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More seniors are choosing cosmetic surgery.
Those over 65 are the fastest growing segment of that group.
When Joan Kron set out to write a first-person account of shopping
for a facelift, the New York City journalist interviewed four
plastic surgeons but had no intention of ever having the surgery.
But as each physician described how he could refresh her appearance,
she became more open-minded about looking as young as she felt.
By the last office visit, she says, "I had crossed the line
from stealth journalist to consumer."
So in 1992, at age 64, Kron underwent a facelift. "It was
a wonderful experience," says Kron, author of Lift: Wanting,
Fearing, and Having a Face-lift.
Cosmetic surgery has surged in popularity, and Hollywood stars
aren't the only ones turning back the hands of time. People like
Kron are among the biggest new fans of cosmetic surgery, according
to the American Society of Plastic Surgeons in Arlington Heights,
Ill. Patients aged 50 and older accounted for one third of all
cosmetic surgery procedures in 1998, the latest year for which
age-related information is available from the society -- and those
65 and over are the fastest growing of this segment. In 1998 alone,
patients 65-plus had 90,911 procedures, up a whopping 272% from
1992.
What's happening here? Several factors seem to be behind the boom.
Health-conscious 65-year-olds "realize that they have another
20 to 30 years to socialize," says Brian Kinney, MD, an assistant
clinical professor of plastic surgery at the University of Southern
California School of Medicine in Los Angeles. And common illnesses,
such as arthritis, diabetes, and heart disease, do not exclude
patients from having cosmetic surgery, as long as their physician
clears them. Plus, in a booming economy, more people can afford
such elective surgery.
A Smorgasbord of Options
Seniors are not lining up solely for facelifts. New methods make
it easier for plastic surgeons to correct specific problems and
spare or postpone facelifts for later years. "With facelifts,
you pull. If you droop 109 years later, you pull again,"
says Kinney. "But a pulled face looks tight and unnatural."
After Kron had her facelift in 1992, she couldn't drive for a
month because tightness in her jaw made it impossible to turn
her head to safely back out of her driveway. These days, new and
subtler procedures make patients look more natural and help avoid
such side effects.
Besides facelifts, there are other possibilities. Laser resurfacing,
for instance, vaporizes the superficial layers of damaged skin
and helps firm the deeper layers with high-energy light, allowing
new, smoother skin to emerge. In the last five years, lasers have
largely replaced deep chemical peels that use harsh chemicals
to rejuvenate facial skin. Wrinkles around the eyes and mouth
and on the cheeks respond well to laser resurfacing.
Laser resurfacing does not work well, however, on much deeper
frown lines, forehead creases, and crow's feet. But these wrinkles
do tend to fade after injections of Botox. When injected
in tiny amounts, this substance "cuts down the nerve activity
that causes these wrinkles," says plastic surgeon Fritz Barton,
MD, a clinical professor at the University of Texas Southwestern
Medical School in Dallas.
The tiny amount of Botox injected shouldn't harm the rest of the
body but banishes wrinkles for three to six months. "People
get Botox twice a year for one, two, or three years until they're
ready for a facelift," says Barton.
Eyelifts, or blepharoplasties, involve removal of fatty bags and
droopy skin on the eyelids and can cut years off a person's appearance.
Of all blepharoplasties performed in 1999, 63% were in people
older than 51, according to the American Society of Plastic Surgeons.
Truths About Recovery
As promising as some of the new cosmetic surgeries are, however,
it takes time to recover from them.
For the first few days after a facelift, "you look like you've
been in a car crash," says Kron. She warns people to cancel
all social contacts for at least two weeks. People also should
plan on going into social hibernation for two weeks after laser
resurfacing, since the treated skin swells, turns bright red like
a sunburn, and oozes and crusts like a blister.
"It used to take a month to heal. Now it takes a couple of
weeks," says Kenneth Arndt, MD, a professor of dermatology
at Harvard School of Medicine. Improvements in lasers and techniques,
as well as better wound dressings, reduce pain and healing time,
Arndt tells WebMD.
After an eyelift, healing takes several weeks, and eyelids may
droop. Headaches, bruising, or pain may follow Botox injections,
but these are usually mild and short-lived.
Overall, older people approved for cosmetic surgery should not
have significant healing problems, doctors say.
To maximize results of cosmetic surgery, surgeons tell patients
to give up smoking. "Even if you don't care about heart disease,
lung cancer, or emphysema, smoking is bad for your skin,"
Kinney says. "If you have any vanity at all, quit smoking."
Whatever their age, anyone considering plastic surgery should
be realistic. After cosmetic surgery, "most people don't
look exactly like they did 10 years earlier, but they do look
significantly better for their age now," Barton says.
Smart Shopping
Legally, any physician can perform cosmetic surgery. But for the
best results, get a referral to a qualified surgeon from your
primary care physician or from friends who have had the procedure
you want. Check the doctor's credentials to see if he or she is
board certified and has experience with the necessary techniques.
(Physicians board certified in plastic surgery, ear-nose-throat,
dermatology, and ophthalmology most commonly do the cosmetic procedures
discussed above.)
Ask to see before-and-after photos of people who have undergone
the procedure you want, and talk with previous patients about
their experiences.
Also, ask about any payment plans the doctor may offer, since
insurance plans generally do not cover cosmetic surgery unless
it is also functional (for example, a nose job to fix breathing
problems) or restorative. Expect to pay about $2,400 for laser
resurfacing, $430 per area for Botox, $2,400 for an eyelift of
both eyes, and $5,100 for a facelift, according to average national
cost data compiled by the American Society for Aesthetic Plastic
Surgery in New York City.
One Surgery Leads to Another
After taking the facelift plunge, Kron added a nose job and brow
lift in 1996 to an operation for sinus polyps that required treating.
If people ask her why she looks younger, better, or different,
she isn't coy, like many Hollywood stars. She's straightforward
and honest, telling those who ask that she had a facelift.
"I call it growing old disgracefully," Kron says.
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