Timeless Beauty

For more than 25 years, Dr. Anna Petropoulos, a double-board-certified, Harvard-trained facial plastic surgeon, has helped patients navigate the changing landscape of overall facial aging through her business Center for Classic Beauty in Back Bay. Known by many of her patients as an “Ageless Coach,” she approaches aesthetics as a long-term conversation about maintaining balance, confidence, and restoration of natural beauty. MyBoston writer Rebecca Rhein sat down with her to discuss how the face changes, what patients often overlook, and how to make informed decisions at any age.

How do our aesthetic needs change as we age, and what does aging well look like through the decades?

The basic goal is the same at every age: maintain what you have and prevent aging changes, like skin laxity. The foundation is understanding how the face changes and to restore its natural balance and contour. However, no patient is like another. Two patients of the same age may need completely different treatments.

In the 20s, the focus is often on prevention, healthy skin, and understanding the facial movement and structure. That’s when I begin to introduce the idea of what’s often referred to as “Baby Botox” to prevent dynamic wrinkles, lines caused by repetitive facial movement. In the 30s and 40s, we begin to see changes in facial contours, skin texture, and elasticity. As we move into our 50s, 60s, and beyond, changes in volume, tissue position, and laxity become more significant. Skin-tightening treatments or other procedures help restore a more balanced, youthful appearance. Some patients who have progressed too far on the timeline of aging may need to utilize surgical options if non-surgical treatments are not sufficient. Thus, the provider must be well-versed and experienced in both surgical and non-surgical options to advise a patient.

What areas of the face tend to contribute to an older appearance in ways people may not expect?

Most patients forget the relationship between the eyes, cheeks, and midface. As we age, facial proportions change, and the goal is to restore them. Sometimes what makes someone look older isn’t a single wrinkle or an area of loose skin, but a change in the overall relationship between these key facial structures.

With so many treatments available, how do you prioritize what a patient needs, and how important is trust in that process?

I start by examining the whole face, not immediately suggesting treatment. We discuss together what is making them look older. What would create the greatest improvement?

Trust comes from education and experience, but also from having an honest conversation. I want them to understand what I see and why I make a particular recommendation. And sometimes the most appropriate recommendation is to do less. A good result shouldn’t announce that you’ve had something done. My goal isn’t to create a different face. It’s to preserve or restore the best version of their face.

How important are skincare, sun protection, nutrition, and lifestyle when it comes to aging well?

They are fundamental. The skin needs proper nutrition and building blocks to maintain healthy structural proteins and elasticity. Sun destroys collagen and creates wrinkles. Scientific skincare, nutrition, exercise, and overall wellness all contribute to how well we age. Hence, at our center, we offer multiple avenues of internal health, wellness, and weight management as part of our offerings to enhance our patients’ lives, especially as they enter menopause.

At what point does someone move from nonsurgical treatments to considering surgery?

It depends on the patient’s goals and their degree of aging. When there is more significant skin laxity, tissue descent, or changes in facial contours, surgery provides a level of restoration that nonsurgical treatments cannot achieve. My job is to be honest with my patients when continuing to layer minimally invasive treatments may not be the best investment. In those cases, surgery can address the actual source of the concern and often provide a more significant, natural, and longer-lasting result.

And what role does maintenance play after surgery?

Aging doesn’t stop after surgery. A surgical procedure can create a significant improvement, but maintaining healthy skin and preventing ongoing laxity helps preserve that result.

Patients describe you as an “Ageless Coach.” What does that mean to you?

The best reward is the relationships I build with patients over the years and even decades. I’ve watched their children grow up while my own family has, as well. In a sense, we’ve grown through life together. I see patients through all stages of life, and ageing is a part of that, but only on paper! We’re all ageing together, but that doesn’t mean we’re any less beautiful.