When Is it Too Late for Plastic Surgery?

More and more seniors are saying it's never too late and are signing up for various procedures. Here's what you need to know if you're considering plastic surgery later in life

The silver ladies may be embracing the hottest hair trend by letting their color go au naturel, but when it comes to wrinkles, baggy eyelids and sagging skin, the senior set wants to wipe the tarnish off their golden years.

Nevertheless, the elusive Fountain of Youth can’t be found in an infomercial product, and there are no magical potions in drugstore remedies and department store creams.

“The late Charles Revson, who was the head of Revlon, was once famously quoted as saying that what he was selling was hope in a jar,” says Dr. I. Kelman Cohen, the world-renowned plastic surgeon who grew up on the shores of Lake Winnisquam in Laconia. “There really isn’t a miracle cure in any over-the-counter product.”

So savvy seniors are electing to undergo plastic surgery in record numbers.

There were more than 10 million surgical and non-surgical cosmetic procedures performed in the United States in 2014, and according to the American Society of Aesthetic Plastic Surgery (ASAPS), women and men aged 51-64 accounted for 24.6 percent of the surgical and 32.9 percent of the non-surgical procedures.

Moreover, the 65-plus set signed on for 7.9 percent of the surgeries and 10.9 percent of the non-surgical methods. Consider that only four years before, just 5.2 percent of people in their age bracket went under the knife.

Why the spike in popularity? With healthier lifestyles, people are living longer and they want to look as good as they feel. Some feel the pressures of a cut-throat work environment or the competitive dating game. While reasons vary, experts agree the numbers will accelerate as baby boomers age.

“More and more people over 50, and even in the over-65 group, are coming in to our office,” says Dr. Robert Feins, a board certified plastic surgeon who practices in Manchester and is an ASAPS member. “The population is aging, and as that bulk of the population gets older, they go for the surgeries that are age-appropriate for them.”

The most commonly requested surgeries by seniors are liposuction, facelifts, breast lifts, eyelid lifts and tummy tucks. Breast augmentation, forehead lifts, lower body lifts, arm lifts, breast reductions, cheek augmentation, chin augmentation and nose restructuring also make the wish list.

But do the risks escalate in an older patient? Researchers at the Cleveland Clinics answered no, with a caveat.

“It’s not the patient’s age that’s a limitation. It’s the co-morbidities, the other illnesses and medical conditions about the person,” says Dr. Bruce Topol, who also practices in Manchester as a board certified plastic surgeon and is a Fellow of the American College of Surgeons. “If someone has to be on aspirin because they’ve had a stroke, have had a heart attack, have a stent in their heart or had corroded arteries surgery, that’s a risk for bleeding. If somebody is on blood thinners, it is contraindicated to do any type of cosmetic surgery because the risk of bleeding is very high. Diabetes is another high-risk factor.”

But 60 really is the new 40 and advances in medical science, technology and technique make plastic surgery safer than ever. The results are better too.

“We’ve got a larger variety of operations we can do now and there are different techniques that are available that weren’t available 20 years ago. Our approach to aging, especially facial aging, is different now than it was 30 years ago,” says Dr. Feins. “Also, anesthesia has become safer. A general anesthetic of 30 or 40 years ago was a much tougher event than it is now. All of this is combining to make it safer and easier for older people to have cosmetic surgery.”

Although the ASAPS study revealed that the New England states rank as the lowest region in the country for seniors (4.9 percent) seeking cosmetic procedures, the social stigma has been erased. It is no longer a question of vanity nor does it have to be limited to Hollywood divas and jet-setters.

“The idea that this is a rich person’s pursuit is absolutely false. Most of the people going through cosmetic surgery are middle class wage earners who save up to get this done because it’s important to them,” says Dr. Feins.

For those who want to spend less or shy away from an operation, the non-surgical alternatives can help bring back that youthful glow.

“The request for those kinds of aesthetic things are way up and people are having the injectables much more so than surgery because it’s faster, easier, cheaper, and it doesn’t require going to the hospital and all of the expenses related with that,” says Dr. Topol.

Injectables include the paralytic Botox to block muscular action that causes wrinkles, plus facial fillers with trade names Radiesse, Juvederm, Voluma, Sculptura and others, which plump up wrinkles.

Skin rejuvenations, including chemical peels, dermabrasion and laser skin resurfacing, skin-tightening procedures and non-surgical fat reduction (CoolSculpting and radiotherapy), are also increasingly popular.

But they are not permanent.

“So much can be done with fillers, Botox, peels and other things, but the trouble is that they are short-lived and thus can be disappointing,” says Dr. Cohen, who is the chairman emeritus of the plastic and reconstructive surgery department at the Medical College of Virginia Commonwealth University.

Dr. Cohen also cautioned against shortcuts.

“The business of going in for the surgical mini-lift, the 30-minute facelift or the quick peel at lunchtime, or whatever, they’re all transient,” he says. “You have to anatomically put things back the way they were when the patient was 25. Unless you structurally restore things and in the proper way, you don’t have a chance of getting a lasting result,” he says.

Plastic surgery can never make all of someone’s life problems vanish, but as long as the patient has realistic expectations and is emotionally healthy, the rewards far outweigh the risks.

“For the women in their 50s who come in with sagging breasts and stuff going on with their faces and necks, and with whatever else, and as long as they’re emotionally stable, if you fix it all, then they’re happy,” says Dr. Cohen.

“As people go through life transitions, they still want to look good,” says Dr. Feins. “Patients will come in and tell me, ‘My child is getting married and I’ve got to look better than my ex-husband’s new wife.’”

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Tips for Successful Surgery      

• Be healthy physically. Have a complete medical check-up to screen for any risk factors. Don’t hide anything; this is your life at stake.
• Be healthy emotionally. Cosmetic surgery can’t and won’t fix any of the underlying problems making you miserable.
• Follow doctor’s pre- and post-operative orders exactly. Communicate. Cut corners and you will compromise your results.
• Make sure your doctor is board certified in plastic surgery.
• No smoking. Quit weeks before your operation. It’s also wise to cut out the caffeine and alcohol.
• Stay out of the sun. Protect your skin from damaging and aging UV rays, which will make scars more visible.
• Expect to look worse before you look better. It takes time for swelling and bruising to dissipate before you see results.
• Be realistic. You’ll look marvelous, but you won’t look exactly like Gisele Bundchen or Tom Brady.
• Be more realistic If you’re 65, not even the most gifted surgeon can turn the calendar all the way back to 25. You want to look natural and refreshed, not ridiculous.