title: A Holistic Approach to Antiaging as an Adjunct to Antiaging Procedures: A Review of the Literature.
abstract: BACKGROUND
  Aging is a multifactorial process and depends on both intrinsic and extrinsic factors. Procedural options for diminishing signs of intrinsic aging and cosmetic rejuvenation have expanded dramatically. However, less attention is paid to counseling patients on options for mitigating extrinsic factors related to aging.
  
  
  OBJECTIVE
  The objective of this study was to review changes that occur with intrinsic and extrinsic aging, and provide evidence-based holistic counseling recommendations that can be used synergistically with aesthetic procedures to maximize antiaging interventions.
  
  
  METHODS
  A PubMed search was conducted for articles on intrinsic and extrinsic aging as it relates to skin, fat, muscle, and bone. Key clinical trials and studies on the effect of diet, hormones, exercise, sleep, stress, dental hygiene, smoking, pollution, and oxidative stress on the aging process are reviewed, and treatment recommendations are summarized based on available evidence.
  
  
  RESULTS
  Conventional cosmetic procedures and cosmeceuticals work together with nutritious diet, exercise, dental hygiene, hormonal balance, stress reduction, smoking and pollution avoidance, and healthy sleep patterns for a better effect on antiaging.
  
  
  CONCLUSIONS
  A combination approach of multiple nonsurgical modalities along with healthy lifestyle recommendations to minimize intrinsic and extrinsic aging factors allows cosmetic practitioners to target multiple facets of aging concurrently and maximize the aesthetic interventions cosmetic dermatologists/practitioners provide.
authors.affiliation: *Department of Dermatology, University of Utah School of Medicine, Salt Lake City, Utah;†Goldman, Butterwick, Groff, Fabi & Wu, Cosmetic Laser Dermatology, San Diego, California;‡Department of Dermatology, University of California, San Diego, California.
authors.forename: Sandeep S
authors.initials: SS
authors.lastname: Saluja
authors.forename: Sabrina G
authors.initials: SG
authors.lastname: Fabi
mesh_terms: D000375:Aging / Q000502:physiology*; D000397:Air Pollution / Q000009:adverse effects; D003357:Cosmetic Techniques; D004032:Diet; D037001:Directive Counseling; D004781:Environmental Exposure / Q000517:prevention & control*; D015444:Exercise / Q000502:physiology; D006694:Holistic Health; D020249:Hormone Replacement Therapy; D006801:Humans; D009910:Oral Hygiene; D012890:Sleep / Q000502:physiology; D012907:Smoking / Q000009:adverse effects; D013315:Stress, Psychological / Q000517:prevention & control; D013472:Sunlight / Q000009:adverse effects