You don't think avoiding death is a good thing?
Also why do you think you're an expert on his internal experience?
As someone who's engaged in cultural norms (drinking, staying up late, overconsumption of all manners) and who's tried to 'maximize life', maximizing life is much more satisfying (even if others are like 'meh it's not even working, he's still f-ed up', it's not really about them)
And if you have the $$ to actually track metrics it's even more satisfying because it softens the criticism of naysayers to actually have results in front of your face.
You can call him egoic or attention seeking or even accuse him of trying to make money (everyone has to make a living) but I don't get hating on people trying to be healthy. I've never understood that (even if I think someone's ideals are foolish I commend anyone who actually wants to take care of themself in a society that is selling you bad habits every millisecond).
You're taking this too personally.
There are people who track their metrics and feel like trash even though their metrics say they should be feeling great, but then there are people who don't track metrics and feel great despite being far from ideal. It's more of a human perception thing than probably anything biological unless the differences in, say, sleep depth and time were so obvious that one wouldn't need an app to tell them they're under-rested.
Bryan Johnson says he goes to bed strictly at 8PM. Never later. Never, never, never. Watch the video of him with his father and son doing the plasma exchange. He's trying to make it seem like he's reconciling with his father after years of being apart, but all he can focus on when the mask slips is that his bedtime is approaching and he can't allow himself to stay later after the photoshoots or to hang out. They have a strict filming schedule, and then they go to bed. I'd rather die 5 years earlier and go to bed a little later or a little earlier so I can, you know, enjoy my day's activities. Imagine playing an amazing video game, having an amazing conversation, spending time with a long-lost friend, but your crippling fear of death keeps you on a schedule that says you need to cut this short so that you sleep at 8PM every night. Watch the video about how much he hates to travel because he can't perform is dozen+ "longevity" rituals while on the road, and how he'd never be able to bring his specific diet with him. In his videos it's clear he's a nervous basket case. I don't bemoan him for being rich, and he can do what he will with his money, but I pity him because he clearly doesn't use it for any other purpose than to combat his crippling fears of oblivion while presenting poorly-fitting mask of normalcy under the guise he's just an eccentric billionaire who's also doing this for the benefit of humanity. I don't see him as vain as much as I see him terrified.
In short, I don't see him crying about getting a scar on his face, but if you told him this facial scar shortens his estimated life expectancy by 1 year, he'd lose his mind trying to get rid of the scar tissue (or pay his doctors millions to do the mental labor for him). Hence, his appearance isn't about vanity as much as it is about him not looking old so that he isn't reminded of his mortality.
He reminds me of a TV show about mental disorders where two borderline anorexic twin girls felt so connected to one another, fearing that one would die before or without the other, that they ate the exact meals (barely anything), followed in one another's exact footsteps, and when one picked up something for some reason, the other tried to duplicate it exactly afterwards while the other waited for them so that they spend the same amount of calories. These girls were not "living life" with one another. They were so afraid of losing one another that they spent each day obsessively avoiding death or the thought of being out of the other's presence.
If Bryan's doctors were actually honest with him rather than being his highly-paid yesmen, they'd diagnose him with OCD and anxiety.