More Elderly Seeking Cosmetic Surgery

Phyllis Porter is a grandmother, but she no longer looks like one. The 80-year-old just got a face-lift and breast implants.

Porter went to Massachusetts Eye and Ear Infirmary in Boston for six hours of cosmetic surgery, which also included a chemical peel, eye-lift and lip enlargement. She described it as a freeing experience.

"All my life I did things I was supposed to do," Porter said. "Never had sex until I was married — that's kind of rare nowadays. I always was conventional. I always did what I was supposed to do. Now I'm going to do what I want to do. I've earned the privilege. That's the way I feel."

Dr. Sheldon Sevinor, who has been in practice for 23 years in Boston, has done more than 1,000 breast augmentations, but Porter was his first 80-year-old patient. But she may not be his last. Sevinor believes Porter is part of a "downaging" trend, in which people older than 65 undergo surgery to make them look as young as they feel.

Over 65 Set Seeking Nips and Tucks

Statistics show the number of cosmetic surgery patients over 65 has grown more than 352 percent in the past five years, according to Dr. Richard Erlichman, a member of the American Society for Aesthetic Plastic Surgery.

"As a matter of fact, over the past several years, that has been the largest-growing group of patients by age category," Erlichman said.

There are special precautions doctors must take with older patients.

"Most of these people have medical problems that people in their 30s and 40s don't, including high blood pressure and coronary artery disease," Ehrlichman said. "And those have to be taken into consideration before any type of surgical procedure is performed."

Several doctors agreed that a patient's health is more important than her age when it comes to cosmetic surgery. But the idea of an 80-year-old woman going for cosmetic surgery did raise some doctors' eyebrows.

"Breast implants in an 80-year-old? That's certainly not the norm, and only a very unusual circumstance would justify the procedure in my opinion," said Dr. J. Regan Thomas of the University of Illinois College of Medicine in Chicago.

Since cosmetic surgery is elective, it should only be undertaken if the patient is at minimum risk, doctors say. Seniors who are healthy and active can be excellent surgical candidates, but there are numerous red flags to look for in their medical records.

"There may be greater likelihood that patients in older age groups may have systemic illnesses or conditions that put them at greater risk from surgery, such as diabetes or hypertension," Thomas said.

Older people are also more likely to be on medications that can interfere with surgery. Someone who has undergone a stroke, for instance, might be taking aspirin or anticoagulants that could have an effect on the surgery. They might also be susceptible to blood clots in the legs, Thomas said.

Six-Hour Surgery May Be Too Long

Thomas also questioned the multifaceted nature of Porter's procedure. He said that the facial peel could interfere with the healing process that follows the face-lift. Futhermore, he said, if it was a phenol-based "deep peel," it could put the patient at risk for cardiac arrhythmia, especially if the patient's kidney function or liver function is decreased because of advanced age.

Another doctor also said cosmetic surgery should only be done in rare exceptions for people in their 80s.

"If I could be convinced that someone was indeed one of these exceptions, I would still be reluctant to do six hours worth of surgery," said Dr. Grant S. Gillman, who heads the facial plastic and reconstructive surgery division at the University of Pittsburgh School of Medicine. "Certainly it would be more prudent to stage things in that age group."

Gillman also says that older patients take longer to heal, and often have lesser results, because older skin lacks the elasticity needed to bounce back from surgery quickly. He also said older people often have other conditions that may have an adverse impact on their healing.

Dr. Julius Few of Northwestern University's medical school said that prior to undergoing surgery, elderly patients like Porter should have a "thorough evaluation by her medical doctor, with appropriate test to evaluate the heart and other major systems."

Nevertheless, limits based strictly on age should be avoided, and there might even be a plus for older folks, he said.

"There is experimental evidence that suggest that older individuals are less likely to form hypertrophic [prominent] scars," Few said.

Older Men Get Face-Lifts, Too

It's not just older women who are taking the cosmetic surgery plunge.

Fred Watson, 65, had his eyes and face lifted because he felt that his age shouldn't prevent him from feeling good about the way he looks.

"I know, realistically, I may only have a few more years left on this earth, so I try to take care of not only my face, but also my body," Watson said. "I exercise, eat right, I eat my veggies."

Cosmetic surgery for older people may also signify a shift in how people regard old age, Porter's surgeon said.

"What is really means is that we're reinterpreting what it means to get older," Sevinor said. "Older is becoming better."

Porter is still recovering from her surgery. The recovery is expected to take anywhere from six months to one year.

Her husband says he supported her decision to have the surgery. "It took a while to heal, but I would love her even if she didn't do it," Charlie Porter said.

She did take some flak from pals in her knitting circle, though.

"I don't understand why she had to get the surgery," said her friend Althea, who is also 80. "I don't remember seeing any wrinkles."

Porter says she loves the way it turned out, and she wants to always look the way she does now. She feels she has a new lease on life, and a renewed passion for living it.

"I think people are saying that people 80 years old should be picking out their cemetery lot, should be thinking about how many pills they're taking," Porter said. "I don't want to think about cemetery lots. I want to think about living."