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updated 8/13/2010 9:08:53 AM ET 2010-08-13T13:08:53

"One of my patients, a TV actress, came into my office the other day pretty upset," recalls Ava Shamban, M.D., a dermatologist in Santa Monica, California. "She is in her early thirties and has noticed that people have suddenly started casting her as a killer. Her face has changed — the corners of her mouth have started turning down just slightly, and it has given her a much harder look."

It's one of life's crueler jokes. Your thirties are supposed to be your best years: You finally have a handle on your relationships, you're on track at work, you've built a respectable shoe collection. In other words, you've gotten your act together. But it's at this exact moment that life throws you for a beauty loop. "Thirty is often the age when you start to see your looks changing ... and not for the better," Shamban says.

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Those first deep wrinkles begin to emerge, turning once-charming crinkles into full-on crow's-feet. High school-style acne may decide to make a comeback, or crop up for the very first time. Damage from decades-old summer-camp sunburns can begin to emerge as brown spots and saggy skin. A formerly plush ponytail may become a scrawny shadow of its former self. You get the not-so-pretty picture.

Hormones are one of the main culprits for all these maladies. "The majority of hormone changes start around age 30," explains Beverly Hills endocrinologist Eva Cwynar, M.D. Because we're engineered to have babies in our teens and twenties, our reproductive hormone levels begin to taper off in our thirties, which can result in hair loss and funky skin conditions. Human growth hormone, or HGH, begins to peter out too, which means cells don't turn over as quickly. This puts the brakes on collagen production, giving way to dull, slack skin. "When we're 18, our growth hormone levels may be around 800. By 30, they've dropped to 150. It's normal. It's just how we age," assures Cwynar.

And if you spent your twenties on a beach chair with a glass of chardonnay in one hand and a cigarette in the other, those vices will begin to show, quite literally, on your face. "You start to see the cumulative effects of hard living on your skin in your thirties," says dermatologist Rebecca Giles, M.D., owner of FIX skin clinic in Malibu, California. Everyone is going to see some changes in her thirties due to hormonal shifts, "but for those who have been tanning, drinking, smoking, and eating poorly, the problems are going to be worse."

To keep you looking gorgeous throughout your thirties and way beyond, we asked dermatologists to identify the major skin and hair issues you're bound to encounter during this decade and offer ways to keep problems at bay. If you've already detected some beauty erosion, don't fret. There's still time to undo the damage.

Cellulite
Roughly 85 percent of women have some cellulite, and those first thigh dimples often show up around age 30. A less active lifestyle can lead to a cottage cheese-like appearance. "By their thirties, a lot of people have desk jobs and don't have as much time to work out," Shamban says. Adding to the problem: Collagen production starts to taper off at this age, making the skin thinner and cellulite more noticeable.

Preemptive strike: Add simple weight-training exercises like squats and lunges to your cardio routine three or four times a week to tone up and blast fat, says Wayne Westcott, Ph.D., co-author of "No More Cellulite."

Stop yo-yo dieting. Repetitively gaining and losing weight stretches the tissue that connects skin to muscle. When that tissue is stretched, it can have a tough time holding in fat pockets effectively.

Turn back time: There's no magic cure for cellulite. That said, to increase the effectiveness of cellulite creams, Shamban suggests using them in conjunction with over-the-counter retinoid creams like Elizabeth Arden Ceramide Plump Perfect Ultra Lift and Firm Moisture Cream SPF 30 ($68, elizabetharden.com). "Retinoids have been shown to stimulate collagen," Shamban says.

Some experts say that in office or in-spa treatments for cellulite may offer temporary relief. "New devices like the Smooth Shapes cellulite machine — a laser-plus-light treatment with suction action — can be moderately effective," Shamban says ($300 per treatment; a series of eight is recommended).

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Wrinkles
Thanks to sluggish cell turnover, everyone sees a little wrinkling in their thirties, but for sun worshippers and smokers," the bell starts tolling earlier and louder," Giles says.

Preemptive strike: "Wearing broad-spectrum sunscreen with at least SPF 30 is the best thing you can do for your skin," says Giles, who recommends using a physical sunblock like titanium dioxide, which doesn't wear of as quickly as chemical sunscreens. And you need to slather it on every day. "If you can see outside without a flashlight, you need to wear sunscreen. Period," says Ranella Hirsch, M.D., dermatologist in Boston.

Layer an antioxidant serum under your sunblock. "Research shows that vitamin C in particular can help make sunscreen more effective," Giles says. Try Neutrogena Ageless Restoratives Antioxidant Booster Serum ($19, ulta.com).

Cut down on processed foods, don't drink excessively, and good grief, quit smoking already! "These habits all contribute to the premature signs of aging, " Hirsch says.

Turn back time: Thirty isn't too young to start using heavy-duty prescription retinoids, especially the superhero of the bunch, tretinoin. It exfoliates cells to reveal smoother skin and also prevents sagging. Apply a pea-size amount to clean skin a couple of nights a week at first (more than that can cause redness and irritation).

If you've been a maximum sun offender, a small dose of Botox — yes, even at 30 — may be in order. When used in conservative amount, it may keep "dynamic" wrinkles (lines that show up only when you frown or smile) from turning into "static" wrinkles (which hang around no matter what your expression). "I'll see some 30-year-old patients for Botox two or three times a year," Giles says. "It doesn't take much to make a big difference."

A chest full of brown spots
Consider these sun spots souvenirs from all those irresponsible spring breaks spent sitting around the pool sans sunscreen. Like wrinkles, they begin making an appearance when you hit the big 3-0.

Preemptive strike: Daily dedicated use of broad-spectrum SPF 30 or higher prevents sun spots from forming and keeps existing ones from becoming darker.

Turn back time: Studies show that retinoids, those all-powerful skin rejuvenators, can zap sun spots. "Your skin regimen for your face can be modified for your chest, which is more sensitive," says Doris Day, M.D., a dermatologist in New York City. "Try applying an OTC retinol product with a moisturizer to clean skin a few nights a week."

"I've had great success removing brown spots with the new AcuTip laser and the Nd:YAG laser," says Beverly Hills dermatologist Peter Kopelson, M.D. Laser treatments can set you back $500 to $2,000, "but if you address these brown spots now, at age 30, you're likely to have fewer issues later on if you continue to wear sunscreen and stay out of the sun," says Kopelson.

Intense pulsed light (IPL) therapy can also lift sun-damage spots from the chest or face. It's an in-office treatment that delivers intense blasts of broadband light therapy deep into the epidermis to kill pigmented cells, which then slough off after a week or two. It's slightly less expensive than lasers (around $500 per treatment), but several sessions may be required to see maximum results.

Thinning hair
It can be downright freaky when you start seeing clumps of hair swimming around your shower drain and some thinning (thinning!) around your temples. This is largely due to the 30-something hormonal shift, which is genetically determined, but big-time thinning can be triggered by stress, a vitamin deficiency, an excess of mercury, or giving birth (moms experience temporary hair loss about two months after popping out a baby as their hormones readjust). More serious causes include hypothyroidism, which often manifests itself in your thirties, and polycystic ovarian syndrome (PCOS), which is most often seen in women ages 30 to 40.

Preemptive strike: Eat a well-balanced diet that's rich in B vitamins, protein, and omega-3 fatty acids, and keep mercury levels in check by sticking to low-mercury fish like tilapia and herring, and eating it just twice a week.

Take a daily multivitamin with hair-and nail-strengthening biotin and zinc, Day says.

Turn back time: If the root cause of hair loss is a thyroid condition, a regular dose of synthetic hormones like Synthroid, prescribed by an endocrinologist, can put your body back on track.

For PCOS sufferers, switching to a low-glycemic (low sugar, low carbohydrate) diet can reduce overall body fat and reset your blood insulin levels. If it doesn't, your doctor may prescribe Metformin, a drug for diabetics that controls blood-sugar levels.

If your doctor rules out a thyroid condition and PCOS, she may recommend a prescription drug called Aldactone (the generic name is spironolactone). "It's a testosterone inhibitor that works like a key in a lock; it takes up space that extra testosterone would," Cwynar says.

Stray hairs
It's a raw deal that when your hair starts to fall out of your head, it starts to pop up in less-than-ideal places, like your chin, nipples, and abdomen. The reason: The ratio of androgens (male hormones) to estrogen may change in your thirties, which can turn a soft, fine hair into a (gasp!) whisker.

Preemptive strike: Hate to be the bearer of bad news, but there's not much you can do.

Turn back time: Traditional hair-removal methods like tweezing, waxing, and electrolysis work, and laser treatments have proved to be highly effective too. "There's also a prescription cream called Vaniqa that can help prevent hair from regrowing, with varying degrees of success," Day says.

Acne
You may associate zits with first dates and SATs, "but it's a myth that acne ends in your teens," says Heidi Waldorf, M.D., director of laser and cosmetic dermatology at Mount Sinai Hospital in New York. "In fact, lots of people see it for the first time at 30." The causes? A natural decline in estrogen levels, switching birth-control pills (which can create a temporary hormonal imbalance), and stress. The adult responsibilities of your thirties (a big-shot job, a kid, or both) may make cortisol levels spike, resulting in a case of adolescent-like acne.

Preemptive strike: Daily cleansing and weekly exfoliation will help keep your pores clear and fend off acne. Waldorf recommends the Neutrogena Wave ($13, at drugstores), a device that uses a salicylic acid cleaning pad to remove dead skin cells. If exfoliating seems tedious or if your skin is very oily, you can simply apply a salicylic acid product daily (try Murad Anti-Aging Acne & Wrinkle Reducer, $58, sephora.com, or Philosophy Oil-Free Acne Treatment Gel, $22, sephora.com). "These exfoliate the skin and penetrate pores to disrupt oil production," Hirsch says.

Turn back time: Wrinkle-fighting retinoids also have a way with pimples. If prescription-strength products are too strong for your sensitive skin (or your wallet), try Olay Total Effects with Pro-Retinol ($23, drugstore.com), which is gentle and nearly as effective. Apply it at night to clean skin.

Ask your dermatologist about in-office peels (a custom blend of peeling agents like salicylic acid or alpha-hydroxy acid that's left on the skin for several minutes, which may result in peeling a few days later). Both are proven zit erasers.

Red bumps around your nose and mouth
Notice a constellation of tiny, painless red bumps on the lower half of your face? Chances are, you've got a case of perioral dermatitis, which is most common among women in their thirties.

Preemptive strike: Quit touching your face! "While the cause of perioral dermatitis is unknown, picking and prodding can trigger it by introducing all sorts of bacteria to your skin," Giles says.

Turn back time: "Nothing is available over the counter to treat this," Giles says. "If you notice these tiny bumps, and they don't appear to be acne-related, see a dermatologist, who will likely prescribe an antibiotic in a pill or lotion form to reduce inflammation."

Brown spots on your face
Big blotchy patches on the upper lip, cheeks, and forehead are called melasma. While typically considered one of those annoying estrogen-related pregnancy symptoms, they can occur in 30-something women who have never been preggers. "Sometimes oral contraceptives can cause these patches, but sometimes they pop up for no particular reason at all, and even just a few minutes in the sun makes them worse," Day says.

Preemptive strike: According to Day, nothing can prevent melasma entirely, but slathering on Neutrogena's new Spectrum+ Sunblock Lotion SPF 55 ($12, at drugstores), which protects skin from UVA and UVB rays, as well as certain wavelengths of infrared light, can stop patches from getting darker. "The latest research indicates that infrared rays and heat play a role, and traditional sunscreen doesn't shield the skin from them."

Turn back time: Melasma can be tough to treat, but light chemical peels such as the Vi peel, a combination of ingredients like salicylic acid, retinoic acid, and vitamins, can be effective in lifting the pigment from your skin.

Don't have the bucks (or the pain threshold) for a peel? "Using a topical lightening cream with kojic acid or hydroquinone can lessen the appearance of melasma," Kopelson says. Apply SkinCeuticals Pigment Regulator ($85, skinceuticals.com) every other night, building up to every night.

© 2012 Rodale Inc. All rights reserved.

Photos: Fading stars or better than ever? How famous faces are aging

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  1. Madonna, 51

    In 1985 (left) and 2009

    We asked msnbc.com contributor Dr. Tony Youn, a Michigan-based board-certified plastic surgeon who has been featured on "Dr. 90210" and runs a popular celebrity cosmetic surgery blog, to weigh in on how these famous faces are aging.

    Dr. Youn, who hasn't treated any of those featured, shares his observations:

    Is the Material Girl made of plastic? Almost. Madonna looks much younger than 51. Her cheeks are full, her neckline is sharp, and there are no wrinkles to be found. I believe she's had a facelift, Sculptra injections to her cheeks, multiple laser treatments or chemical peels, Dysport injections and possibly an eye lift. (WireImage, AP) Back to slideshow navigation
  2. Jane Fonda, 72

    In 1967 (left) and 2008

    Jane Fonda was recently quoted as saying she attributes her looks to 30 percent sports and nutrition, 30 percent genes, 30 percent good sex and 10 percent plastic surgery. With her sharp jawline, elevated brows, and wide-open eyes, this 72-year-old-star, in my opinion, has had a facelift, browlift, and eyelid lifts. I’d estimate her looks are from 30 percent genes, 20 percent sports and nutrition, and 50 percent plastic surgery. It takes more than Jane Fonda’s workout to look this good for this long. (Getty Images) Back to slideshow navigation
  3. Jack Nicholson, 72

    In 1977 (left) and 2009

    When it comes to steering clear of plastic surgery, Jack Nicholson is “As Good As It Gets.” He is aging gracefully, with nary a sign of the plastic surgeon’s knife. While many of his younger peers are injecting vials of Botox, Nicholson’s wrinkles are deep, natural, and untouched. Good thing, too, since too much Botox would make him look like his “Batman” character, the Joker. Now he just looks like an older, wiser and distinguished Hollywood star. (WireImage. Getty Images) Back to slideshow navigation
  4. Andie MacDowell, 51

    In 1992 (left) and 2009

    Unlike many 50-year-old actresses and models, Andie MacDowell appears to be completely natural, except for maybe a touch of Botox here or there and possibly skin tightening laser treatments such as the Cynosure laser facial. Her face is smooth and likely reflects a lifetime of avoiding the sun, taking care of her skin, and undergoing preventive treatments. (WireImage, Getty Images) Back to slideshow navigation
  5. Bruce Jenner, 60

    In 1993 and 2009

    Bruce Jenner reportedly underwent a botched nose job and partial facelift back in 1984, leaving him looking, in my opinion, feminized and unnatural. He subsequently underwent a revision facelift on his reality program “Keeping Up with the Kardashians” and looks a whole lot better. His jawline is sharper and he doesn’t look quite as operated on. But why does he still look a bit strange? It’s likely because his nose is still too thin and his eyelids are far too open for a 60-year-old man. He proves my belief that it’s better to do plastic surgery right the first time, than try to fix it later. (Getty Images) Back to slideshow navigation
  6. Cindy Crawford, 43

    In 1990 (left) and 2009

    The prettiest woman of the past two decades still looks amazing. Cindy Crawford is really a Super Role Model for aging gracefully. She looks barely five years older than she did in the early 1990s. Her skin remains flawless. She may have had some minor skin tightening treatments such as the new eMatrix by Syneron, but other than that it appears her looks are due to TLC and not the OR. If only we could all age like her! (WireImage, Getty Images) Back to slideshow navigation
  7. Clint Eastwood, 79

    In 1965 (left) and 2009

    Clint Eastwood looks too tough to have had plastic surgery. Because 90 percent of plastic surgery patients are women, these techniques can sometimes make men look a bit effeminate and unnatural. Eastwood exhibits many of the signs of a man who has resisted the knife: a low brow, loose skin under his neck and terribly sun-damaged skin. The only procedure I believe he may have had is an upper eyelid lift. His upper eyelids actually appear heavier and more hooded back in 1965 than they do today. But even if I think he may have had plastic surgery, I wouldn’t dare tell him. (Getty Images) Back to slideshow navigation
  8. Kenny Rogers, 71

    In 1985 (left) and 2006

    Kenny Rogers has admitted to gambling with an eyelid lift - and losing. His plastic surgeon reportedly removed too much upper eyelid skin, causing him to look permanently surprised. He also appears to have had a browlift, further accentuating his possible botched eyelid work. He is a good example of the need for plastic surgeons to be very conservative when operating on men. Unfortunately, he doesn’t look anything like the country legend used to be. (Corbis, Getty Images) Back to slideshow navigation
  9. Courtney Cox, 45

    In 1996 (left) and 2009

    This cougar has done everything she can to stay looking young. Courtney Cox is clearly “Friends” with a plastic surgeon. In addition to possible chemical peels like the Obagi Blue Peel, she also appears to have had her lips plumped up, likely with a filler such as Juvederm. Her cheeks also appear a bit fuller, which could be due to fat grafting or Sculptra injections. Her skin is so smooth and flawless, I bet she’s received millions to try the skin care product she represents, Kinerase. Finally, in my opinion, her forehead exhibits the smoothness that only Botox or Dysport can provide. (Getty Images) Back to slideshow navigation
  10. Diane Keaton, 64

    In 1979 (left) and 2008

    Diane Keaton looks like a normal 64-year-old woman. Her eyelids are getting heavy, her neckline is a bit loose, and her hair is graying. While I wouldn't say she looks young for her age, she remains an attractive woman. I doubt she's had any work done at all. At least she looks better than her "Annie Hall" co-star Woody Allen! (Corbis, Getty Images) Back to slideshow navigation
  11. Ellen Barkin, 55

    In 1996 (left) and 2009

    Ellen Barkin looks better than 99 percent of 55-year-old women. Is that because of genes, preventive skin care, or plastic surgery? I would bet a bit of all three are involved in keeping this Golden Globe-nominated actress looking young. Her brows appear higher today than they were back in 1996. This could be due to an endoscopic browlift. Her eyelids also look more open than they did 14 years ago, possibly due to upper eyelid lifts. Her skin is extremely smooth, and may have had help from skin tightening treatments such as the Cynosure Smartskin Laser. Also, do her lips appear that they are getting larger with time, possibly due to lip injections such as Prevelle? (Corbis, Getty Images) Back to slideshow navigation
  12. George Clooney, 48

    In 1988 (left) and 2009

    George Clooney is the type of man women love but men love to hate. Unlike many of the celebs in this slideshow, the question of whether or not he’s had plastic surgery is not “Up in the Air.” He looks as good as he does without any plastic surgery. Although many blogs have accused Clooney of undergoing a nip here and a tuck there, I see no sign that he’s had any work done at all. He’s one example of a person aging like fine wine. And he’s a darn fine actor, too. (Getty Images) Back to slideshow navigation
  13. Jessica Lange, 60

    In 1976 (left) and 2009

    Jessica Lange’s appearance seems to have changed drastically over the past couple years. This is most evident in her eyebrows, which are more arched than most runway shoes. I would bet that a combination of Botox and an overdone brow lift are to blame. Her eyelids are also excessively tight for a woman her age, a possible consequence of upper and lower eyelid lifts. Her cheekbones also appear higher than they were back in 1976, and may be the result of cheek implants. Overall, I think this Academy Award winner would still look like a winner if her brows were a bit lowered. () Back to slideshow navigation
  14. Joan Van Ark, 66

    In 1987 (left) and 2008

    Joan Van Ark unfortunately looks like a wax figure version of herself. Her skin is too tight, her lips look overly plumped, her eyebrows are too high, and her jawline is excessively sharp. I would attribute her unnatural appearance to multiple deep chemical peels, lip implants, a browlift, upper and lower eyelid lifts, a facelift, Botox and filler injections.

    Moderation and using a surgeon who’s a member of the American Society of Plastic Surgeons are the keys to looking good with plastic surgery. I doubt she’s followed these rules. At least her hair looks fabulous. (AP, Getty Images) Back to slideshow navigation
  15. Al Pacino, 69

    In 1992 (left) and 2008

    Does “Scarface” have any plastic surgery scars on his face? I would guess yes. Al Pacino appears to have undergone a conservative upper eyelid lift, as demonstrated by the lack of extra skin on his upper eyelids. Because he appears to have limited any work he’s had done, this Academy Award winner looks great. He’s aging gracefully, just like his performances in “The Godfather” movies. (Getty Images) Back to slideshow navigation
  16. Susan Sarandon, 63

    In 1995 (left) and 2008

    Although Susan Sarandon recently split up from her much younger beau, Tim Robbins, this 63-year-old has always looked as young as him. Like a handful of other serious actresses of her generation, she appears to have resisted the plastic surgeon’s knife and looks great due to a combination of good genes and great skin care. Her skin is smooth, but not overly smooth, and she has all the wrinkles of a woman her age, just not in excess. Even in her sixth decade of life, this timeless beauty looks good enough to play Thelma OR Louise. (Getty Images, AP) Back to slideshow navigation
  17. Johnny Depp, 46

    In 1990 (left) and 2009

    Johnny Depp is one of those guys that make looking good seem easy. He has stringy hair, doesn’t shave, wears funky glasses and he still looks better than 99 percent of men his age. Although there are rumors that Johnny Depp has had plastic surgery, I strongly doubt he has. He shows the wrinkles of a man his age. His great bone structure (high cheek bones and strong jawline) contribute to his youthful appearance. Johnny Depp may be a lot of things, but he is no plastic surgery junkie. (Getty Images) Back to slideshow navigation
  18. Julie Christie, 68

    In 1965 (left) and 2008

    Is Academy Award-winning actress Julie Christie really 68? You wouldn’t know it, given how great she looks. In my opinion, Christie, is one of the best examples of good plastic surgery in Hollywood. I believe she’s had her eyelids done, a facelift, and fat injections to her cheeks. These procedures can result in the sharp neckline, youthful eyes, and soft cheeks that she displays with such glamour. The fact that she is a classic Hollywood talent only adds to how fantastic she looks. Her plastic surgeon should get his own Academy Award. (Getty Images) Back to slideshow navigation
  19. Michael Douglas, 65

    In 1976 (left) and 2009

    Is Michael Douglas desperately trying to keep up with his younger wife, Catherine Zeta-Jones? Douglas appears to have undergone a facelift or two in addition to an upper eyelid lift. Several years ago photos circulated across the Internet of him with what appeared to be stitches from a possible facelift. So why does he still have loose skin under his jawline? Well, since guys have thicker, more sun-damaged skin than women, the tightness of a facelift does not last as long for them. That may explain why, even after having what I believe are two facelifts, Douglas still looks a bit aged. But what would you expect from a 65-year-old man trying to keep up with a gorgeous 40-year-old wife? (WireImage, Getty Images) Back to slideshow navigation
  20. Meg Ryan, 48

    In 1998 (left) and 2009

    America’s sweetheart has become almost unrecognizable in recent years. Meg Ryan’s lips look excessively puffy. I believe they’ve been enhanced with a permanent implant, such as Gortex. This substance can cause the lips to look big, stiff, and unnatural. They’re usually placed by threading it through the lips via small incisions. She also appears to have possibly had cheek implants, causing her to look a bit bulgy. The good thing is that both lip and cheek implants are completely reversible, taking only a 20-minute surgery. If she really wants big but natural-appearing lips, I would recommend that she remove whatever implant she may have, and replace it with fat. (Getty Images, AP) Back to slideshow navigation
  21. Meryl Streep, 60

    In 1980 (left) and 2009

    When you are as good of an actress as Meryl Streep, you don’t even need to consider having plastic surgery. Streep may not be the youngest-looking actress, but who cares? She’s one of the few aging Hollywood actresses who doesn’t seem to have any problem developing wrinkles, loose skin and even some early jowls. While I bet she’s getting some nice mild chemical peels, such as the AFA Clay Peel, I doubt that she’s doing anything more than these ‘lunchtime’-type treatments. Kudos to her. (Getty Images, AP) Back to slideshow navigation
  22. Nick Nolte, 68

    In 1994 (left) and 2008

    I don’t believe Nick Nolte has had any plastic surgery - he looks rugged, masculine - even grizzy - but completely natural. His eyelids are sagging, his forehead is creased, his face is gaunt and his skin is sun-damaged. While I wouldn’t say he’s aging gracefully, I would say he’s aging naturally. (WireImage, Getty Images) Back to slideshow navigation
  23. Nicole Kidman, 42

    In 1997 (left) and 2009

    Nicole Kidman’s face appears to be morphing by the month. Some days I think she’s had her lips plumped, other days I think she’s had her forehead Botox’ed. Overall, I believe she’s had both of these treatments, in addition to injections of filler such as Sculptra into her cheeks.

    In some people, aggressive Botox injections can create an overarched eyebrow, which I’ve called a Botox brow. While I don’t see it in this photo, I’ve seen it in others, including one on my blog www.celebritycosmeticsurgery.blogspot.com. In my opinion, less is more for Kidman. (Star Max, NBC via AP) Back to slideshow navigation
  24. Olivia Newton-John, 61

    In 1980 (left) and 2008

    It appears that ‘80s beauty Olivia Newton-John is “Hopelessly Devoted" to a cosmetic injectables. Her face looks unnaturally plumped up, possibly due to fat grafting or injections of Sculptra. Her lips appear to be enhanced as well, likely due to a filler such as Restylane or Juvederm. Her forehead is very smooth, excessively so for a woman who is 61 years old. (WireImage, Getty Images) Back to slideshow navigation
  25. Priscilla Presley, 64

    In 1968 (left) and 2009

    If Elvis could see Priscilla Presley now, he’d be “All Shook Up.” A couple years ago, she admitted to undergoing silicone injections from a phony doctor causing her to have a terrible result. Today she doesn’t look anything like the classic beauty she was just 15 years ago. Her skin is so smooth, it almost looks like it has a waxy sheen, a possible result of excessive laser treatments. Her lips and cheeks appear over-plumped, possibly with fat or another filler. Her forehead is excessively taut, maybe the result of too much Botox. (AP, Getty Images) Back to slideshow navigation
  26. Sharon Stone, 51

    In 1994 (left) and 2009

    Why is Sharon’s face as smooth as a Stone? While I don’t believe she’s had any actual plastic surgery, it is quite possible that her youthful appearance may be aided by medical grade skin care, such as La Roche Posay, with some chemical peels or laser treatments, like the Jessner’s Peel. She is aging very gracefully, with none of the obvious alterations of many of her Hollywood peers. In fact, she’s aging so well, maybe we’ll see a “Basic Instinct 3.” (WireImage, EPA) Back to slideshow navigation
  27. Sheryl Crow, 47

    In 1996 (left) and 2009

    All Sheryl Crow wants to do is have fun and avoid the plastic surgeon's knife. She looks great, especially for a 47-year-old breast cancer survivor. Her skin is clear and smooth, and she doesn't show any obvious signs of plastic surgery. She is aging very gracefully. I have one recommendation for Sheryl: Do not "Soak Up the Sun." Stay in the shade and wear sunblock to continue looking as good as you do. (WireImage, Getty Images) Back to slideshow navigation
  28. Sylvester Stallone, 63

    In 1986 (left) and 2009

    Sly Stallone looks like he’s gone a few rounds with a plastic surgeon. His eyebrows are excessively arched, causing him to resemble Cruella De Vil. This may be due to a brow lift. His eyelids are also tight, with nary a sign of loose skin. His jawline is also way too sharp for a man who is 63 years old. These features could be caused by an eyelid lift and a facelift, respectively. His cheeks also appear higher than they used to be, a possible consequence of silicone cheek implants.

    All this possible plastic surgery is making him look strange - and a bit like Satan. I believe this would be a good time for him to throw in the plastic surgery towel.

    Reader poll: Which celebrity do you think is aging best? (WireImage) Back to slideshow navigation
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