s own fat) enhanced by platelet-rich plasma sometimes have remarkable tissue-inducing effects.
Furthermore, it is possible that effects may occur beyond the treated area (paracrine effects, for example). Anti-ageing medicine and appearance interventions influence each other, and addressing both simultaneously creates a synergistic effect. The most important point is not to harm, *primum non nocere*. This Hippocratic principle is timeless. To achieve the desired result, these medical acts must be performed by fully qualified practitioners, and indications should be made reasonably.
References
1. La Padula S, Hersant B, SidAhmed M, Niddam J, Meningaud JP. Objective estimation of patient age through a new composite scale for facial aging assessment: The face – Objective assessment scale. J Cra-niomaxillofac Surg. 2016 Jul;44(7):775-82.
2. Sá PO et al. The Effect of Reduction Mammaplasty on Body Posture: A Preliminary Study. Plast Surg Nurs. 2020;40(1):29-34.
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