what are epigenetics?

Epigenetics refers to the way your behaviors and environment can cause changes that affect the way your genes work. As you age, epigenetics change naturally as part of normal development and aging and because of exposure to environmental factors over the course of your life.

Think of epigenetics as turning genes “on” or “off”.

  • What does this mean? One example would be do you make a certain protein? More of it? Less of it? Epigenetics tells your DNA what to do.
  • DNA methylation works by adding a chemical (known as a methyl group) to DNA and demethylation removes it. This is a focus of looking at how epigenetics affects people.
    • methylation generally turns genes off
    • demethylation turns genes on.
  • DNA methylation decreased with age. Scientists measured DNA methylation at millions of sites in three different age groups- a newborn, a 26-year-old, and 103-year-old, finding methylation decreases with age..

These are not genetic mutations. Epigenetic changes are reversible. They change HOW your body reads a DNA sequence, not the actual DNA.

What are common epigenome factors?

When you read these environmental and behavioral factors, you will think of course these matter! But what is interesting is the WHY. It turns out as we study more we can document how these environmental factors actually activate your DNA to act in a different way. Fresh air and low pollution? Your body will function better. Live in a high pollution area? Your DNA will not function as well, which can lead to increased inflammation, sickness, cancers, and more.

  • Pollution
  • Diet    Eating a nutrient-dense diet can provide essential vitamins (e.g., folate and Vitamin B12) that support proper DNA methylation and other epigenetic processes. balanced diet rich in antioxidants and anti-inflammatory compounds can lead to beneficial epigenetic modifications that support healing.
  • Exercise     Physical activity is shown to induce positive epigenetic changes that enhance healing by improving blood flow and nutrient delivery to tissues.
  • Stress
  • Sleep    Quality sleep is crucial for maintaining epigenetic homeostasis. Sleep deprivation can lead to detrimental epigenetic changes that impair cognitive function and healing capability.
  • Smoking    Smoking can result in epigenetic changes. One study showed smokers tend to have less DNA methylation than nonsmokers in the AHRR gene, with the difference correlating to how heavy a smoker they are. After quitting, DNA methylation at this gene increased again.
  • Infections    One study showed TB causes epigenetic changes to immune cells to turn off the IL-12B gene, which weakens the immune system to help the Tb survive.

why do i care as a plastic surgeon?

First, I see many women and men come in at a time where they are reassessing themselves. I think of it a time of life change or a water shed time- they are done with having kids, hit menopause, lost significant weight, or are just assessing how they want to be for the next chapter of their life, their version 2.0.

But are you healthy? Healthy bodies not only look better, but your body IS better. I think this is a great time to focus on your whole body. I do a deep dive with my patients to look at you as a whole- supplements and medications, protein, probiotics, blood glucose, hormones, vaping/smoking/THC, sleep, muscle and fat percentages, and weight. How can we optimize you? Most of my patients leave with a punchlist of things to do.

Yes, there are many things as a plastic surgeon I can recommend which are scientifically proven to help and quicker fixes, from topical medical grade bio-effective treatments like niacinamide and retinol, to supplements which are tested like NAD and creatine, to microneedling with Age Zero exosomes to build collagen, to surgeries. But I am not focused on a quick fix. I truly believe in whole body health- if you are better at a cellular level, your whole body will look and feel better.

Improving your epigenetics is going to help you optimize your surgery and help you heal. There was a study years ago showing how eating a high protein diet before a tummy tuck statistically significantly improved scars and lowered infection rates. DIET made that change. I am a believer in epigenetics and have been advocating for these optimizations with my surgical patients for years.