Ageing may be inevitable, but the right attitude and knowledge can help you face each day confidently.

For her upcoming reality show, Hollywood glamour Jessica Simpson has been travelling the world to explore the meaning of true beauty in different cultures. In the past, she has been scrutinised by the media for many aspects of her appearance - her bust size, hairstyle and weight, to name a few - but she recently said she has gained some perspective and learned the value of inner confidence.

The concept of beauty is undefined as it can be a product of culture and society. However, the way that one carries themself will affect how others perceive them.

As the well-known saying goes, if you look good, you feel good. But the reverse is also true as confidence and inner beauty do show on the outside. Confidence is thought to be one of the most attractive qualities and can be even more intoxicating than physical beauty alone. Together, it's a tough combination to beat.

Many people have found someone physically attractive, even though they were not conventionally ‘good looking'. Somehow their personality, charm, confidence, goodness, wit or energy seem to shine through. It may take inner beauty longer to make an impact than a first impression, but it is what goes the distance and can be present at any age.

Melbourne-based body image researcher and clinician Roberta Honigman says the most common motive for undergoing cosmetic procedures and treatments is a desire to look younger and healthier and feel more confident about appearance. ‘People are living longer, healthier lives, so the discrepancy between how they feel, what they can achieve and how they appear is bigger than it used to be,' she says. ‘Now they have the need to look as young as they feel.'

Honigman says that for some people looking younger might be advantageous, even necessary, in the cutthroat corporate world. ‘People feel as though they have more of a competitive edge if they're looking younger, more awake and alert,' she says. ‘These days, it's almost as though experience, wisdom and maturity are not seen to be as relevant as looking good.'

Ageing
The quest for the hallmarks of eternal youth is unfortunately one that can never be totally sustained, but it can be held on to longer with some understanding of the physical and environmental concerns that age the appearance.

Hollows and gauntness due to loss of volume, shrinkage of the bone structures, loss of collagen, elasticity and gravity are all characteristics of the ageing face. While some of the skin-related factors can be controlled with healthy lifestyle choices and a good product regime, many of the characteristics are a matter of genetics. However, all can be more effectively managed via an understanding of the ageing process.

Cutaneous ageing is caused by two distinct processes - intrinsic and extrinsic factors. Intrinsic, or chronologic ageing, is the inevitable genetically determined process that naturally occurs. It is a result of the degenerative effects of free radicals and the body's inability to perfectly repair their damage. Over time, the cells, tissues and vital organs ‘rust' or deteriorate.

Intrinsic ageing is a continuous process that usually begins in the mid-20s but doesn't become evident for decades. Collagen production begins to slow and elastin has less spring. Dead skin cells do not shed as quickly and turnover of new skin cells decreases.

The signs of intrinsic ageing include the loss and descent of underlying fat leading to hollowed cheeks and eye sockets and loss of firmness which causes the skin to sag.

The extrinsic, or preventable factors, often act together with the normal ageing process. Skin shows the wear and tear of extrinsic ageing, which is environmentally induced and manifests in age-associated skin changes including thinning, laxity, fragility and wrinkles.

Most premature ageing is caused by sun exposure therefore it is important to always wear sunscreen. Other factors include repetitive facial expressions, gravity, sleeping positions and smoking.

Based upon research and studies, experts suspect that elements that keep wrinkles at bay include Vitamin A, Vitamin C, Vitamin E and minerals zinc and selenium. These vitamins and minerals reduce the amount of potentially damaging free radicals and help protect the skin from ageing due to sun exposure.

Structure and volume

Recent studies have shown the shrinking of facial bones also plays a role in ageing the face. Facial bones remodel their three-dimensional shape with age, showing the most pronounced difference measured in the T-zone.

In women the area between the brows and top of the nose (the glabellar angle) is shown to decrease as the area under the rim of the eyebrows retreats, resulting in sagging brows and deflated eyelid skin. In men the glabellar angle decreases and the area supporting the cheeks (maxillary angle) is also shown to decrease. Second to this, the malar fat pad, responsible for cheek fullness, slides down and forward, pushing against the nasolabial fold and making the maxillary angle appear more pronounced.

Lastly, the pyriform angle (the opening of the nose) showed receding bones causing the appearance of an elongated nose and drooping in the surrounding area. The nasal area increases significantly with age.

A good way to assess the changing forms of ageing is to divide the face into the upper third (forehead and brows), middle third (midface and nose), and lower third (chin, jawline, and neck). The midface is important in facial aesthetics because perceptions of beauty are found largely in the synergy between the eyes, nose, lips, and cheek bones (central facial triangle). For aesthetic reasons it is important to consider this area from a three-dimensional rather than two-dimensional perspective. Therefore restoring a youthful three-dimensional facial landscape should be considered the primary goal in facial rejuvenation.

Beautifully

Philosophers, scientists and ordinary people have long puzzled over what makes a face attractive, questioning whether there are objective standards of beauty, or if beauty is in the eye of the beholder.

Plato wrote of the ‘golden proportions' in which the width of an ideal face would be two-thirds its length, while a nose would be no longer than the distance between the eyes. Although beauty is not an exact science, some plastic surgeons believe there is a specific proportion system that the ideal face tends to hover at which includes facial height, width and symmetry.

Images of faces manipulated to make their shapes closer to the average are perceived as more attractive. They fit our prototype of what a ‘face' is. Averageness and the balance of facial features have been scientifically proven to be inherently attractive to the human eye.

A study conducted at Exeter University in the United Kingdom found that newborn babies show a preference for people with features that are conventionally judged as attractive by adults. Almost 100 newborns were shown two images side by side, one showing an attractive face and the other a less attractive one. Around 80 percent of the time the babies looked exclusively at the ‘prettier' face and this was repeated with male faces as well as faces of various ethnicities.

This predisposed bias to beauty was debated long ago by British naturalist Charles Darwin. Beauty and its symbolism of health, youth and fertility played a considerable role in his theory of evolution, instinctively orientating males and females in mate selection. Clear skin, lustrous hair, facial symmetry and full lips were all indications of a healthy and therefore fertile woman to our evolutionary ancestors.

‘These in-built preferences seem to be aimed at ensuring males find suitably fertile females who are healthy enough to reproduce and in turn produce healthy children,' says evolutionary anthropologist Sean McBride. ‘Facial neotony, or the continuation of juvenile traits into adulthood, is appealing to males because it signifies youth. We subconsciously associate large eyes, a small nose and chin, and full red lips with fertility,' he says.

There does seem to be some universal truths in beauty. For instance, unlike the rest of the animal kingdom - where males are the beautiful ones - the human focus of beauty has always been on women's faces and bodies, and this is so in all cultures: it is more important for women to be beautiful.

Throughout history and across cultures, women have manipulated their appearance to conform to a beauty ideal. In ancient China aristocratic women bound their feet as a show of femininity. American and European women in the 1800s cinched in their waists so tightly it sometimes resulted in internal damage. The idea of beauty varies from culture to culture and has changed over time, therefore attraction can be subjective.

The modern philosophy of health and beauty requires a wholeness of the body, mind and soul. In his 2004 book on beauty, John Armstrong argues that beauty cannot be explained by a single principle. According to Armstrong, components of attractiveness may include averageness, symmetry, sexual dimorphism, a pleasant expression, good grooming, youthfulness and, for known faces, can reflect nonphysical characteristics such as how much one likes the person. Personality, love of life and confidence are also universally attractive qualities therefore they can factor into judgment.

The importance of beauty
Over 2,000 years ago, Aristotle said, ‘Beauty is a greater recommendation than any letter of introduction,' a message that still resonates in today's society. Research shows that attractive people are often perceived and treated more positively than their less attractive counterparts, and it goes deeper than the belief that first impressions count.

Social psychologists have identified something called the ‘what is beautiful is good' stereotype. When someone is attractive, we assign many other positive attributes to him or her that have nothing to do with looks. Attractive people are typically judged as more intelligent, competent, sociable, popular and sensitive than less attractive people.

This is described as the halo effect, which many theorists argue is based on cultural myths that say attractive people must be good and ugly people must be inherently bad. From a young age, we are taught this. Good witches are pretty, bad witches are ugly. The princess is always beautiful and the wicked stepmother is always ugly.

The halo effect is a powerful concept. Consider the press coverage of United States president John F Kennedy or the public admiration for Diana, Princess of Wales. They may have been valued for many reasons, but perhaps a large part of their popularity was due to the way they looked.

According to Nancy Etcoff, author of Survival of the Prettiest: The Science of Beauty, looking good has survival value, and beauty confers privilege, popularity and unearned advantages. Studies have found attractive people are more likely to be hired for a job and also enjoy a higher salary.

People are often most confident when they look their best, and being attractive seems to be strongly associated with self-confidence. Economists Markus Mobius of Harvard and Tanya Rosenblat recently reported on an experiment that illustrates that with beauty, comes confidence. Beautiful people were were found to be more confident in their own abilities, despite having the same productivity as the less attractive subjects. Results also showed higher productivity estimates for beautiful people which shows that people associate beauty with confidence.

Confidently
Confidence is about self-respect and self-understanding. How you perceive yourself will ultimately affect how others perceive you.

Consider the ubiquitous ‘Best Celebrity Body' surveys. Although the Hollywood ideal seems to be stick thin, names such as Scarlett Johansson, Kate Winslet and Beyonce, seem to regularly make the list. These celebrities are admired by many women for their voluptuous curves, but a large part of their appeal is due to their confidence in their bodies and how they carry themselves.

Recognising the power of the positive, an increasing number of people are turning to cosmetic procedures to enhance appearance and boost confidence. Advances in technology have revolutionised the field of cosmetic surgery and made it part of mainstream medicine. It's no longer reserved for the rich and famous, but now available to anyone who wants to stay ahead of the age game.

A study at Queensland's Griffith University examined the emotional impact of cosmetic surgery on patients and their families. It found the emotional experience of cosmetic surgery was largely a beneficial one, after which many patients indicated they would undergo the same procedure again if necessary. They said they enjoyed significant positive psychological outcomes, including growth of self-esteem and confidence.

Shifting attitudes
United States activist Betty Friedan once said, ‘Ageing is not "lost youth" but a new stage of opportunity and strength.' However, this does not seem to reflect society's attitude to ageing. In Australia, even though the life expectancy is 79 years for men and 84 years for women, it is often believed they have little to contribute once they reach their 60s.

In some cultures age is revered. In Japan, silver hair and wrinkles are often admired as signs of wisdom, maturity and long years of service. The traditional Japanese ritual of the kankrei celebrates the release of the older person from the responsibility of middle age and recognises new freedoms and competencies. The Japanese even have a national holiday, the Respect the Aged Day.

In Latin cultures the elderly are believed to have an inner strength and they are considered a resource for younger generations. The elderly are considered to be important members of the family because they are links to the past. And in Islamic culture, people's status actually increases with their age.

In the French court of the 17th century, when wigs were symbols of wealth and status, most people applied white powder to their hair to make themselves look older and therefore wiser.

In the 17th and 18th centuries in the US, older people were respected and venerated as transmitters of wisdom and tradition to the younger generations. They were given the best seats in church, and Puritan teachings instructed youth on how to behave towards their elders. One reason they earned respect was because there were so few of them in colonial society. According to social historian David Hackett Fischer, only 2 percent of the population at that time was over 65 years old.

Western societies today seem to have lost sight of the value of age, despite the fact our population is ageing. Most of the top politicians, CEOs and other powerful, influential people are those with years of experience behind them.

Even so, older people are often seen as being feeble in mind and body and as economic burdens on society. For those who do continue to work or return to the workplace, age discrimination is often a barrier.

Despite such stereotypes, statistics show that while older people do suffer more from chronic illnesses, they actually have fewer acute illnesses, fewer injuries in the home and fewer road accidents than younger people.

Similarly, the perception that older workers are less effective than their younger colleagues is disproved by research. Studies of older employees generally show that they perform as well as, if not better than, younger workers on most measures. Consistency of output tends to increase with age, and older workers have less job turnover and less absenteeism than younger workers.

In her book, Emotional Unavailability, US psychologist Bryn Collins encourages her generation (baby boomers) to shift their attitude, embrace the present and live in the moment. ‘Being in the moment means we don't obsess about being old but instead plan to be an elder and take the steps to prepare ourselves physically, cosmetically, emotionally, financially, spiritually and attitudinally.'

In the face of today's attitudes to ageing and beauty, more people are seeking facial rejuvenation to restore a more youthful appearance. It's not so much about turning back the clock as a way of maintaining an outward appearance that reflects how they feel on the inside.

ACSM #47