David B. Reath, MD
Knoxville, TN (865) 450-9253
HKB Knoxville Staff

It’s Official: Cigarette Smoking Really Does Make You Look Older

smoking-and-agingIt’s not every week that plastic surgery’s leading scientific journal makes it onto the splash page of the major news outlets. But that’s what happened this week. The study had to do with the facial appearance of smokers and more specifically how and where smoking makes you look older.

This is a study that comes out of the prestigious plastic surgery division from Case Western Reserve University in Cleveland Ohio. Each year there is an annual Twins Day Festival in – you guessed it –Twinsburg, Ohio. For several years these plastic surgeons collected data and photographs of identical twins in sets where one smoked and the other did not. Then this data was analyzed to determine the effect that cigarette smoking on facial appearance. The reason that identical twins were used is that these individuals are genetically identical so any effects of inheritance could be discounted.

Well the bottom line is that those who smoked looked older. No surprise here. What was particularly interesting was where the aging is seen in the face.

Where Smoking Ages You
The differences were most notable in upper eyelid skin excess, looseness of the lower eyelids and cheeks, appearance of jowls, and upper lip lines. Some areas of the face such as the forehead and crow’s feet area were not affected as much. This study is important because it give a scientific basis for something that we all see: smoking accelerates the aging process.

In the photo below from the study, you can see the difference yourself. Both twins are smokers. The twin on the right smoked 14 years longer than his brother. Notice the difference the eyes and lower half of the face.


Why This Happens
How smoking affects us is not completely understood but much of the damage comes from the development “free radicals” which are injurious molecules that affect the ability of the skin to repair itself, and that impede collagen and elastic fiber production. And, to my mind, there is also less oxygen being supplied to these tissues due to the fact that nicotine impedes blood flow by causing the smaller blood vessels to constrict. Neither of these is good or healthy. Previously these affects have been studied in twins undergoing facelifts where the smokers healed less well and their results did not last as long.

Aging isn’t the only reason to quit
After you have looked at the faces and the skin of smokers, you really begin to see these differences. I am constantly impressed by the profound aging of relatively young people who smoke. But the aging is just one effect. There’s also the increase in high blood pressure, risk of heart disease, vascular disease, and chronic lung disease. And, you can’t taste food as well because the taste buds get fried, so to speak.

Good news for those who quit
If you are a non-smoker, you’re probably feeling pretty good about yourself. And if you’re a smoker, you probably aren’t reading this. But, there is some good news for smokers when they quit. Many of the health risks can be reversed. And some things quite quickly.

Within 12 hours blood oxygen levels increase towards normal.

Within in 24 hours the heart attack rate begins to drop.

Within 48 hours nerves endings in the hands and feet are being repaired and the sense of taste and smell begin to return.

Within one month the lungs begin to repair themselves.

By one year the risk of heart attack is cut in half and the skin will begin to look better.

Will quitting reverse the aging?
As to whether your skin will ever totally recover from years of heavy smoking, well that is something that we don’t have any data on. But, this study that received all the attention is pretty clear in its conclusions: smoking makes you look older. And, the longer people have smoked, the more aged they appear.

I have never smoked. And while I do not feel smug about this, I am very glad I never have because I can see how hard it is to quit. And yet, it can be done. I’ll share a story about my maternal grandmother, Gogie (you can blame my oldest cousin, Tim, for her name).

Gogie smoked all her life, from the time she has in her late teens into her 80’s. And while she was quite vigorous, she had some health issues. There were always cartons of Kent cigarettes around her house. One night while she was on vacation, she woke up unable to breathe. She was very shaken by this because she was alone (my grandfather had predeceased her), and she was absolutely terrified. The next morning she put her cigarettes down and never smoked for the rest of her life.

Clearly it is not easy to give up something as addictive as cigarettes. But it can be done. My grandmother was proof of this.

If you don’t smoke, great! Don’t start. If you do smoke, please do what you can to quit. You’ll live longer and look younger.

All the best,
Dr. David B. Reath



David B. Reath, MD

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Photo Credit: Plastic and Reconstructive Surgery / American Society of Plastic Surgeons

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