Identical twins are usually impossible to tell apart but a study has discovered just how much smoking can change your appearance – with tell-tale signs
The twin who smoked (pictured) showed tell-tale signs(Image: American Society of Plastic Surgeons / Dr. Bahman Guyuron)
If you’ve ever needed a reason to stop smoking, this might be it. A pair of identical twins who were once impossible to differentiate now look world’s apart, and it’s all thanks to one puffing on the cigs.
Usually indistinguishable, identical twins are nature’s control group – providing the perfect opportunity to witness the visual effects of harmful substances in real time. The impact of smoking, in this case, is a scary reality for these twins, who have more than five years’ difference in “smoking duration”. And the physical changes are drastic.
Smoking tobacco can speed up the ageing process by creating dull skin; yellow teeth; gum damage and dry and irritated eyes. Sagging skin is also a tell-tale sign, making the smoker of the two easy to spot hyere.
Researchers like the American Society of Plastic Surgeons have carried out multiple studies with twins to track the natural ageing process compared to a smoker. They found a “marked disparity in the degree of facial ageing” in those that smoked compared to their non-smoking counterpart.
Published by the New York Times, the pair proved the tell-tale aftermath of just a few cigarettes per day. Signs of ageing could be seen in the smoker, especially around the eyes and in the skin.
The different is stark(Image: American Society of Plastic Surgeons / Dr. Bahman Guyuron)
Other twins with varying smoking habits were studied, and a strong correlation between tobacco and increased ageing was found. The complete list of facial side effects were:
Lower lid bags (puffiness under the eyes)Malar bags (swollen sacks under the eyelids, stretching onto the cheekbones)A worsening of upper eyelid skin redundancyNasolabial folds (creases in the skin between the nose, stretching to the corners of the mouth)JowlsUpper lip wrinklesLower lip vermillion wrinkles (fine lines or wrinkles that are appear on the red part of the lower lip)
Dr. Bahman Guyuron, leader of the research study, said: “This study confirms some of what was believed in the most scientific way possible. Among twins with greater than five years’ difference in smoking duration, twins who had smoked longer had worse scores for lower lid bags, malar bags, and lower lip vermillion wrinkles.”
The team believe that, “with a longer follow-up, every smoking twin might have exhibited a difference in ageing”. They added that “smoking reduces the collagen formation, resulting in collagen degradation which reduces the skin circulation. Additionally, nicotine reduces the skin thickness. All of these reduce skin elasticity and create premature ageing”..
In August, 2025, Dr. Guyuron told CNN that he could easily identify smokers by the “festoons of loose skin” under their eyes. Speaking of the twins assessed, he shared: “When I see that [on patients], I don’t have to ask if they smoke. I know they do”.
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