How to Tell if Your Breast Implants are Contracted

My breasts are starting to look weird, what is going on?

Capsular Contracture

A frequent consult seen in our office is patients with breast implants who are concerned because they seem to be changing.  By the time patients come to us, they have strange appearing breasts that are firm and painful.  These patients are suffering from capsular contracture.  This process develops when the scar tissue sac surrounding the implant becomes thick and inflamed.  Anytime a foreign body is placed into a patient (heart valve, hip implant, ankle screw, etc), the body will wall off this device with a scar tissue sac. This is what we call the capsule.  A normal capsule is soft and pliable, surrounding the implant but not putting pressure on it.


Capsular contracture repair. The Before is on the left. She had implant removal and fat grafting.

If the capsule becomes inflamed and thick, it can distort the appearance of the implant. The longer the process is allowed to continue, the more likely that the scar tissue will start to cause pain and may even limit movement of the arm on the affected side.

Most capsular contractures are the result of one of two things.  First, a ruptured silicone implant can cause inflammation. The silicone inside the breast implant is irritating to the scar tissue, and frequently leads to thickening.  The older versions of silicone implants (think 70’s, 80’s, and 90’s) had a thinner outer shell more prone to breaking.  They also had a thinner internal silicone that can be problematic with rupture.  For this reason, if a rupture is diagnosed with a silicone implant, the implant should be replaced.  The second reason for contracture is something called a biofilm.  A biofilm is a low grade, subclinical infection, think plaque on your teeth as an example.  This infection does not cause a rip roaring infection landing you in the emergency room, but causes chronic inflammation (like the inflammation plaque causes on your gums called gingivitis).   These bacteria are typically normal skin flora that unfortunately become introduced at the time of surgery.

In the past this process was very difficult to treat and women frequently had recurrent issues with abnormal scar tissue.  Many women wish to keep their implants and the process results in multiple surgeries and frustration.  In our practice we have developed a treatment that has a very low recurrence rate.  The key to such low recurrence rates is treating every possible cause at the time of surgery.  First, he entire capsule needs to be removed.  Not a single piece can be left behind or recurrence is almost certain.  Although some surgeons will leave the “back wall” or portions behind, we have found this as a common cause of recurrence.  Cultures are sent at the time of surgery to test for biofilm, and patients are treated with antibiotics for at least two weeks.  The last vital piece is use of acellular dermal matrix.   This is a prosthetic which is a component human skin, the dermis or strength layer.  Use of this has been shown to reduce rates of recurrence as well.

Some women just want their implants out, and this is a reasonable option as well.  We have many options for implant removal that will leave you with breasts you are proud of.  Stay tuned for future blog posts about the amazing options for patients opting for implant removal instead of replacement.


Kelly Killeen MD, FACS

Plastic and Reconstructive Surgeon


What is the Difference Between a Lower Facelift and a Full Facelift?

Hold still

People often ask about the difference between a full facelift and a lower facelift (or mini-lift). When assessing the face, surgeons usually think of this area as being divided into 3 general parts: the upper face, the mid-face and the lower face. The upper face consists primarily of the forehead and the brow complex (which can include the upper eyelids). The mid-face usually incorporates the lower eyelid area, the cheek region and the skin fold area extending down from the nostrils  (known as the nasolabial fold. The lower face includes primarily the jawline and the area adjacent to the chin (this is an area where jowls commonly form).

In a lower facelift, the lower third of the face is lifted and rejuvenated. This is a great surgical procedure for patients who feel that they have started developing jowls or have lost some definition along the jawline. This is generally the procedure that patients are seeking when they stand in front of the mirror and pull up on the sides of their face from in front of their ears. This surgery does not generally improve the nasolabial fold or the cheek position, however.

A full facelift, on the other hand, generally incorporates a forehead lift (or brow lift), upper eyelid lift (blepharoplasty), and lower blepharoplasty, in addition to the lower facelift. Some surgeons address the mid-face with a mid-face lift, while others address it with fat transfer to the face (using fat from the abdomen, thighs or love handles). Other surgeons and patients prefer to use filler (instead of fat) to address the mid-face.

While most patients who require work on the upper, mid and lower face tend to undergo a full facelift in order to address all their concerns at once, there are some patients who prefer to break it up into 2 surgeries. One surgery would address the upper face and a second surgery to address the lower face. One reason to undergo a full facelift rather than breaking it up would to have one recovery period, as opposed to 2 sets of surgeries from which to recover. The recovery time for a full facelift is generally approximately 3 weeks, with some patients requiring up to 6-8 weeks to recover. Most patients are presentable and return to work at 3 weeks. The recovery time for a lower phase, in generally is approximately 2 weeks, with some taking up to 4-6 weeks to fully recover. Most patients are presentable and return to work at 2-3 weeks.

Dr. Sarmela Sunder
Double Board-Certified
Facial Plastic Surgeon

Breast Implant Illness (BII) – a Rare but Real Problem

After getting breast implants, some women experience symptoms including fatigue, hypothyroidism, gastrointestinal problems, autoimmune symptoms, joint pain, and more. Only some of these women have capsular contracture and are visibly  “reacting” to their implants, and we see many of these women who decide to have their implants removed.

As a group, we are dedicated to working with these patients to uncover the underlying cause of the BII. Over 50% of these patients carry biofilms, and specimens taken from these patients at the time of surgery are positive for different varieties of bacteria. Keep in mind this is not an infection, but bacteria that is living on the implant surface.
Despite that the bacteria are not causing an abscess, fever, or pus, they can cause inflammation and burden the immune system, especially on patients prone to inflammation and oxidative stress. To diagnose the biofilm, cultures are obtained during surgery with sterile technique from a direct capsule specimen and did not touch the skin surface. Note there is a lot of P. Acnes, which is usually known for its involvement in facial acne. Notorious for causing inflammation, we are not surprised to find it in some of our most symptomatic patients.

Surgical removal of the implant for BII (breast implant illness) involves removal of the entire capsule (capsulectomy). There has been debate about whether this is necessary or not, but those of us that are veterans in the field have found positive cultures in capsule remnants where implants have been removed with a prior surgery. Therefore it important to remove the whole capsule.
We also find silicone and silicone granulomas in capsules frequently, even in patients who do not have ruptured implants. Typically the incision is made under the breast (in the inferior mammary crease), although the areola can be used as well. Removal can be “en bloc”, which involves a larger incision, or whole component, which means the implant is removed, then the capsule is removed. Most patients prefer the smaller scar of the component removal, which can be performed without spillage of implant or capsule contents.

With implants placed under the pectoral muscle, the pectoral muscle must ALWAYS be repaired. Leaving the pectoral muscle with the cut from the original augmentation can result in pec flex deformity, which can be deforming. Reconnecting the pectoral muscle with the rib surface both repairs and strengthens the muscle to its original position. For women who want to maintain fullness in the breast we often combine fat grafting with implant removal or an internal lift to maintain fullness and create and restore a beautiful, natural breast shape.

Many of our patients with BII find that their symptoms improve after removal of their implants.

Cassileth, LisaLisa Cassileth, MD, FACS
Founder, Cassileth Plastic and Reconstructive Surgery
Founder, Bedford Breast Center
Clinical Assistant Professor, UCLA
Chief, Cedars Sinai Medical Center, Division of Plastic Surgery, 2013-2018
Medical Director, 436 Beverly Hills Surgery Center

Breast Augmentation: When You Should – Or Shouldn’t – Have Breast Surgery

Whether or not to have a breast augmentation is a highly personal decision, and the reasons women elect to have this procedure performed are as different and unique as the women themselves. However, no invasive surgical procedure is as simple as getting a haircut or a manicure, and while an excellent, board-certified plastic surgeon will help you achieve a beautiful, successful result, breast augmentation is a choice to be considered very carefully. Here are some of the most common reasons why you might think about having breast augmentation surgery.

“I think larger breasts would be a better fit for my body.”

Many women feel that breast augmentation will help create a more symmetrical body shape, particularly if they have full hips. Many women’s fashions are designed for a breast size between a B and C cup, so clothing may fit more flatteringly and comfortably.

“I recently had a baby, and want my breasts back the way they were!”

It is very common for the body to change significantly post pregnancy, due both to changes in body weight and the effects of breastfeeding. Many women experience dramatic sagging and reduction of dermal elasticity, and wish to surgically restore the firmness of their breasts. A breast augmentation can help return the breasts to their previous, more youthful state.

“I lost a lot of weight, and my breasts look worse than they did before.”

Losing weight suddenly, either naturally or with the assistance of bariatric surgery, may result in sagging skin, causing the breasts to droop. A breast augmentation, or breast lift in conjunction with reduction, may help give the breasts a firmer appearance.

“One breast is larger than the other.”

Most women’s individual breasts differ slightly from one another, with minor variations in either shape or size. However, some women have one breast that may be as much as a cup size larger than the other, making finding clothing and undergarments difficult, and even causing physical discomfort. Breast augmentation can even out asymmetrical breasts, creating a uniform look.

“I’ve had/will have a mastectomy, and I’d like breast reconstruction surgery.”

If you’ve had a partial or double mastectomy, you have no doubt considered breast reconstruction surgery so that your breasts are restored to as much of their pre-surgery condition as possible. If you’ve been diagnosed with breast cancer and advised that a mastectomy is the best treatment option, you may want to consult with a plastic surgeon who specializes in breast reconstruction. Dr. Lisa Cassileth has pioneered and perfected the Cassileth One-Stage Breast Reconstruction, which is a total breast reconstruction performed alongside a mastectomy, allowing the patient to emerge from a single surgery with breasts restored to a natural-looking, healthy state.

Making the best decision for you

While the above circumstances are typical for women considering breast enhancement or breast reconstruction, there are also numerous other reasons. However, many of those reasons may not be particularly healthy, or conducive to a successful outcome. These reasons include:

  • Pleasing a spouse or partner who is pressuring you.

  • You found a surgeon who will perform the breast augmentation cheaply.

  • Your employer or potential employer wants you to.

It is extremely important that you consider your options very carefully, and discuss your personal reasons for getting a breast augmentation with your physician. A board certified plastic surgeon who specializes in breast reconstruction and augmentation will provide you with the guidance you need to ensure a successful result.

Cassileth Plastic Surgery and Skin Care is proud to offer a medical team of breast specialists with a reputation for delivering exceptional patient care and exquisite results. To learn more about your breast reconstruction options and schedule a consultation, visit the Cassileth Plastic Surgery breast reconstruction page and begin your journey to a new you!

Breast Implant Revision – Is Capsule Removal Necessary?

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Most plastic surgeons say, “never”. A small group says, “always”. Why is this and what is the real answer? The truth is that there are situations where the capsules need to be removed. There are three good ones:

1. The presence of a biofilm. This is a low grade bacteria that can cause capsular contracture. Capsular contracture is the presence of a higher, firmer, and often painful, implant. If your implants fell and look abnormal, you may have a biofilm. The biofilm usually entered with an implant on a previous surgery, but wasn’t a strong enough bacteria to cause a true infection. The biofilm does cause chronic inflammation however, which leads to the contracture. You are at higher risk if you have had multiple prior surgeries or an areolar incision.

2. Free silicone. Especially if you have had silicone implants for a while, I often find old silicone in the capsule from an old leaky implant, sometimes form a previous pair. Best to remove it and just “keep it clean”, especially if you are worried about sickness from old leaking implants, it takes out the doubt that something there may still be affecting you.

3. BIA-ALCL. This is a rare cancer, called Breast Implant Associated Anaplastic Large Cell Lymphoma. It presents with fluid (seroma) around the implant and is cured by capsulectomy. Older implants with texture place you at higher risk, and any patient with an unexplained seroma around the implant should be tested.

These three situations are fairly rare, and if your implants are “normal” you may not choose to remove the capsule. From a surgical point of view, once I see the capsule that gives me additional information. Sometimes the capsule is fine, see through, and would be difficult to remove as it so gossamer thin (link to normal capsule video). At other times I am shocked by how thickened and calcified it is. In these cases, when the patient is healthy and we don’t know ahead of time if there will be a problem, I remove the capsule based on the appearance. A complete capsulectomy, if the capsule is abnormal, is certainly worth the increased recovery time; this will involve a drain for a few times and will be slightly more sore.

The disadvantage of removing the capsule is that it does make the surgery more extensive, and if you are fat grafting to replace some of the lost volume, then it limits how much fat can be grafted. So, I do argue against the attitude of removing it no matter what; you should never electively do any surgery without a good reason. Finally, don’t forget to ask your surgeon to repair the pectoral muscle if your implants are sub-pectoral. Either way, go to a surgeon that doesn’t have a “never” or an “always” attitude; the right answer is in between.

Lisa Cassileth MD, FACS


Should I Replace My Breast Implants?

measuring-womans-bustWhen you first decided on getting a breast augmentation, it likely did not occur to you that you may want, or even need, to have your implants removed later on. However, every year there are thousands of women who undergo breast implant removal surgery for a wide variety of reasons. Some women have physical or medical complications, some have a change of heart or their idea of the “perfect figure” changed.

Our patient chose to have her breast implants removed on the 20th anniversary of her breast enhancement procedure. Here is her story and what she experienced leading up to her decision.

Our patient’s story

As a teenager, I looked forward to having full, big breasts like my older sister. Despite lots of hope and wishful thinking, my breasts were a small B. Years later, in my 20’s, I felt insecure with my small breasts. After much debate and careful thought, I decided to get breast implants when I turned 25. Having a breast augmentation made me more confident and outgoing. For the first time in my life, I found joy and empowerment in wearing bikinis, tank tops and tight dresses.

Over the past few years, I began thinking about having my breast implants removed. My breasts began to cause back pain, and they made it nearly impossible to exercise without discomfort. I also watched as the body confidence movement took off, celebrating women of all shapes and sizes. As I thought more about my breasts, I realized that my augmented look simply didn’t feel like me anymore.

So, on the 20th anniversary of my breast implant surgery, I got my implants removed – and I couldn’t be happier. While I don’t regret my decision to get implants, I happy and proud of my decision to remove them; I’m thrilled to have returned to my natural breast size and shape. In making my decision, I wanted to work with an excellent Beverly Hills plastic surgeon and am so happy I found Cassileth Plastic Surgery. They made my breast implant removal surgery an experience that restored my happiness in my physical appearance and my comfort.

Ideas of Beauty Can Change

Over time, through fashion or personal preference, a women’s ideals evolve and often change, including what is considered the perfect breast size. Many patients come to Cassileth Plastic Surgery to have their breast implant revision surgery to have their breasts replaced or removed after having had implants for years. This procedure can be combined several other procedures, including fat transfer to breast — where fat is liposuctioned from one part of the body (usually the tummy or “love handles”) and transferred to the breasts, to fill out the area, in a natural way.

We support each and every one of our patients and their view of beauty. There is no perfect breast, just the perfect breast for you. We want everyone that comes to our office to have the body and breasts they desire and will work with you to achieve the results you want.

Exercise or cosmetic surgery to get your flat belly back?

tummy tuck in beverly hillsMaybe you had kids. Maybe you got old. Either way, there is something you are really not happy about in your tummy zone. When we see patients for abdominal laxity, or fat, or skin, we have a huge arsenal of new (and old) techniques that can help. Each patient may benefit from a different combination of treatments, some don’t even require surgery!

Level 1: The muscle zone.
Pregnancy stretches your abdominal wall out, leaving may patients with a rectus diastasis. How can you tell if you have one? Lie on your back, and so a small sit up, coming up only inches off the floor. Now feel your muscles. Are they together in the midline, or is there a gap? Did the abdominal wall get flat when you do a sit up, which is good, or did it actually stick up and out more? Does your belly look flat in the morning, but you just can’t “suck it in” by the end of the day or after a big meal? If so, you have a rectus diastasis. With exercise that focus on external obliques and core strength, you can close that gap by 3 to 5cm. We offer a combined exercise and binder regimen,m called the Tuppler technique, with great results for the diastasis only patient. For patients with a greater gap, we offer a surgical rectus diastasis repair. This can be done through a C-section only type small incision, or can be combined with a tummy tuck if you have a lot of excess skin.

Level 2: The fat.
A little fat that you can’t lose on your own is perfect for Coolsculpting, a noninvasive technique that removes unwanted fat with no downtime. For patient with more than a handful of extra fat, we offer liposuction as well as laser-assisted liposuction, which can be done for up to 5 liters of fat removal. We have a lot of patient with excess fat and skin, which is perfect for a combination procedure of liposuction and skin removal. These results can be very dramatic, as they aim to completely transform your waistline and remove any and all overhanging skin.

Level3: The skin.
Skin can be mildly excessive after kids, and we recently purchased the Thermi Laser a radio frequency laser that tightens excess skin without invasive surgery. If you have an actual overhang, it may require a mini-abdominoplasty (just skin on the lower abdomen only) or a full abdominoplasty (excess skin is on the lower and the upper abdomen)

For more information about these procedures or other treatments available at Cassileth Plastic Surgery call 310.819.9340 and schedule an appointment today with the best plastic surgeon Beverly Hills has to offer!

New Mom’s: Is Exercising Not Working for You?

happy-mom-and-babyWhile there is nothing that changes your life in such a positive way as having a baby, for some new mothers, getting their body back to their pre-pregnancy look, or any desired look, can be a difficult hurdle to overcome.

Extreme dieting isn’t really a viable option for a new mom and having the time to spend hours at the gym is unlikely. Even if a new mom can find the time to do so, it’s no guarantee of results.

Pregnancy and childbirth often create tremendous stresses on a woman’s body that diet, exercise and time are not going to undo. But it is possible to get that body back with a Mommy Makeover.

“Your life really changes after you have kids. You devote your time and energy to taking care of your children, following up on their care and making sure they’re well-fed, clothed, and safe. We really let our physical appearance become something on the back burner. A mommy makeover is such a nice thing to give moms.” – Dr. Kelly Killeen

A Mommy Makeover is a combination of procedures that offer patients different choices and may include the following procedures:

Tummy Tuck (abdominoplasty)
Mastopexy (lift)
Facial Rejuvenation
Liposuction (fat removal)

Moms may choose between surgical and non-surgical options for their makeover experience. Hormonal changes, after a pregnancy, can affect the skin as well as the body.

Dr. Cassileth and Dr. Killeen recommend patients wait at least 6 months after pregnancy, as well as after the child is weened, before a mommy makeover procedure is considered. After 6 months, most women achieve a more stable body weight. (Post-pregnancy weight fluctuations may otherwise obscure the surgical experience).

“Thank you for giving back to me a very positive body image. People always told me it was an achievement to have lost over 110 lbs, but even after the weight loss, I could not stand to see my stomach… Today I have become a stomach exhibitionist, strutting my flat abdominals for all to see. There have been sightings of my bellybutton all over town. Imagine that!!”

To find out more about how a Mommy Makeover would work for you, come see us for a consultation by clicking here or by calling us at 310.819.9340.

Big Talk About Breast Reconstruction

Recently the Cosmetic Surgery Times wrote a wonderful and insightful article about the successful Reddit AUA (ask us anything) hosted by our own Lisa B. Cassileth, M.D., FACS, and Kelly Killeen, M.D.

In this interview following their lively and popular Reddit Q&A (over 2,100 comments), Dr. Cassileth and Dr. Killeen discuss why women should “expect more” with mastectomies and breast reconstruction, including sparing their nipples and avoiding devastating scarring.

Check out the entire article:
Cosmetic Surgery Times Logo

Big Talk About Breast Reconstruction

by Randy Dotinga, Cosmetic Surgery Times

A pair of Beverly Hills plastic surgeons has a simple message for women with breast cancer who seek mastectomies and reconstruction: Expect more.

Beverly Hills Plastic Surgeon Dr. Lisa CassilethLisa B. Cassileth, M.D., FACS, and her partner Kelly Killeen, M.D., tell their breast reconstruction patients that it’s often possible to spare their nipples and avoid devastating scarring. It’s all thanks, they say, to their partnerships with top breast surgeons and a strong focus on aesthetics.

“Women often feel they can’t be naked after a mastectomy, that they feel asexual: ‘I’ve had this happen to me and I’ll move on, but I’ll never be able to be naked again or have anyone see me naked again,’” says Dr. Cassileth, the clinical chief of the Division of Plastic Surgery at Cedars-Sinai Medical Center and an assistant clinical professor at UCLA.

The reality, she believes, is the exact opposite. In fact, women can often even get the breasts they always wanted.

Beverly Hills Plastic Surgeon Dr. Kelly KilleenDr. Cassileth puts it this way when she talks to breast cancer patients: “Sorry to be so superficial, but my job is to make you hot.”

In July, the two surgeons became a hit on the Internet bulletin board Reddit when they took part in an AUA — Ask Us Anything — titled “We are two female Beverly Hills plastic surgeons, sick of seeing crappy breast reconstruction — huge scars, no nipples, ugly results. There are better options!” Their discussion drew more than 2,100 comments.

Cosmetic Surgery Times reached out to the surgeons and asked them to describe their approach to mastectomy and breast reconstruction.

Q: What does the public misunderstand about breast reconstruction after breast cancer?

Dr. Cassileth: The reality is that women have no idea about it. Maybe their mothers or someone they know had a mastectomy, but it’s a taboo subject. You may never be told that you have this big cut across your chest. Then they look online, and the pictures can be really horrific. These women come into my office, and they’re shell-shocked. They just want to get this done.

Q: How have surgeons typically looked at the nipple in mastectomies and reconstructions?

Dr. Killeen: Traditionally, cancer surgeons considered the nipple to be part of the breast tissue, and it was removed. In fact, the nipple can be safely left behind in most patients. This leads to superior cosmetic outcomes, and women feel psychologically better keeping their nipple. Unfortunately, a lot of the country has been slow to adopt this as the standard of care.

Q: Why do you think nipple-sparing surgeries are so uncommon?

Dr. Cassileth: The majority of surgeons I’ve worked with don’t know how to do that. That’s why I’ve reversed the flow so we only work with breast surgeons who are fabulous.

Q: So you choose the breast surgeon instead of a breast surgeon choosing you?

Dr. Cassileth: I’m driving the consult back to the general surgeon, not the other way around. I’m first, and they’re second.

Q: What does your approach mean for the risk of mastectomy flap necrosis, a common complication of breast reconstruction?

Dr. Cassileth: The published complication rate is 15%. I’ve seen an average of 30% among surgeons, and one surgeon reached 55%. They want to do a good job, but they’re not fully aware, it doesn’t hit them like it hits us. All we care about is the aesthetic. When we choose the general surgeon, we keep statistics on every single one of our patients. We’re under 1%. I had one surgeon get up to 2%, and I said this will never happen again.

Q: You perform breast reconstruction at the same time as the mastectomy instead of separating the procedures. What does that accomplish?

Dr. Killeen: Traditionally, a lot of surgeons don’t pay as much attention to creating a perfect pocket. They don’t think they have to get it right the first time, since can be fixed when the patient comes back to get an implant later.

When you get the implant in on the first go, you have to treat that reconstruction with respect. You aren’t coming back another time.

Q: In the Reddit Q&A, you mention something surprising about how many men deal with the breast reconstruction of their loved ones. Can you tell that story?

Dr. Cassileth: When you give a man an implant to hold, they close their eyes and massage it: What does that feel like? I like it when they do that. They’re really committing. They’re fully committed that this will be their wife’s boob.

Q: How can men support the women in their lives when they undergo these procedures?

Dr. Cassileth: The woman’s facing this idea that they’ll somehow be maimed or damaged. They’re inhibited by the idea that their husbands are judging them. If the husband weighs in too heavily, even if he’s trying to be helpful, women will often take that as a criticism of themselves. They’ll feel more nervous and insecure about their reconstruction. Men who say “I love you, I don’t care about what you look like” — even if they’re lying — help women to feel unconditional love.

Skin Cancer Awareness Month: Ways to lower your risk of skin cancer

ways to lower risks of skin cancerSkin cancer is by far the most common cancer in the United States, and it can be deadly. Fortunately there are things you can do to reduce your risk of getting skin cancer. Limiting sun exposure is the best way to protect yourself, here are other top tips to help lower your risk.

Avoid Tanning Beds

If you are a tanning bed devotee, the best way to lower your skin cancer risk is to avoid them! Tanning beds direct UV light to the skin, which causes the skin to produce melanin (brown pigment) and causes damage that may lead to skin cancer. In fact, a law making its way through the Kansas legislature would ban minors from using tanning beds because of their harmful effects on skin. Dr. Kelly Killeen, a Beverly Hills plastic surgeon and an advocate for anti-skin cancer issues, spoke to the legislature on behalf of the bill. As a medical professional and a survivor of melanoma herself, Dr. Killeen has seen firsthand how tanning can harm skin health and elevate cancer risk.

Use Sunscreen

Apply sunscreen with an SPF of 30 or higher on your face and neck every day, even when it is cloudy. As an added bonus, you’ll keep your skin looking younger than those who do not use sunscreen. Over 90 percent of visible signs of skin aging is caused by the sun’s ultraviolet rays. If you anticipate being outside for more than 15 to 20 minutes, apply sunscreen to your whole body. A good rule of thumb is to use a shot glass-sized amount of sunscreen to cover your skin. Reapply every two hours, or after swimming or sweating.

Use Alternative Skin Tanning Products

If you crave that sun-kissed glow, consider using tanning lotion or a spray tan instead of heading out into the hot sun. Unlike the orange streaky looks of the past, today’s tanning alternatives look natural.

Wear a Hat

If you do venture out into the sun, always wear a hat (particularly if you are balding). A hat protects the crown of your head, which can receive considerable amounts of sun exposure.