Some women don’t realize that Latisse (the first of lash thickeners to be FDA approved) was a drug originally intended for glaucoma. An unexpected side effect was that it was found to increase the growth of eyelashes. It was then approved to treat hypotrichosis (a technical term for medical hair loss) and over time has been prescribed to treat what marketers call “inadequate eyelashes.” Much the way Retin-A cream and Botox (produced by the same company that created Latisse) once served to treat medical symptoms, Latisse now routinely serves cosmetic purposes. Miracle drug? Or another slippery slope for women to slide down?

I have no trouble with the idea that there are products and procedures that enhance a woman’s natural beauty. In fact, I accept the fact that women are probably hardwired to pay attention to how we look and that we need to take care of our appearance in ways that feel appropriate for our age. Take Victoria’s Secret, for example, and the many bras they now offer for women of all sizes, shapes and ages. Are there any reasons why a woman who doesn’t mind a little push or tug, shouldn’t enjoy sexy underwear options that were unavailable to previous generations? Spanx doesn’t bother me either. Women say the squeezing and constriction are worth the shaping it provides. In fact, compared to the ungainly padded bras and girdles of yesteryear, these seem more appealing to today’s women who are interested in making efforts toward looking great at any age.

Where I have trouble, is when women ask my thoughts about unalterable cosmetic procedures: breast implants, liposuction, brow and facelifts. I am concerned when patients talk about the constant surgical work they have done to upkeep their various body parts — for example, adding “hand rejuvenation” to their list so that their aging hands match up with their youthful faces. I ask them to think carefully and thoughtfully about their expectations — the whys, the costs and general long-term consequences. And it’s perhaps here where my issue with “longer lashes movement” comes into play. In my mind, using a prescription medicine to enhance a woman’s appearance lies somewhere closer to plastic surgery than Spanx or padded bras. And yet, its casual use is taking off at a rapid rate with women of all ages.

So, maybe the better question is, where do products like Latisse lead us? Have we created a disease we now call “inadequate eyelashes” that requires a new product, that mascara cannot take care of? Have we just found another way for women to feel they fall short as they yearn for some permanent and radical solution to reach ideal beauty? And what about the potential physical and psychological consequence of repeated usage of lash thickener? When we try any new beauty fad, are we relying on the due diligence of the cosmetic industry or the FDA? We need only recall that steroids (also once used for medical purposes) were found to enhance athletic ability and then ultimately were discovered to be dangerous, both for the long-term health of the athlete and of the sports world in general. It led to a deep mistrust in who was using and who had true talent, resulting in drug testing in all of sports.

Then there’s the use of stimulants, originally prescribed for children suffering Attention Deficit Hyperactivity Disorder, now being used as the new “brain power” drug. Ritalin and Adderall, two popular ADHD medications, have been reported to enhance a student’s ability to concentrate regardless of any diagnosis. A recent 60 Minutes report by Katie Couric described the routine use of these drugs by students on college campuses. A school counselor on the program said she believed that close to 80 percent of the seniors in fraternities and sororities were popping these pills to raise test scores and achieve higher grades.

And let us not forget the Viagra and Cialis craze. Look where that’s led our husbands, lovers, fathers and brothers. Once used for symptoms of Erectile Dysfunction resulting from prostate cancer or an enlarged prostate, they are now packed as part of the overnight bag to ensure a fun evening. Men — especially midlifers — tell me that the promotion of these products in the media has provoked unexpected feelings of inadequacy.

Lastly, we need only look at the exponential rise in the use of cosmetic procedures to witness one of the most slippery of slopes men and women are finding themselves on. Plastic surgery, Botox, injectables, fillers, laser treatments — the list is long — are regularly used to alter looks, defy aging, enhance and improve. And not just by the rich and famous (although, according to the New York Times, it’s the famous who are now just beginning to see the negative consequences of surgical procedures as they find that their plastic bodies and frozen faces are a turn-off to casting agents). Enhancements made surgically are permanent and permanently problematic.

So back to those eyelashes. I suppose I do realize what bothers me. First, it’s the long-term safety factor. We, our daughters, and all those young women who are being offered these new products, are like variables in an experiment that has not yet shown proven success over time. As a psychologist, the biggest issue for me is that yet another feature, characteristic or human natural quality will come under question: what is real and what isn’t? Our mothers’ generation used to ask, “does she or doesn’t she?” Our generation of girls now asks “has she or hasn’t she?” Even boys-who-would-be-ballplayers now ask, “does he or doesn’t he?” What questions will our sons and daughters ask in the future? Will they wonder if anything about a man or a woman is real? Will we trust women to be who they appear to be? Can men really have the bodies they do without drugs? Last for four hours on their own? Does that Harvard degree mean the same thing if it was achieved while taking the SATs on Adderall?

Wouldn’t it be reassuring if women could at least love their lashes as they are? What do you think?

YOU’LL BE COMING DOWN  by Bruce Springsteen
White roses and misty blue eyes
Red mornings, then nothin’ but gray skies
A cup of coffee, a heart shot clean through
The jacket you bought me gone daisy gray-blue
You’re smiling now but you’ll find out
They’ll use you up and spit you out now
Your head’s spinnin’ in diamonds and clouds
But pretty soon it turns out

You’ll be comin’ down now baby
You’ll be coming down
What goes around, it comes around and
You’ll be comin’ down

Easy street, a quick buck and true lies
Smiles as thin as those dusky blue skies
A silver plate of pearls my golden child
It’s all yours at least for a little while
You’ll be fine long as your pretty face holds out
Then it’s gonna get pretty cold out
An empty stream of stars shooting by
You got your hopes on high

You’ll be comin’ down now baby
You’ll be coming down
What goes around, it comes around and
You’ll be comin’ down

For a while you’ll go sparklin’ by
Just another pretty thing on high

Like a thief on a Sunday morning
It all falls apart with no warning
Your cinnamon sky’s gone candy-apple green
The crushed metal of your little flying machine

You’ll be comin’ down now baby
You’ll be coming down
What goes around, it comes around and
You’ll be comin’ down

You’ll be comin’ down now baby
You’ll be coming down
What goes around, it comes around and
You’ll be comin’ down

Copyright © 2007 Bruce Springsteen (ASCAP)

There are many women who aren’t looking for dramatic changes in their appearance. They are looking for ways to improve their looks, appear healthier and rested without radically changing how they look. They don’t want to look twenty years younger. They want to look the best they can at their own age. They want to take control over the uneasy, out of control feelings that come with the increasing changes they see on their faces. They’re not trying to compete with younger women. They’re proud to have reached the age they are and feel as good as they do and now they want to look as young as they feel. Just as these women have come to take for granted that coloring their hair makes them feel good, these women want solutions for their aging skin that also make them feel good. So, where is the slippery slope?

First of all, remember that aging is continuous and inevitable. No procedure stops the clock. Once you start these processes they require constant up keep. Up keep costs money and takes time. Botox, for example, lasts about three months, and fillers, about a year. And we’ve yet to meet a woman who hasn’t wanted to continue once she likes what she sees. Not only does she want more of the same, but one procedure often leads to another. The way a newly painted room makes the furniture in it look older, so does a wrinkle free forehead make crow’s feet seem more pronounced. And when wrinkles return bringing a woman’s face/neck/body back to its original state, she notices them more than ever.

So, can you take advantage of these procedures and avoid the slippery slope? Look at it this way, would you go up a high mountain and ski down without knowing the terrain, without knowing if there is an end in sight or if you can make it down safely? Do we have evidence yet that repeated dermatological procedures are healthy for your skin? What about women who start these in their thirties, or twenties? Imagine over 200 injections of botox or 400 fillers in a life time? We’ve heard of teens encouraged by dermatologists to avoid wrinkles by never getting them in the first place. Do we know if the elasticity and health of your skin can tolerate long term non surgical dermatological procedures?

We believe women need to know more and think carefully before they engage in any “age defying” procedures, dermatological or surgical. These may bring you great pleasure, just as the ski slope might for a skier who knows how to make good choices. When it comes to your face, your body and your aging process, be smart, be thoughtful and you’ll be more beautiful. Tell us what you think. — Dr. Vivian and Dr. Jill

Genetics and beauty are not dealt out evenly at birth, but EVERYONE ages. Women who grew up counting on their looks for their sense of well being seem more desperate to stop the changes that come with age. They find themselves trying harder to hold on to their youthful looks and, as a result, their changing looks make them feel less attractive. Some of these former beauties have taken their looks for granted and it’s only when they face losing their youthful looks that they begin to take care of them. By the time women in their 50s show up at their high school reunions, it’s the women who feel confident in their lives, not just their looks, that appear attractive. The playing field has changed.

We believe women can feel increasingly beautiful if they redefine beauty as they age. Women who hold on rigidly to their sense of youthful beauty lose their appeal as they try too hard to hold on to it. Women can gain a sense of attractiveness as they age, even if they never thought of themselves as beautiful, by gaining confidence that their beauty comes from how they take care of themselves, who they are and who they’ve become. What do you think? –Dr. Vivian and Dr. Jill

Now we are therapists treating hundreds of women who may be fulfilled and evolved in many ways, but are still having difficulty coming to terms with the lines of time.  Here are some great psychological tips we tell women to ‘think’ about that help them change the way they ‘feel’ and ‘look.’ They worked for us. They can work for you!

1) Beauty is not just a physical experience, but a psychological one as well – We all tend to think of beauty as a skin-deep issue, all about how we physically look. But research tells us that perception of what is deemed attractive and unattractive is much more complicated.  Why do you think some beautiful women say, ‘I’ve never thought I was pretty?’ yes, even beauties like Uma Thurman and Michelle Pfeiffer have drawn attention to what they consider flaws. Similarly, there are women who may not be your typical image of beauty, yet when you ask them they say they are quite confident in their looks. Serena Williams never tries to cover up her unconventionally muscular physique: in fact, she flaunts it and somehow it makes her more appealing. What makes people feel attractive goes well beyond our physical self. It runs deep, much deeper than the eye can see.

2) Although we can’t stop the physical changes of aging, we can change our experience of aging – No one, not any doctor, dermatologist or surgeon can stop physical changes of aging. There may be ways to look better, take care of your skin and bodies that put things temporarily on hold, at least on the surface. We’re all for that! We’re also for ways we can experience–and even enjoy– our changing looks. If we take care of ourselves, it makes us feel better and we smile more. When we smile, we look more attractive. The sooner we go through an interior process, (we offer six steps in our book) the better you will feel and feel inside and out.

3) While aging is inevitable and irreversible, self-image is not. Self-image can be fluid and timeless – Self-image is not an actual still picture of oneself. It is an internal experience, how we see ourselves from within, over time throughout our lives. It’s flexible and malleable. And if we understand that self image is changeable, then that is what we try to help women conquer. Not age itself. That’s a battle we can’t win.

4) Beauty is in the ‘I” of the beholder – If we become our own internal ‘eye,’ we can take control over how we see ourselves, rather than give it over to other people to determine if we’re attractive or not. Our six steps serves to change the internal lens through which we see, not only ourselves, but others as well.  The result? Women will be less self critical and less critical of each other.

5) Chronological age does not have to define you. You can define yourself at your chronological age – A particular age has little to do with how old you feel.  You can define how you want to be 40, 50 and onward. We also don’t have to let magazine images define what is beautiful. Some women in their 20’s feel old. Some women in their 60’s feel young.

6) Put your beauty in your identity, not your identity in your beauty. Your identity is made up of many aspects of yourself. How you look is just one of them. As you get older, more aspects of yourself can make up your identity; for example, your experiences in life, your accomplishments and your relationships. If you hold onto youthful beauty as a narrow definition of yourself, you’re especially unlikely to enjoy your looks as you age. You leave out so many other ways to feel good about yourself.

7) Take an honest look at who you are, not what you look like – Mirrors tell only a little of what we really look like. Gaze again and go beyond, past your reflection and see who you are as a person. Think of what you see as only the image of yourself, that informs the world of your physical self. But who you are is more than what they see.

8) Rob beauty of its power over you. Take back that power and you will feel more beautiful Our culture has given beauty power over women. We are told who and what is beautiful. We know that youth is beautiful. Most people see babies as beautiful. But so can grandmothers be beautiful. Some of the most beautiful women in the world are those who smile, engage and appear happy at any age. If you take back the power of what makes you feel attractive, you will become more attractive to yourself and others.

9) Become less afraid of aging and you will look more beautiful. – When you see a face that is scared, you would hardly call it beautiful. There is nothing pretty about fear. Women need to accept that aging happens and that becoming more courageous about all aspects of our lives will enhance them…and us.

10) Beauty matters to all women, but to those who age beautifully, it matters neither too much nor too little – We all know that a core aspect of our identities is our appearance. No doubt our looks matter. But women who allow beauty to matter, but keep it in balance with all other aspects of their lives, can enjoy their looks at any age.

Bottom line: Dealing with your looks as they inevitably change, is a psychological process as well as a physical challenge. Master the first and the second will come with much more joy. When it comes to your face, your body and your aging process, be smart, be thoughtful and you’ll be more beautiful.

Dr. Vivian and Dr. Jill

Growing up, we all expect to get married. Generations ago, your family’s wealth determined whether or not you were marriageable—think Jane Austen novels. But in our childhood, the currency was looks. The prettiest girls got the best guys. Once you’d found your mate and had your children, though, your looks were more or less irrelevant. True, women might mourn the loss of their youthful beauty and the power it gave them. They might faithfully and optimistically use makeup and moisturizers—and some of the more daring might even have colored their hair—but there wasn’t much in their arsenal. What’s more, aging—and looking as if you had aged—was a fact of life. There certainly wasn’t any shame connected with it…….

Then the women’s movement ushered in a wealth of new options. We were told that our worth derived not from being Mrs. Someone, but from using our intellect and our drive to make something of ourselves. Beauty wouldn’t determine our prospects. In fact, we were told to downplay our looks. To “dress for success” was to wear a man-tailored suit

Yet today, things have shifted once more. Successful women are expected to have the knowledge and wisdom that comes largely from experience, which requires aging…but you’re not supposed to look old. A magazines that celebrates and supports successful women over 40 features in its pages only women who look younger than they are. So we’re back to square one: Losing your beauty diminishes your power. Experience is good, but showing the signs of experience is bad. And, the implicit message is, you have to use all the tools available (including surgery) to erase those signs.

What’s a woman to do? How did we get on this ride, and how do we get off? Let us know your thoughts. –Dr. Vivian and Dr. Jill

After Matt Drudge put an unflattering picture of Clinton on his web site, Rush Limbaugh commented about it on air. “So the question is this,” the radio personality said. “Will this country want to actually watch a woman get older before their [sic] eyes on a daily basis?”

The only other candidate whose age seemed to evoke any notice is, of course, John McCain, who, had he won would have been 72 when entering the White House. In a six-page cover story about his candidacy in Time Magazine, only a couple of sentences were devoted to discussing his age—and, as an inseparable issue, his health—and the paragraph ended by quoting McClain making light of those “liabilities.” Others, of course, considered McCain’s age to be a more serious concern, one that perhaps should have excluded him from running altogether. Running the same week as the Time story was Anna Quindlen’s essay in Newsweek called “How Old is Too Old?” She took serious issue with McCain’s presumption that being the oldest person ever to begin a Presidency was immaterial. True, she began the essay on on a light note, unscientifically theorizing that the presidency ages a person in dog years, “[based] on before-and-after photographs of the occupants of the Oval Office.”

But we didn’t hear Quindlen or anyone else suggesting that the citizens of the U.S. would find it distasteful (as Rumbaugh implies) watching a man get older. While their constituents may have objected to the policies of Margaret Thatcher or Golda Meier, do you think their looks were cause for comment? Is Limbaugh’s point of view one you think that others share? Is this an American thing? And why? We’d like to hear your thoughts. –Dr. Vivian