I spend a lot of time thinking about aging. Since I was a teenager, I have known that my professional calling was to become a nurse. After receiving my master of nursing degree and national certification in Gerontology, the study of aging and its effects, I spent years studying the human struggle with the natural signs of growing older to understand how we could slow the effects of time. In the past, our tools were largely restricted to lifestyle changes proven to increase longevity-healthy eating, exercise, and sunscreen. However, those interventions did little to combat the external effects of growing older.
In recent years, aesthetic medicine has established itself as a specialty, offering many new tools to help patients achieve positive results consistent with their self-image. I was immediately interested and decided to shift my professional focus from Gerontology (the study of aging and its effects) to Aesthetic Medicine. Since then, the field has grown exponentially. According to the American Society for Aesthetic Plastic Surgery (ASAPS, 2017, nonsurgical procedures have grown at an incredible rate in the last two decades. Between 1997 and 2016, surgical procedures grew by 99% compared with an incredible 650% surge in nonsurgical procedures. The balance has clearly tipped as patients look for a more subtle, natural way to turn back time.
Contributing to that growth is the fact that the treatments available have increased in number, improved, and evolved. Since Botox first came to market in 1989, we have seen the advent of dermal fillers, improved peels, and techniques such as microneedling that allow us to offer more subtle solutions to combat the appearance of aging. Recently, we were introduced to deoxycholic acid, which represents an alternative to chin liposuction that was unavailable when I started my career. The ASAPS indicates that photorejuvenation, nonsurgical skin tightening, and neurotoxin injections were among the top five nonsurgical procedures that saw a significant increase in popularity in 2016, with neurotoxin injections being the most popular procedure overall.
"MEMORY AGE" AND "SELF-IMAGE"
Having witnessed a powerful internal struggle among my patients (that of wanting to age gracefully, yet turned off by the overly done norms of the aesthetics industry), I focused my practice on achieving natural-looking results that remained true to one's natural beauty. Although my patients agree that they want to look like a younger, more refreshed version of themselves, defining that in more specific terms is often difficult for them to do. I am always listening for what it is patients really want. What are they really trying to achieve? Are their expectations reasonable, or did they all just want to look 21 again? The answer may be in their memories.
We recently asked 350 women aged 30-70 years across the United States to tell us what their "memory age" is (Next Steps in Dermatology, 2017). Participants were asked to close their eyes and conjure up a mental picture of themselves and tell us how old they look. It turns out that we are all carrying around a "memory photo" of ourselves that is about 10 years younger than we are today. In fact, most women (62%) had a 1- to 10-year gap (Next Steps in Dermatology, 2017) between their "memory age" and real age-an achievable goal when we consider the many nonsurgical tools available to us today.
APPLYING "MEMORY AGE" IN PRACTICE
Findings of this survey provided us with yet another powerful tool to apply in practice-a patient's own memory. Whether a respondent was 35 or 65 years old, the survey made clear that nobody is trying to recapture his or her youth-They just want to turn the clock back a bit. But to when?
The women surveyed told us that their "memory age" was linked to an important period in their lives, although not necessarily what you might expect. Some of the respondents associated it with important personal milestones such as falling in love or getting married, but the overwhelming majority-40%-associated their "memory age" with feeling successful in their career (Next Steps in Dermatology, 2017). At first, I was puzzled, but then I realized that everyone's "memory age" is linked to a time in his or her life when he or she felt most confident.
Nowadays we use "memory age" as an important first step in understanding what patients are trying to achieve, beginning with having patients reveal their own "memory age" during their consultation. We even ask them to bring a photograph or two representing their "memory age" so that we can pinpoint what areas they would like address, together. This added step has allowed us to approach our patients in an entirely new way-one that focuses on achieving an outcome of confidence and less on areas they are simply unhappy with. It also helps remove some of the subjectivity that is naturally associated with aesthetic medicine so that both the practitioner and the patient are completely on the same page as we work toward a goal.
"MEMORY AGE" AS A TARGETING TOOL
From a business perspective, much of the medical aesthetics industry spends a great deal of resources marketing to Baby Boomers. But our "memory age" study revealed that it might be more beneficial to look at their younger counterparts. Only 15% of all respondents told us they have tried injectables (Next Steps in Dermatology, 2017). But when this group is split by age, the numbers tell a different story: 30% of women aged 30-44 years have tried injectables, whereas less than 6% of women aged 50-70 years have tried injectables. Life and business are competitive, and Gen X is working hard to keep its edge-something I can relate to entirely as a member of this generation.
The good news is that most women we surveyed cited youthfulness in terms of fewer wrinkles and better skin (Next Steps in Dermatology, 2017) is the main differences between their actual age and their "memory age." Fortunately, we as practitioners have quite a few tools in our toolkit that can help them get back to that place in their mind.
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