At our recent meeting of the American Society of Aesthetic Plastic Surgery I watched a panel discussion called “Facelifts for the Elderly”. (Funny Story: One of the panelists, a well-respected practicing surgeon, wryly suggested that the discussion should have been entitled, “Facelifts by the Elderly” as he surveyed those on the panel.)
Interestingly, this whole topic is getting a lot of attention on The Today Show, ABC News and even the New York Times. As major media outlets continue to debate the pros and cons of it, what seems to be missing is that age is actually less important in this decision than health. Here’s what I mean: From the outset, we should remember this is totally elective surgery, and if it can not be done with a reasonable degree of safety, it should not be done at all. While there is no absolute guideline about how old is too old, there are some rather straightforward principles that can guide us.
Health Versus Age
I have seen 70-year-olds whom I would much rather operate on than some 40- or 50-year-olds because age is an arbitrary number that has nothing to do with health. Health is a function of cardiovascular fitness, current medical diseases, and perhaps inheritance (like a very strong family history of heart disease). Overall health is much more important than age alone (we speak of physiologic age rather than chronological age). The bottom line is that if your health is good, your age is not too important.
Another consideration in the age vs health discussion is recovery time. Some operations, like a tummy tuck, have a much longer recovery than something like eyelid surgery and the recoveries may be more difficult from a physiologic standpoint. The level of health, or other chronic diseases (like high blood pressure) may be different in terms of who is a good candidate for one operation as opposed to another. You will need to be healthier, relatively speaking, for the larger operation.
Motivations For Surgery
The thing that most of the discussion circles around is the motivation for the surgery. There are a lot of “good” motivations for such surgery. The “wrong” motivation for surgery in older patients is the same as for everyone else; doing it to please someone else, or meet someone else’s expectations. In this case the wrong motivation for a 70-year-old would also be wrong for a 25-year-old.
One of the major motivations is to look as good as you feel; to have the outside match the inside. People are living longer, and people are healthier at older ages. I guess that 70 is the new 50 (well, maybe 55) so it really can make sense to have something done in your 70’s and 80’s. When your life is full and good, it’s natural to feel and act more youthful, and look the part as well.
Competitiveness in the job market is another factor. People are working longer, and may need to compete with a younger work force. The wealth of experience that someone has acquired through years of work in a field, should not be undercut by an older appearance. While it should not be so, we are judged on our appearances and the more vigorous you look the more competitive you may appear to be.
Other motivations are change in marital status, change in careers, or just finally having the money or time to do something that you have always wanted to do.
What is all boils down to is that cosmetic surgery at any age can be a very reasonable option providing that your health will safely permit it and your motivations are reasonable.
All the best,
David B. Reath, MD