Darrick Antell, M.D., a Park Avenue plastic surgeon, knows all about lifestyle choices and your skin because he has performed more plastic surgery on identical twins than any other surgeon worldwide. In the process, he’s carefully noted how the habits we adopt reflect on our aging.

It started while Dr. Antell was serving his residency. He treated a twin who had been badly burned in a fire and learned firsthand that twins’ mirror appearance is a very big thing to them. In time, he repaired the burned twin’s injuries but both sisters mourned the loss of their lookalike appearances.

And then, from time to time, Dr. Antell operated on one or both twins who were aging differently – but wanted to be dead ringers for each other again. And, he took the occasional case in which one twin had suffered an unfortunate accident.

Then, in 1997, Dr. Antell traveled to the annual Twins Festival in Twinsburg, Ohio, looking for research subjects among the thousands of sets of twins who gather there annually on the first full weekend in August to celebrate their sameness. Dr Antell was looking for situations in which one twin lead a fairly conservative life while the sibling was, or had been, a sunbather, smoked, drank to excess, perhaps used some drugs, had a few careless accidents and lived a stress-filled life.

Eventually, Dr. Antell located six sets of likely twins for a study on aging. In some cases, one twin had been conservative and lived quietly while the other spent more time catching rays, puffing smokes, quaffing more alcohol, and coping with some stressful times.

“The point of the two-year twin study was to document the ‘Nurture versus Nature’ debate about the effects of aging,” says Dr. Antell. “Is it lifestyle or heredity that causes us to age?”

Because identical twins grow from a single egg, they have identical genes and should age exactly the same.

“But, as a plastic surgeon and expert in skin, I could easily see that one twin often looked like an older version of his or her sibling,” says Dr. Antel.

The study, “How Environment and Lifestyle Choices Influence the Aging Process” was printed in a 1999 issue of the medical journal, “Annals of Plastic Surgery.” For the scholarly work, Dr. Antell studied hundreds of photos, conducted intensive interviews on the ways twins lived their lives and eventually performed facelifts on a select group to bring them back to being identical.

The study’s conclusion? Smoking is the skin's biggest enemy. If a twin smoked (or had other skin-damaging habits, like sunbathing), he or she looked, on average, five to seven years older than the non-smoking lookalike. The second most consistent factor that contributes to accelerated aging: sun exposure.

“The evidence was clear,” says Dr. Antell, “When one identical twin looked older than the other, external factors accounted for the differences in appearance.

For instance, one set of twins, Gay and Gwyn, were indistinguishable during the early parts of their lives, spent in Maryland. But Gay -- who now jokingly calls herself the “bad twin” -- lived in California for thirty years and baked in the sun year-round, smoked, used pot and drank socially for ten years. She had a history of depression which worsened after one of her children died; Gay also lived for a couple of summers in China and Thailand and now lives year round in sunny Hawaii. Gwyn, on the other hand, had only moderate sun exposure, never smoked or drank nor suffered a major tragedy like the loss of a child.

“Pictures of Gay and Gwyn at the same age look like shots of the same woman taken ten to fifteen years apart,” says Dr. Antell. “The pattern of the crow’s feet around the twins’ eyes is very similar -- the lines are essentially in the same place on both faces, but they’re deeper and more severe in Gay. The same phenomenon exists around the mouth and in the more excessive skin of Gay’s upper eyelids.”

Smoking, according to Dr Antell, is even more damaging than the sun because of its “total body” effect. Smoking reduces blood supply to all internal organs, as well as the skin, and impairs the body's ability to heal itself. The surgeon argues that a smoker's lined skin can be seen as a reflection of internal damage, as well as evidence of a direct assault on the skin.

“Twins who smoked also had more grey hair,” says Dr. Antell, “and looked older.”

The study also suggested that emotional stress can leave its marks on the skin, too.

“We had some cases in which one (always the older-looking twin) had some serious personal problems — the death of a loved one, for example, or divorce or stress at work,” he says. “Those problems show themselves in deeper crow's feet and in deeper lines between the eyebrows.”

Too much stress creates a “fight or flight” response in the body which, according to Dr. Antell, can further starve your skin of sufficient blood. Adrenaline, the fight or flight chemical, tightens blood vessels and shuts down the capillaries in your skin. So when you are overly stressed, skin quality just isn't a priority for your body.

In comparison, some twins had lived a very quiet lifestyle like one pair of 60-something Mennonite sisters – who had “great” skin -- and lived peacefully on a farm for their entire lives. They were identical in every respect.

The moral? “Practice defensive aging,” says Dr. Antell, “and avoid the obvious things that can make you older before your time.”

© 2005 HealthNewsDigest.com