Cosmetic Surgery in the Older Patient

Cosmetic surgery in the older patients

A study that came out last month showed that older patients compared to younger patients (less than 65 years of age) had no increase in complications following cosmetic surgery procedures.

This was a counter-intuitive finding given that as we age our bodies are supposed to heal more slowly, our skin grow less elastic, etc. Older patients should have an increase in complications, but they don’t, and that is exactly what I have seen in my cosmetic practice.

 

What age is too old for cosmetic surgery?

I sometimes get asked that question, and the answer is, obviously—never.

Age

We all know people whose chronological age is much older than their appearance and their activity level much higher than someone much younger. I have only to think of my in-laws, who are so active that I cannot keep up with their daily activities, outings, parties, etc. So age by itself is meaningless.

Physical condition

As we age, some of us will have more varied and complicated medical histories that may preclude certain surgeries or increase the risk of surgical complications in others.

For example, some elderly patients are on blood thinners such as aspirin or Coumadin to help the circulation of blood in their limbs or to their heart or brain. Cosmetic plastic surgery procedures, by their very nature, are at high risk for complications of bleeding, and having a patient with anti-coagulants is not a good idea. The risk of stopping these medications, even for a short time, must be weighed against the potential benefits of the surgery.

Other medical problems, such as heart disease or diabetes, may require your plastic surgeon to modify their surgical approach or technique.  And yes, there are some patients who are too frail or have too many problems to be good surgical candidates for cosmetic surgery.

Skin healing in the elderly

No matter what, as we age on this planet, our skin becomes aged, less elastic and thinner. This makes the risk of bruising more common in older patients, and though not a complication, bruising and swelling can decrease the healing time after cosmetic surgery. On the other hand, the elderly, like newborns, have a lower and slower inflammatory response to the trauma of surgery and will heal with better scars!

 

Special considerations for plastic surgery in the elderly

Given that age by itself is not a determining factor for suitability for cosmetic surgery, there are some precautions that should be taken by all patients, particularly older ones:

  • Have medical clearance from general doctor/internist.
  • Review all medications and stop all anti-coagulants.
  • Establish that there is a support system to help in the post-operative care and travel.
  • Establish that there is proper and adequate nutrition.

With proper screening of older patients there is no reason that cosmetic surgery cannot be performed safely and effectively. My oldest patient to date was an 86-year-old man who came in for a second neck lift after his initial one at age 65! He did great and looked marvelous…