Many an older patient has been discouraged from undergoing plastic surgery because they were “too old.” The source of this discouragement is frequently family members who are concerned for the health of their older relative or who may be secretly hoping that the money spent on cosmetic surgery would instead find its way into their inheritance! Another source of the discouragement can be the patient’s primary care doctor who may not see the worth of the surgery for someone who has a life expectancy measured in years as opposed to decades. When I speak to older patients, however, I find that they are people who are just as interested in looking good in their senior years as they were in their younger years, but who now have the financial means and time to pursue plastic surgery. Is it safe, though?
A recent study out of Vanderbilt University Medical Center looked into this issue. As reported on www.surgicalproductsmag.com on 10/31/14, 129,000 patients who underwent cosmetic surgery by board-certified plastic surgeons were included in the study over a five year period of time, with 6,700 being over 65 years of age. The complication rate for major complications following cosmetic surgery among the over 65 group was 1.94% and for those under 65 it was 1.84%. The average age of the over 65 group was 69 years old and it was 39 years of age for those under 65. This similar complication rate was observed despite the older population having a higher rate of negative health factors such as diabetes and higher average body mass index (more overweight).
The procedures studied ranged from liposuction to facelifts. Only one showed a higher complication rate among the older patient population – tummy tucks where the rate was 5.4% for the older patient group and 3.9% for the younger patients. There was also a comparison of complication rates following cosmetic surgery in patients over 80 versus younger patients. The rate for the octogenarians who averaged 82 was 2.2% versus 1.9% for the younger group.
So what can we conclude? Cosmetic surgery properly performed by a board-certified plastic surgeon can be done as safely in those patients above the age of 65 as those under 65.
The key word is “properly.” In my own practice every female patient over 55 and every male over 45 is asked to see a medical doctor for preoperative clearance and tests. I also use discretion in what I will do for each patient. For instance, I would be hesitant to perform a tummy tuck and breast reduction on a 70 year old woman, but would usually do this for a healthy 35 year old. This type of judgment is what allowed the authors of the study discussed above to obtain the low complication rates in all age groups.
Your thoughts?
George Sanders, M.D.
