RENEE MONTAGNE, host:
This is MORNING EDITION from NPR News. I'm Renee Montagne.
STEVE INSKEEP, host:
And I'm Steve Inskeep.
Today in Your Health, we are all about appearance. In a minute, we take a look at speed dating and how it changes the way we look for a mate.
MONTAGNE: First, we'll hear about changes in the face that are more than skin deep. NPR's Deborah Franklin checked in with a plastic surgeon and a physical anthropologist to learn why there some things that nips and tucks just won't fix.
DEBORAH FRANKLIN: You know the look of a bad face-lift. Plastic surgeons call it "windswept."
Dr. HOWARD LANGSTEIN (Plastic Surgeon, Rochester University): If you simply just pull the skin tight, it has a pretty unnatural look.
FRANKLIN: Howard Langstein�heads the plastic surgery department at Rochester University.
Dr. LANGSTEIN: A more youthful look, that is the look that we are born with -the puffy cheeks, the cherubic face - that's the look of youth.
FRANKLIN: And restoring that look of youth is Langstein's goal. Recently, to figure out why so many face-lifts go so wrong, he and some colleagues decided to check the bones beneath the skin, figuring we all lose bone in the hips and spine as we get older, maybe bones of the face change, too.
So the doctors collected a bunch of 3D CAT scans - X-rays - of adult faces and grouped them for comparison - young, middle-aged and 65 or older. Everybody in the study was healthy and had all their teeth. Still, something seemed off with one group of scans.
Dr. LANGSTEIN: I think you look at the old-aged CAT scans and you'd have a hard time saying that looks normal. You would say this looks very different than what I would imagine a skull to look like.
FRANKLIN: The cheekbones in the skulls of that 65 and older group seemed sunken, the lower jaws thinner, and something around the eyes.
Dr. LANGSTEIN: We could actually compare the measurements. So we could tell that the eye socket, the opening of where the eye would be, is enlarging as patients are aging.
FRANKLIN: And the chins are receding. The oldest faces looked a little slack-jawed. Langstein figured he was onto something, and other surgeons got excited, too.
Dr. LANGSTEIN: They came up to us and said, well, we've been operating on patients for decades and we've seen these changes on patients - individual patients.
FRANKLIN: They just had not pegged it to aging. They should've asked David Hunt. He's a physical anthropologist at the Smithsonian's Natural History Museum in Washington, D.C.
Dr. DAVID HUNT (Physical Anthropologist, Smithsonian National History Museum): This is my office - lab and office here.
FRANKLIN: And he doesn't waste time with soft tissue. He goes straight to the bone.
How many skeletons do you have in here?
Dr. HUNT: Oh, I think there's probably 150 people represented in here.
FRANKLIN: And that's just in his lab. Hunt oversees more than 30,000 human skeletons in the Smithsonian's collection - from the Neanderthal era to present day.
To one side of his long worktable, a classic-looking skeleton dangles from a stand - chiseled jaw, perfect teeth, from somebody in their 20s, probably. Hunt says it's in our high-flying 20s that our bones are at their best.
Dr. HUNT: And it really is pretty stuff. And it's smooth, and it's solid and hard and dense. And that's great.
FRANKLIN: Except that bone is not just a hunk of calcium. It's alive, constantly being remodeled, eaten away and rebuilt, so that every dozen years or so, each of us has a whole new skeleton. Hunt says that's good - and bad.
Dr. HUNT: When you're in your 40s, this is the second regeneration of replacement of bone. And the bone is not as well made.
FRANKLIN: By middle age, the texture of that bone is rougher - eye sockets starting to sink, jaw receding, and you know the rest. You can get all the exercise and drink all the milk you want, he says, and you're still going to get some bone loss in your face just from aging.
Dr. HUNT: Nothing stops it. That's the thing.
Dr. LANGSTEIN: It's one of those things that, in retrospect, you sort of say, duh. I should have known that. Nothing stays the same on the body.
FRANKLIN: Howard Langstein says even before they figured out about the bone loss with age, he and many other surgeons had already started to add chin implants and injections of compressed fat to their face-lifts to restore a touch of roundness here and there.
Dr. LANGSTEIN: Interestingly, it almost always turns out to be in the cheek area and right along the side of the jaw, and those correspond to the areas where this study shows that the bones have aged.
FRANKLIN: But what if you want to slow down facial droop without surgery? Take a tip from the guy who's seen 30,000 skeletons: hang onto your teeth. Hunt shows me a skinny, toothless lower jawbone that looks like the withered-away blade of an old ice skate.
Dr. HUNT: Mainly, what you're seeing is the impact of tooth loss, and then the body taking away those no-longer-used sockets where the teeth used to be.
FRANKLIN: But here's the thing, he says: Skulls of baby boomers today look a lot younger than those of our grandparents in middle age, thanks to better dental care, antibiotics and fluoride. So just keep flossing and smile.
Deborah Franklin, NPR News.
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