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Extended Longevity – The Anti-aging Revolution

Plastic Surgeons expend great effort toward hiding, or, to an extent, reversing the effects of aging. Surgery is our main tool used to combat the effects of aging, especially as patients live to more advanced ages. Although these patients undoubtedly feel better about themselves and derive advantages from the improved quality of life, the actual length of the patients life-span is minimally affected. Of late, much effort has been directed toward and increasing the individual’s life-span.

The traditional approach to anti-aging medicine has involved multiple disciplines, but commonly has been the domain of physicians practicing geriatric medicine. They have focused on conditions such as senile dementia, chronic rheumatologic and cardiovascular diseases. The last decade, however, has seen involvement by scientists, physicians, sport medicine specialists, endocrinologists, chiropractors etc., adopting a preventative approach to aging, with efforts beginning in early middle age. The emphasis has changed from treating disease to focusing on areas such as nutrition, supplements, genetic testing, exercise and mental stress relief. These are all accepted, mostly proven modalities of improving healthy life span. With the constant infinitive of the secrets of genetic chromosomal make-up, newer aging profiles are being defined, and manipulation of chromosomes, hormonal interventions and enzymatic solutions are being experimented with, in an effort to alter the aging process. In this vein, the layman has been introduced to hundreds of ‘easy-fix’ solutions to aging and supplements of vitamins, herbs, hormones, injections have all been introduced to the battlefield. It is essential that we take an academic approach to the subject and focus on the scientific data at hand.

Consider the 4 theories of aging:

  1. The cellular wear and tear theory: Overuse and abuse (often dietary) cause an accumulation of biochemical damage to tissue and organs that leads to failure. Low calorie diets with proper nutrition have resulted in lower incidence of cancer and longer, health lives.
  2. Normal waste products of cellular metabolism produce progressive damage to the DNA required to maintain and repair cells. This cellular damage has been shown to slowdown using antioxidants, such as vitamins C, E, lycopene, Co-enzyme Q-10 and others.
  3. Normal hormonal function is needed to monitor and preserve cellular function. Hormone replacement (growth hormone, melatonin, dehydroepiandrosterone, etc) or augmentation is controversial. For example, growth hormone levels drop with age – the logic has been to restore the levels to that of a 20- or 30- year-old. There are no long-term human data to suggest that this has an anti-aging effect, but there is an improvement in memory, immune function, strength, skin tone, circulation, and fat distribution. The risk of untoward effects with long-term hormone use is not well known.
  4. Programmed cell death, apoptosis, suggests that life span is predetermined and coded in the DNA for cell types, except cancer and germ cells. Shortening of telomeres occurs with cell proliferation and correlates well with ageing in humans. Telomerase is a ribonucleoprotein, and is the body’s most widely studied mechanism for extension of telomeres to circumvent cellular ageing. Reversal of apoptosis using telomerase at the chromosomal ends limits cellular senescence. However telomerase activation also is a critical step in human tumour progression. Chromosomal manipulation is at the frontier of anti-aging research but is still unproven in its safety or efficacy.

Behavioral factors are not to be overlooked when considering life span. Emotional and mental health, long stable marriages and relationships, strong families, participation in community affairs, active spiritual life, social interaction, a personal interest in work, hobbies, education and learning, all provide meaningful reasons to live and are.

31 October 2002
Acknowledgements:
Prof Alan D Widgerow