The elderly patient: our forgotten market

The advent of the internet has forced our hand to market to patients through Facebook, Twitter, Snap Chat and Instagram.  But are we neglecting an important sector that is not drawn to social media for its information regarding plastic and aesthetic surgery?

According to the Australian Bureau of Statistics, the number of older adults has grown by 170.6% over the past two decades, compared with an overall population increase of 30.9% in the same period.  The Cosmetic Surgery National Database Statistics (Aesthet J Surg 2017, 37(2)1-29) indicate that over this same period, the increase in plastic surgery amongst the elderly was 1,263%.  With improving life expectancy, and more time spent in the workforce, elderly patients are seeking to maintain an appearance consistent with their younger attitude.

“Wear and tear” and environmental exposures are facts of life.  The appearance of tight skin and prominent cheekbones, well-defined contours—with contrasting plump areas and subtle depressions —is what defines a youthful face.  With age and time, however, these boundaries start to stretch and lose integrity, which leads to fat pad displacement, or blending into areas where fullness didn’t exist before (e.g., jowls), and descent of skin and soft-tissue of the face.  With gravity, these structures start migrating downwards.

In terms of rejuvenation and correction of the ageing face, a youthful face is well-supported, with appropriate fullness and hollows (light reflexes and shadows on photographs), without the sagging or tissue spilling/descent we see with aging.  In some areas the fat atrophies (shrinks away) and creating hollows (for instance around the eyes).

These days, there is a raft of surgical and non-surgical procedures available to assist your elderly patients by looking their best for longer.  Surgical procedures include a full Facelift, partial Facelift such as a Browlift, blepharoplasty to treat sagging eyes, lip lift, and the non-surgical options are numerous from injectable treatments, laser skin rejuvenation, chemical peels, derma-needling, medical-grade skincare, the list goes on.

Fortunately, there is evidence to suggest that surgery is not associated with a higher risk for appropriately screened elderly patients.  In a North American study of 6,786 elderly patients, the 30-day major complication rate was no higher than for younger patients (Yeslev M. Aesthet J Surg 2015; 35(7), 864-73).  Interestingly, the ‘older’ group also had a greater number of patients who were males, higher BMI and had higher rates of diabetes mellitus. Patient fitness for surgery should, therefore, be assessed by their physiological age rather than by their chronological age.



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