Act 2 Column: Surviving plastic surgery, health means more than age

For older adults considering cosmetic surgery, the patient's health, not age, is the more important factor, Rita Pav's doctor told her.

So age never crossed her mind when Pav, now 67, a retired financial adviser with Smith Barney, had a face-lift two years ago, because she was in good health.

The same was true for Sandee, 59, of Long Beach, assistant director of the legal writing program at a Manhattan law school, who had a face-lift in 2007. She did not want her last name used.

"There's no reason why older adults in good health should shy away from cosmetic surgery if they desire it," says Dr. Lyle Leipziger, chief of the Division of Plastic Surgery at North Shore University Hospital/Long Island Jewish Hospital, who was the surgeon for both Pav and Sandee.

Indeed, more older patients who can afford it and who can benefit from aesthetic surgical techniques are taking the plunge. "Women and men age 65 and older accounted for 7 percent of cosmetic procedures performed in 2000, and the number of procedures performed on people in this age group increased 352 percent since 1997," according to the American Society for Aesthetic Plastic Surgery Web site.

Some retired adults over 65 plan to re-enter the job market or have active social lives and may be seeking new marriage partners, says Dr. Malcolm Paul, past-president of ASAPS.

On the ASAPS Web site, Paul predicts, "As our life expectancy continues to increase, having cosmetic surgery in our 70s and 80s will become increasingly common. People today see no reason to age in the traditional way. They want to look their best at every age, and cosmetic surgery can help them do that."

Leipziger concurs. "As the baby boomers are aging, this is becoming obvious," he says. "They are taking better care of themselves: exercising, dieting, then they look in the mirror and may not see how they feel on the inside."

His oldest face-lift patient was 82. "She was exceedingly healthy. She took no medication and swam a mile a day," Leipziger says. "I see men coming in, too, some to make their eyes look more refreshed and some for face-lifts. The key is, as long as the patient is healthy and has realistic expectations as to what can be accomplished. There's tremendous improvement in self-esteem and personal empowerment."

Of course, those improvements aren't cheap and generally are not covered by health insurance. Costs range from about $2,900 for eyelid surgery to more than $6,700 for a full face-lift, according to ASAPS, and that only covers the surgeon's fee. The hospital stay, anesthesia, prescriptions and other related costs will add considerably to the final bill.

Pav, a former Kings Park resident who lives in South Carolina but is on Long Island frequently to baby-sit her five grandchildren, was motivated to have a face-lift by "a tired look" and she also overheard men making comments about a woman's sagging neck as a telltale sign of aging. She decided the time had come to bring her facial features in sync with her youthful outlook.

During a recent visit to Leipziger's Great Neck office for a periodic maintenance facial, Pav, a vivacious woman with strawberry blond hair, recalled, "People would ask me if I was tired, and I was not. I'm very energetic. . . . I think it was the whole droop; that's what I was really concerned with . . . I think the neck is a big giveaway," she says. "You start wearing a lot of turtlenecks and scarves . . . . The question of age never entered my mind because I don't feel my age," she says. "I'm always keeping myself in good shape to the best of my ability. I've always been self-confident, friendly and outgoing, which was being overshadowed by my declining appearance."

Sandee's impetus was her daughter's engagement. An attorney who practiced in the state appellate courts before changing careers, she decided to undergo the surgery after years of "being bothered about how I looked. I always thought I had a pretty face, but I was unhappy because I started to get those folds around the nose and mouth," she says. "Dr. Leipziger had me go to my internist for a full examination. Everything checked out fine. By the time of my daughter's wedding three months later, I felt like the bride. It was just a matter of looking like myself again."

Sandee said, "I'm happy out there showing off my face. I feel when I'm talking to my students I'm not an old school marm; I feel more contemporary. It definitely cheers you up to look as good as you feel inside."

But, she acknowledges, "There's still a stigma, that this is self-absorbing, that it's for celebrities. I think that's old hat. It's affirming, a confidence builder. That's one of the reasons I'm exposing myself to anybody that's dillydallying like I did."

For those on the fence, she advises, "Take the plunge. It has its rewards. Even at this age, there are a lot of wonderful things out there to do. These are precious years."