Aging, wrinkles, and fear: clinical and humanistic approaches in anti-aging plastic surgery

Purpose: Aging is accompanied by visible changes such as wrinkles, sagging, and volume loss. Wrinkles serve not only as biological markers of aging but also carry psychological and social implications, often associated with reduced self-esteem and the fear of aging, or gerontophobia. This article aims to provide an updated overview of wrinkle management while integrating clinical, psychosocial, and humanistic perspectives.Current Concepts: Treatment strategies for wrinkles include topical agents such as retinoids and peptides, injectable therapies including botulinum toxin and dermal fillers, energy-based devices such as radiofrequency, fractional lasers, and high-intensity focused ultrasound, and surgical options including facelift procedures and blepharoplasty. Each modality has unique mechanisms, indications, advantages, and limitations. In older adults, physiological changes in the skin, comorbidities, and polypharmacy require careful patient selection, conservative treatment approaches, and tailored aftercare. Advances in minimally invasive techniques have expanded treatment options, yet patient education and expectation management remain essential.Discussion and Conclusion: Wrinkle treatment in older adults extends beyond cosmetic enhancement. It intersects with psychological well-being, identity, and dignity. Gerontophobia, driven by cultural stereotypes and media representations of aging, heightens patients’ anxiety about appearance. Clinicians are challenged to balance aesthetic goals with empathy, helping patients discern between achievable rejuvenation and unrealistic expectations. Optimal management of wrinkles requires the integration of clinical expertise with a humanistic, patient-centered approach. Surgeons must serve not only as technical experts but empathetic partners who support patients’ self-esteem and quality of life. In an aging society, such a holistic approach underscores the social responsibility of aesthetic surgery.