Aesthetic plastic surgery, also known as cosmetic surgery, has gained tremendous popularity over the past 15 years and the number of procedures, both surgical and non-surgical, has increased by 200-300%.
We are fortunate, as with this increase in popularity, there has been tremendous improvement in technique, allowing plastic surgeons to obtain reproducible and natural results in most cases.
But what age is “too old” for plastic surgery? There is no black and white answer to this question, as each individual is different. Certainly there have been many patients in their seventies and even eighties who have had facial plastic surgery. The same is true for other procedures as well. Recently, I performed a rhinoplasty (nose surgery) on a spritely 65 year old female. After taking care of every one else in her family, she decided it was time to take care of herself!
If a patient has common medical conditions (such as high blood pressure, diabetes, etc.) which are well controlled, the risk of complications are very low. A recent article from the Journal of Plastic and Reconstructive Surgery looked at advanced age and safety of ambulatory (out patient) surgery. The article states, “In sum, although various data illustrate that older age”(over 65 years of age) “can modestly increase the risk of intraoperative and/or postoperative complications associated with ambulatory surgery, this risk is arguably not great enough to constitute a contraindication to ambulatory surgery based on advanced age alone.”
There has also been data on the risk of death from general anesthesia in an outpatient setting. The risk of death from general anesthesia in this setting is 1 in 50,000. Assuming a plastic surgeon performs 500 cases per year under general anesthesia (I am not aware of any plastic surgeon with such a high volume of procedures), it will take 100 years to reach 50,000 cases! In comparison, the risk of death while driving is 1 in 5,000 (which is ten times higher). To achieve this low risk, however, requires the patient to be medically cleared for surgery, the surgery be performed in an accredited surgery center, with a board certified plastic surgeon who is well-trained and safe.
Fortunately, many procedures can also be performed under local anesthesia, reducing the complication rate even lower. Procedures such as liposuction, upper and lower eye lid surgery, some types of face lifts, ear set-back surgery, chin augmentation, mini tummy tuck, mole removal and certain types of lasers for facial rejuvenation can be performed under local anesthesia. In addition to higher safety, there is an additional benefit of lower cost to the patient as there is no anesthesiologist or surgery center fees.