Aging on your own terms: What patients should know before plastic surgery
Legendary actress Joan Collins was once quoted as saying, "Age is just a number." Today, that statement may be more relevant than ever. We are living longer and hopefully healthier lives. As Baby Boomers and Gen X head into their golden years, they are also helping rewrite what it means to age gracefully. Many are embracing plastic surgery, and while the standard facelift, a staple of older generations, remains popular, adults in their 60s and older are looking beyond the face and exploring additional options to help them look as young as they feel.
Plastic surgery may not be a magical fountain of youth, and it is not going to make a patient in their 60s look like they are in their 20s again, but with strategic and thoughtful planning, patients entering their golden years are making their own rules and aging on their own terms.
It's never too late to start the journey
Let's get one thing straight. You are never too old to start a new and exciting journey. That sentiment rings true for patients looking to explore their plastic surgery options as well.
Aviva Preminger, MD, laid out the case for never being afraid of asking questions, no matter what your age.
"I would actually say that I think people are often worried that they've missed the boat and it's too late, and there's something they've wanted to do, and now it's too late for me to do this kind of thing," said Dr. Preminger. "And I think the message is that usually it isn't. If you're healthy and you're taking care of yourself, give it a shot. Go see a plastic surgeon, have the conversation and obviously go to someone who's qualified and board certified."
If you are interested in winding back the clock a little, the first step is to arrange a consultation with an ASPS Member Surgeon. Look for a plastic surgeon who can share images of patients in your age range so you can get an idea of which one may be the right fit for your aesthetic goals.
Jeffrey Lisiecki, MD, suggested that patients start by being their own advocate.
"I think patients should start by making a case for themselves about what their concerns are, what areas bother them and what their main priorities are," said Dr. Lisiecki. "Making sure that they have all of that in mind for when they go in for a consultation to make sure that they can address all their concerns."
He continued by explaining that doing your research is a wonderful first step. Still, nothing can substitute for an in-person consultation and an in-depth conversation with an experienced plastic surgeon who can help assess your concerns.
Which plastic surgery options may be right for you?
There may be an unspoken rule that patients over a certain age are only interested in facelifts. While that may be one of the most popular procedures for patients 60 and over, that isn't the only option on the table.
"My practice is very face and nose heavy," said Dr. Lisiecki. "So, for patients 60 and up, facelifts are definitely the main thing. And then all the adjunctive procedures that go along with the facelift or can stand alone as their own facial aesthetic surgeries, so brow lifts, blepharoplasty and facial fat transfer."
Dr. Preminger mentioned that breast reductions and liposuction are also popular procedures for patients in their 60s and older. She added that procedures and treatments that enhance the face, eyelids, neck and hands can show signs of aging, sometimes to an even greater degree than the face.
When it comes to determining which plastic surgery procedures can help you achieve the results you are craving, be sure to have an open and honest conversation with your plastic surgeon about what you want to achieve. Dr. Preminger made a good point – the procedure you want may not be the one that delivers optimal results. Skin quality, elasticity and texture change as we age.
"When it comes to liposuction, for example, you need to set expectations appropriately," said Dr. Preminger. "The skin envelope in a 70-year-old is not the skin envelope of a 20-year-old. It's not going to contract the same way when you empty the fat between the skin. There are things that we can do to help correct that, like using energy devices such as radiofrequency combined with liposuction to improve skin contraction."
As they get older, patients may want to add certain procedures to achieve the results they seek.
"Patients in their 60s also, we definitely do start to do more adjunctive procedures in combination with the facelift and lip lifts are definitely something that comes to mind in this age group as well," said Dr. Lisiecki. "As patients get older, I'd say brows and lips, the likelihood of adding a brow lift and a lip lift definitely increases. The other big thing in this age group is that patients in their 60s and beyond have undergone much more photoaging of their skin than those in their 30s and 40s. So, we're doing skin treatments as well. Laser resurfacing plays a huge role in this age group as part of their overall facial rejuvenation."
Is age a barrier? Plastic surgery candidacy in patients over 60
One of the hangups patients may have about their age is the belief that they may be "too old" to undergo plastic surgery. It's time to throw that notion out. Now more than ever, people are living longer and taking better care of themselves. It is not unusual to see patients in their 70s ready to invest in plastic surgery and themselves.
"I really think it's more a matter of your biological age than your actual age," noted Dr. Preminger.
Age is not a barrier to surgery. Plastic surgery is highly personal, so a plastic surgeon will take the time to review a patient's complete medical history, medications, aesthetic goals and other factors to determine whether a patient is a surgical candidate. That patient could be 77 or 42 – the number may not matter as much as the physical and mental condition of the patient seeking plastic surgery. A healthy and active 65-year-old patient is going to be an excellent candidate for plastic surgery as opposed to a 40-year-old patient who heavily smokes or lives an unhealthy lifestyle.
"It's not so much about age in the number; it's about the amount of aging you've experienced and how you've treated it so far," said Dr. Lisiecki. "I see 60- and 70-year-olds who are as robust, fit and healthy as any 30-year-old. So, it's not, you know, it's not a question of the number, it's a question of, you know, where you're at health-wise."
Age may not be the barrier to surgery that you think it is. However, it is still critical to have an honest and open dialogue with your plastic surgeon about your lifestyle and medical history. Medications that may be more prevalent in an older population, like blood thinners, heart medications and hormone replacement therapies, can interact with anesthesia to create dangerous, even deadly complications. GLP-1 medications can also cause issues.
Talk to your surgeon about all medications and supplements you take and be open about any health issues you may have, such as hypertension, mobility problems and other medical conditions. This allows your plastic surgeon to evaluate your candidacy accurately and personalize their approach to surgery, recovery and your overall care. Never leave out crucial details because you think they will disqualify you from getting surgery.
"I would say that it doesn't mean you're not a candidate for a more extensive procedure," said Dr. Preminger. "We may just need to do some planning and coordination to make surgery possible."
Get real: Plastic surgery results over 60
An experienced and skilled plastic surgeon can achieve monumental results, but no one can work miracles. Patients in their 60s and 70s shouldn't walk into surgery expecting to come out looking like they are 30 again. Most don't expect that, but it brings up an important point about setting realistic expectations.
"At least in my practice, people are not coming and asking to look different or even asking to look 30," said Dr. Lisiecki. "I don't hear 60-year-olds saying, 'Make me look exactly like I did when I was 30.' I think they want to look like the best version of themselves and a more youthful version of themselves, but with the understanding that, you know, it's not that they're not going to shave 30 years off one procedure, they might shave 15 years off one procedure."
Patients may want to look at pictures of themselves when they were younger. What did you like about yourself at this stage of life? What aesthetic goals do you want to achieve by considering plastic surgery? Share those thoughts with your surgeon to start the conversation about realistic expectations.
"When we're doing a breast reduction on an older patient, there are different considerations than for a younger patient," said Dr. Preminger. "When someone is 25, I have conversations about breastfeeding and future hormonal changes, such as pregnancy, weight fluctuations and menopause. When someone is 65, most of those changes have happened already. I think that whatever we can do to try to improve communication is critical in achieving the best results always."
Putting in the work during recovery
Say it again for patients who have only skimmed the article – age is only a number! It is not always indicative of how quickly or slowly a patient will recover from surgery. While the healing process can slow as you age, a birthdate does not determine what your recovery process is going to look like.
"Honestly, I don't see a lot of difference between older and younger patients in terms of how quickly they heal or anything like that," said Dr. Lisiecki. "I think that goes back to it's not the age, the number. It's the aging process, and a lot of people in their 60s and 70s are taking good care of themselves and are healthy."
Putting effort into being active and eating healthy. Hydration and nutrition during the recovery phase are vital, as is gentle movement to help maintain blood flow.
"I talk to my patients about nutrition when they're healing from surgery and all those things," said Dr. Lisiecki. "So, a healthy person in their 60s and 70s doesn't necessarily have any reason that they shouldn't feel well from plastic surgery."
Patients also want to be mindful about restarting any medication they may have had to discontinue before surgery. Always follow your plastic surgeon's postop instructions. These aren't optional guidelines. This is your recovery roadmap, ensuring you are in the best possible position to recover safely and achieve optimal results.
Choosing to age on your own terms means investing in yourself
There are numerous reasons a patient may want to explore their plastic surgery options later in life. Life happens. Sometimes an event like divorce or children flying the nest gives a person time to think and reflect on their own wants and needs. These significant life events can impact the timing of procedures.
"Mom guilt" is real. It can take time to feel like you can give yourself permission to do something for yourself. Some patients wait until their children are off on their own and financially stable to finally consider their plastic surgery options. Men and women going through a divorce, or those who are on their own and want to jump back into the dating pool, may be looking to enhance their features. Some patients don't feel financially stable enough to invest in surgery until later in life, while others don't have the time to focus on themselves until they are retired.
The why is your own, as is the choice to age on your own terms and in your own way. A board-certified plastic surgeon can be your guide on this journey, helping you explore options that can rejuvenate your aesthetic and help you look as good as you feel.
To find a qualified plastic surgeon for any cosmetic or reconstructive procedure, consult a member of the American Society of Plastic Surgeons. All ASPS members are board certified by the American Board of Plastic Surgery, have completed an accredited plastic surgery training program, practice in accredited facilities and follow strict standards of safety and ethics. Find an ASPS member in your area.
