As we all know, the American population is aging. The number of Americans age 65 and older is expected to more than double by 2050, and the number age 85 and older may increase fivefold. While the elderly account for only 12% of the U.S. population, they undergo nearly 40% of all surgical procedures. As more nonagenarians and even centenarians, now undergo major surgery such as cardiac bypass, the medical literature has become replete with hundreds of articles within the past twenty years assessing the safety of surgical procedures in older adults. Some studies have identified ages above which certain procedures become too risky, such as lung transplantation above age 70. Others have instead shown the relative safety of surgeries such as breast reconstruction in patients 65 and older. Unfortunately, very few studies have addressed the safety of cosmetic surgery in older adults. Despite this, the number of cosmetic procedures performed on patients age 65 and older has increased six fold in the past ten years, a 30% greater increase than for all ages combined. There is no doubt that the graying of America will continue to manifest itself in surgeons’ waiting rooms around the country, and good medical research will be needed to establish what procedures can be done safely in this age group.
Recently, a group of researchers at the Cleveland Clinic decided to examine whether the risk of complications of facelift surgery was any higher in patients age 65 and older than it was in adults under age 65. The study was published in the June 2011 issue of the journal Plastic and Reconstructive Surgery, and was subsequently cited by many in the media including the New York Times and ABC Nightly News, as well as by the websites of plastic surgeons across the nation. The authors reviewed over 200 facelift surgeries performed over a three year period by the same surgeon. An identical surgical technique was performed for both older and younger patients. The oldest patient was 83. The study showed that for seniors with appropriate medical screening, complication rates were no greater than in adults under age 65. The authors then asked: “How old is too old for a facelift?” The data did suggest that complication rates may increase for patients age 70 and older, but the results were not conclusive due to small numbers of patients in this age group. Thus, the answer to this question will have to wait for another day.