Ditch: Overcomplicated Skincare Routines
If your bathroom counter looks like a chemistry lab, Dr. Karam says that’s part of the problem. “Most people end up dropping a few of the things, something runs out, they forget to reorder it,” he explains. “It’s hard to manage eight- or 10-step routines.” Instead of chasing every new product launch, he emphasizes the importance of what he calls the three C’s: “Commitment, consistency, and continuity.” A simple routine you actually stick with will outperform a complex one you abandon every time.
Start: Focusing on Skin and Shape
One of the biggest misconceptions in anti-aging? That skincare alone can fix everything.
“In our practice, I call this the two-pronged approach: skin and shape,” Dr. Karam says. “Skin is addressed with skincare and sun protection. Shape is addressed surgically when you see laxity and sagging.”
He adds, “When you put these things together, you have magic. You have true time-machine-type facial rejuvenation.”
Ditch: Thread Lifts, Liquid Facelifts, and Energy Devices
Once hailed as non-surgical miracles, thread lifts and liquid facelifts are at the top of Dr. Karam’s “don’t bother” list.
“Thread lifts were supposed to be a non-invasive replacement for facelifts,” he explains. “But the results generally last about three to six months, and there’s risk of infection, contour irregularities, and nerve damage. It ended up being a complete waste of time, money, and risk.”
As for liquid facelifts? “You can’t volumetrically lift the face without leaving it looking distorted,” he says. “You end up looking heavier and more rectangular instead of that youthful heart shape.”
Energy devices aren’t spared either. “I see patients all the time who’ve lost so much facial and neck fat that is irreplaceable,” he warns.
Start: Using Proven Actives Consistently
Rather than chasing gimmicks, Dr. Karam says anti-aging success lies in time-tested ingredients.
“Retinol is absolutely my favorite skincare ingredient by far,” he says. “There have been thousands of clinical studies showing it boosts collagen, speeds up cell turnover, fades pigmentation, and smooths texture.”
He also highlights vitamin C, niacinamide, peptides, and hyaluronic acid—each playing a specific role in skin health. “Think of skin as needing four pillars: regeneration, protection, barrier support, and brightening,” he explains.
Ditch: Ignoring Sun Protection
If there’s one non-negotiable rule, this is it. “We know that 70 to 90 percent of skin aging is caused by sun exposure,” Dr. Karam says. “Sun is the greatest accelerator of skin aging.”
He emphasizes sunscreen, hats, and antioxidant protection as lifelong habits—not optional add-ons.
Start: Addressing Sagging the Right Way
When laxity appears—typically in the 50s—Dr. Karam says it’s time to stop pretending creams and injections can do surgical work. “You do skincare your whole life. You do some Botox to prevent fine lines. And then when the time comes, you pull the trigger and have a lift,” he explains.
“You don’t need lots of fillers. You don’t need threads. It’s that simple.”
The goal, he says, is always natural rejuvenation: “People want to retain their identity but look refreshed—like they did in their 30s or early 40s.”
Ditch: Skimping on Sleep, Exercise, and Lifestyle Habits
Anti-aging doesn’t stop at skincare. “Lack of sleep directly affects the fibroblasts that create collagen,” Dr. Karam says. Alcohol, smoking, and vaping also accelerate aging dramatically.
“Resistance training sends powerful anti-aging signals to the entire body,” he adds, noting that maintaining lean muscle mass becomes increasingly important with age.
Start: Playing the Long Game
Perhaps Dr. Karam’s most reassuring message is that it’s never too late.
“It’s literally never too late. We’ve had people start skin rejuvenation programs in their 70s and 80s and still see dramatic changes,” he says.
His final takeaway for 2026? “Anti-aging doesn’t have to be complicated. Protect your skin from the sun. Use the right active ingredients consistently. And when sagging starts to happen, address it properly—not with gimmicks.”
As Dr. Karam puts it: “That’s the formula that works.”