6 Tips for Aging with Intention (with or without plastic surgery)

It's never too late to reclaim agency over your health

Sep 17, 2024

ICYMI 👉

One of my older patients recently came to see me to discuss cosmetic surgery. She had been fussing over her neck and jowls for months, lingering in front of her bathroom mirror and feeling bad about herself. She admitted that her distress wasn’t just about sagging skin; it was about the amount of brain space she’d inadvertently devoted to worrying about her appearance.

Am I crazy to worry about this stuff? she asked me.

white and blue bird — Photo by Dmitrii Medvedev on Unsplash

I reassured her that she wasn’t alone—that it’s normal to bemoan the changes in our skin, body and face that come with age. I also told her I’m not opposed to cosmetic surgery. My job is to help patients assess risk, not to judge them for their decisions. In that spirit, I asked her to consider something deeper: “Is there something you’re trying to fix with cosmetic surgery, other than the sagging skin?”

She stared at the wall beside us, paused for a few seconds and said, I guess I just want to feel more control over this aging process. With that, we launched into a robust discussion about losing her husband during COVID, the experience of loneliness as friends moved out of town, and her fears about occasionally forgetfulness and her sense of frailty. She agreed that some of these emotions were driving the urge to fix her face.

I suggested that we try to address these issues head-on. Why? Not because plastic surgery was the wrong thing to do. But because I wanted her to work on reclaiming agency over parts of her health that she seemed to have given up on. There were many.

At the end of our conversation, we still hadn’t decided whether cosmetic surgery was the appropriate plan for her. However, we did conclude that it was worth reconsidering plastic surgery after six months of working on all of the above.

Here is what I recommended to her:

My Top 6 Tips for Aging with Intention

Seek emotional support.

There’s no prize for soldiering through hard times alone. Just because grief and vulnerability are normal parts of life doesn’t mean you wouldn’t benefit from more support. As I asked my patient, What is the downside of reaching out to a therapist, grief counselor, or support group? Mental health is health. As I wrote about here, mental health affects our everyday thoughts, feelings and behaviors. It affects how we relate to other people. It affects our sense of self-efficiency and self-worth.

While there is no one-size-fits all prescription for addressing your mental health, I think that appropriately addressing our own mental health requires a number of key ingredients:

Permission to be human and the grace to love ourselves
Awareness of how we avoid, numb, or deny our own fear and shame
Humility about what we do not know about ourselves
Courage to allow ourselves to be loved and accepted for who we are
Strength to admit our flaws and areas for growth
Wisdom to know the difference between what we must accept and what we can change
Willingness to change, grow and ask for help

Focus on your muscles.

My patient had assumed that frailty was an inevitable consequence of aging. While she’s correct that sarcopenia or muscle loss happens more readily as we age, it’s very possible to fend it off. Most people know that exercise is important for every aspect of health; however, they often don’t realize how important strength training is. Muscle mass is essential for metabolism, energy, balance, and coordination—not to mention things like getting up from a chair and lifting grandkids. Yet we lose muscle mass with age. When your muscles are strong, your joints are less stressed and you are less prone to falling and fractures. Some simple ways to get strength training are though:

Yoga. (Don’t like regular yoga? Try chair yoga)
Wearing a weighted vest while walking.
Lifting light weights.
Formal physical therapy. I believe everyone needs a good body mechanic in their corner, for tune-ups when needed and for maintenance of good skeletal health. Ask your insurance if they’d cover it!

Eat More Protein.

As I said to my patient, protein is like premium gasoline. You need it regular stops at the gas station to fill up on it. Dietary protein is essential for satiety (the feeling of fullness), energy, weight management, maintenance of lean muscle mass, post-exercise recovery, immune function, focus, concentration, cognitive health, and mental health. How much do you need?

Ideally we should consume 0.7 to 1.0 grams of protein per kilogram of body weight.

My patient, for example, weighs 110 pounds. That’s 50 kg (i.e., number of pounds divided by 2.2). So she needs between 35 grams (50 kg x 0.7 gram/kg) and 50 grams (50 kg x 1 gram/kg) of protein per day.
To determine your daily protein intake, you can multiply your weight in pounds by 0.36, or use this online protein calculator.

Optimize cognitive health.

Forgetfulness is one of the more frustrating and anxiety-producing aspects of aging. Which is why one of the most common questions from patients is how to preserve memory. Of course, distinguishing normal, age-related memory loss from serious disease requires a medical evaluation, but here are some basic tools I recommend to my patients to help optimize cognitive function:

Regular exercise. Again and again, exercise—even walking—has been proven to improve cognitive function and prevent decline.
Eat lots of antioxidant foods. Omega 3 fatty acids are key. Think: blueberries, walnuts, salmon, and avocado.
Prioritize sleep. Sleep is the glue for our overall health; it is critical for cognitive health. If you are having trouble getting the sleep you know you need, talk to your doctor about it!
Use it or lose it. Keeping your brain active is essential. From crossword puzzles to polishing up your high school French, flexing your mental muscles is the best way to keep your brain healthy.
Face mental health issues head on. Because complicated grief, depression and anxiety can cause forgetfulness, confusion, and other cognitive problems, it’s critical to address mental health issues like we do any other organ system. (See above.) Be honest with your doctor about what’s really going on!

Prioritize social connection.

Loneliness is the feeling of being alone, regardless of the amount of social contact. Social isolation is a lack of social connections. There’s no shortage of data showing that loneliness and social isolation are linked to serious medical conditions, from heart disease to dementia. Similarly, the data are clear that feelings of connectedness and belonging are good for our health—and that being with other people is a basic biological need.

The solution? Reach out to friends and family. Pick up the phone or send a quick email to people you love. Even if it’s a hassle, show up in person when able. Re-engage in activities you used to love—from yoga class to your bridge group. Connecting with other people isn’t a luxury; it’s critical for your health.

Practice good humor.

Studies have shown that laughter and positivity can have a profound impact on both our physical and mental health. Laughter can boost our immune system, reduce stress hormones, and even improve cardiovascular health. A 2019 meta-analysis found that people with an optimistic outlook had a 35% lower chance of suffering from a cardiovascular event.

Laughter and positivity are not a cure-all, but there’s a reason the phrase Laughter is the Best Medicine has been needlepointed on pillows for generations. We are all going to face hardships, some of them devastating. But heartache and humor may be flip sides of the same coin.

The upshot.

Aging is no picnic. There’s a lot about it we cannot control. But when patients ask me how to prevent age-related illness and despair, I remind them that they have a lot more agency than they think—with or without a facelift.