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The population in the U.S. continues to age. It is estimated that people 65 and older will double in the next two decades. In fact, those 85 and older is the fastest growing segment in society. By 2025, nearly one in five people will be over 65 years of age.

Because of this aging population, I am seeing more and more older patients who desire some form of plastic surgery. While once an inconceivable and thought to be an impossible occurrence, I have seen and done four patients over 75 in the last six months for neck procedures, an 82 year-old for Botox, and a recent 87 year-old for a neck lift! Most of the very elderly patients that I see are largely for eyelid and neck aging issues. The eyelids are easy to understand due to the functional issues (visual field obstruction) that they pose. The neck waddle is also psychologically understandable as it is something that they see every day and can be very emotionally distressing as it flaps around when they move their head.

In my experience, older patients are no more likely to have complications after surgery than their younger counterparts provided two issues are taken into consideration. First, they must have good general health and be taking no medications that would endanger them significantly if they stopped taking them. Fortunately, eyelid tucks and direct neck excisions/lifts can be done under local anesthesia supplemented with some sedation so a general anesthetic may be avoided in many elderly cases. Secondly, the operation should be minimized and tailored to account for the patient’s age. The goal is to achieve results with safety as priority number one. For this reason, for example, I almost always prefer a direct neck lift to a traditional facelift in patients over 80 years of age. Elderly patients have very realistic expectations and easily understand and appreciate the trade-offs of more limited procedures. And they certainly want a quick recovery.

There is no reason to not offer plastic surgery to this growing elderly population. They prove that it is never too old to care what you look like. And if your health is good and there is something that bothers you that can be improved safely and quickly, why not?

Dr. Barry Eppley

Indianapolis, Indiana

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