More and more people over the age of sixty are undergoing cosmetic surgery operations. Although they still represent a small percentage of the around 200,000 interventions performed annually in Spain, it is a novelty that elderly women and men resort to plastic surgery to continue feeling attractive and visible.
“I think it’s wonderful that sixty-year-old women want to have breast surgery. This is what I see that has changed the most, because before at certain ages you had surgery on your face and forgot about your body,” confirms Dr. Maritina Martínez Lara after publishing Confessions of a Plastic Surgeon. Why do we have surgery? (Dome Books).
“We have been postponing that age at which we stipulated that old age began by more than a decade, and if before it was considered to be in the mid-sixties, now we mark it in the seventies,” he quantifies.
There are factors that are interacting so that sixty-somethings and seventy-somethings have decided not to throw in the towel on aesthetics. On the one hand, couples who break up after living together for many years continue to increase (breakups after the age of 50 constituted 27% of marital dissolutions in 2021, 10.6% more than in 2013). The objective is to live well for the long time ahead, taking into account that life expectancy at birth in Spain is 83.2 years. And also, if the flute sounds, finding a partner again, which means having a social life and being in the limelight.
What motivations do you see among those who opt for cosmetic surgery at an advanced age?
The age from which it began to be considered that the body no longer mattered so much and that only health was of concern has been postponed. It is no longer unusual for a 70-year-old person to come in for cosmetic surgery. If this person has good health conditions, then we will operate on them without any problem. I believe that we operate more and more because our social life is much more active than the one our mothers or grandmothers had. It’s not so much about looking younger, but rather not looking so old.
The Christmas period is the best time for cosmetic surgery. What is your opinion that some clinics offer knockdown prices at this time?
That there is nothing more contrary to medicine. Medicine cannot be offered or given away, because it requires certain conditions. We are not talking about a consumer item that can lead you to say: “ok, since there are so many sales, I’ll do it.” This is contrary to our code of ethics and the ethics of any doctor.
Even so, it is something that is repeated every Christmas…
It is true that plastic surgery is being commercialized a lot. When a doctor has his practice and manages it in the usual way, these offers have no place. The problem is when the surgery is in the hands of franchises. In these cases, it is no longer possible to talk about doctors but rather about large companies that want to do business.
Although women represent 85% of clients, more and more men dare to use the scalpel. What does each sex demand?
Clearly what women and men over sixty years of age demand most are blepharoplasties or eyelid surgery. Liposuctions after the age of sixty, on the other hand, are not so common due to the complications that can arise after a certain age. After blepharoplasties, men ask for facial surgeries. They also want neck surgery to remove the double chin. As for women of these ages, what they do most is facial surgery and facelifts. Also treatments for blemishes and then, in relation to body surgery, breast surgeries for sagging breasts or secondary breast surgeries for those women who need to change the prostheses that were put in years ago, because they are damaged. Likewise, at these ages it is common to be asked to reduce the size of the breast and, to a lesser extent, abdominoplasty or abdominal surgery, when it is very bulging.
Are there women over 60 years old who ask you to increase their breast size? I’m telling you this because in her book she points out that Spanish women see a small breast as abnormal, even though the majority have size A or a small B…
Some women over sixty years of age want to increase their breast size, it is true, but it is not so common, because at this age what women want, above all, is to be comfortable.
What can and cannot be improved after certain ages?
We can greatly improve the appearance of the face to have a fresher and more relaxed appearance. The idea is to be able to recognize yourself when you look in the mirror because when we don’t feel so old we act with more vitality. There are times when you look at a photo of yourself and exclaim: “Oops! That’s me?”. What cannot be improved after certain ages is if the skin is wrinkled or loses tone, because you have to assume your age.
Sentimental disagreements at very late ages have become common. Some call these breakups “gray separations.” Do you detect a different attitude toward cosmetic surgery among aging baby boomers than their parents had?
Completely. Those who used to separate at 40 years old now do so at 60. Maybe I don’t notice as much difference in women, but men now have much more surgery than before. There has been a big change here.
If we talk about the effect of years on the face, what wrinkles should be treated?
Let’s see, a wrinkle itself is not as important as the stigma it transmits. It is not the same to have a wrinkle on your forehead at 30 years old, when it can be very worrying, than at 60 years old, when it is very normal. On the other hand, having eyelid bag surgery has a much greater aesthetic impact. Drooping eyebrows, upper eyelids with excess skin, bags on the lower eyelids, sagging cheeks, pronounced furrows on the side of the nose or sagging neck contribute a lot. On the contrary, crow’s feet and frown lines are very normal and do not make you look older.
How would you define what is a true necessity and what is a whim? Are only surgeries that solve vital problems really necessary?
The concept “need” is very subjective. It is one thing to have a heart problem that requires surgery and quite another to have the surgeries we are talking about that can help you feel good about yourself, repair your self-esteem and identify with your body.
What would be a whim then?
Anything that doesn’t involve going through the operating room and having to administer anesthesia, because when people have to have surgery they think about it a lot. Capricho would be more of a botulinum toxin (Botox) treatment, hyaluronic acid, a facial radiofrequency treatment against wrinkles and all those things.
Which cases have the best prognosis at advanced ages?
Those in which the patients, in addition to being healthy, have good tissues, favorable anatomy and good eating and physical activity habits. The person must be healthy and not have diseases that make surgery dangerous. It is also a plus not to smoke or have smoked, not to have sunbathed much and to have maintained more or less stable body weight.
What can be expected from the maintenance of results?
In surgery, two and two do not always equal four, that is, mathematics does not work… There are variables that make the results of two identical surgeries different in each case, since there may be, for example, different healing processes. The tissues of a person of a certain age do not resemble those of a twenty-year-old person, so logically the solutions last less time.
Do you think the idea that at a certain age you have to forget about aesthetics is changing?
Completely. The whole concept of age is changing. Now a 50-year-old woman does almost the same things as a 35-year-old woman.
Lately there has been a lot of talk about the effects of social media filters that make you want to look like your digitally retouched photo in real life. Some people call this “selfie dysmorphia.” To what extent should plastic surgeons have procedures with which they can compare the mental health of their patients?
Plastic surgeons are not psychologists but we know about these situations. Sometimes these symptoms of anxiety and depression respond to the fact that the person in question does not accept the image of them. When we consider that plastic surgery can help, then we operate. On the other hand, if we see that the person asks for touch-ups and more touch-ups and is never satisfied, we understand that the problem lies somewhere else, even if it stems from the aesthetic part. In these cases, we try to stop these people and prevent them from having surgery, although it is very delicate to recommend that they visit a psychologist.
