Between the ages 25 and 65, the nose stretches by 10%, on average, its tip moving downward by about a quarter-inch. The brows can sink by a third of an inch, the ears by slightly more, the cheek tissue by as much as a half-inch. Overall, more than 30% of a person's facial area may drop from above the mid-face line into fleshy folds below.
"At some point you look in the mirror and you just can't believe it's you," said B.J. Roberts, 71, of Los Angeles, who recently had cosmetic surgery. "Everything is hanging, everything is sagging, and you just want to feel uplifted."
While most people who have cosmetic procedures done are middle-aged, Roberts' generation is hardly being left behind. The number of cosmetic procedures performed on people 65 and older has more than tripled, to about 450,000, during the past five years, according to statistics from organizations representing plastic surgeons. The most common procedures for this group are face lifts and eyelid surgery, and newer, nonsurgical techniques such as chemical peels and Botox injections, which are used to smooth out wrinkles.
And the numbers are expected to soar in coming years--as the oldest in the baby-boomer generation reach their 60s.
The reasons have much to do with how long, and how well, older Americans are living, researchers say. Seniors are more socially and sexually active in their later years than ever before. Millions of them are staying in the work force into their late 60s and 70s, competing with younger workers for jobs and promotions. And in both arenas, for better or worse, one's physical appearance matters.
"This is the Pepsi generation, the Viagra generation," said Dr. Loren Lipson, chief of geriatric medicine at the USC School of Medicine. "You retire now, and there's no question you could have 20 or 30 years of life left--good, active years. We're living in a society that is not only aging rapidly but living longer than ever before, and in much better health, because of exercise and better medications."
As a rule, many doctors who treat older patients are reluctant to recommend cosmetic work. It's expensive; there's always a risk of disappointment; and people in their 70s and 80s often have health concerns that are more pressing than looking "refreshed."
There are no signs, however, that such concerns are dampening the enthusiasm of seniors seeking cosmetic make-overs. The demand for such services is particularly brisk in communities where more affluent seniors have settled, particularly in Sun Belt states such as Arizona, California and Florida.
In retirement enclaves, where active seniors spend their days on golf courses and tennis courts, the usual reservations about surgery and age have broken down. "We'll see patients at 75 who had a bypass when they were 60, who are taking antihypertensive medications and who have some arthritis. They've got two new hips, and here they come off the tennis court saying, 'OK, doc, I want this, and I want that,'" said Dr. David Morrow, a dermatologist and plastic surgeon in Rancho Mirage.
Dr. Calvin Peters, a plastic surgeon in Orlando, Fla., estimates that he sees about three times as many seniors in his office as he did a decade ago. Other doctors estimate that as many as one in four of their patients are age 75 and older--a sharp difference from a few years ago. As long as they're medically stable and have no apparent psychological problems, they're candidates for facial work, said Morrow. "And you better not say the word 'old' to these people. They don't like it at all."
They don't like being treated as older, either, especially in the workplace. Many older Americans complain that they've been patronized, or made to feel invisible, by younger co-workers, said Clare Hushbeck, who handles workplace discrimination cases for the AARP. This perception is common among seniors across the professional ranks, from clerks to upper management, experts say.
'No Question This Is a Youth-Oriented Society'
"After a while, it's just a feeling you get. You notice a change in the way people treat you," said Eileen Barret, 68, an insurance consultant in New York who recently had cosmetic facial surgery. Younger colleagues "don't think you're as sharp, you're the old lady in the group. Maybe they have a grandmother who looks like you .... But there's no question this is a youth-oriented society, and if you want to stay competitive, you certainly don't want to look tired. You want to look alert, rested, like you've had a good sleep."
Barret said she has no intention of retiring soon. "I'm not ready. I love my work, and the fact is I feel the same way I did when I was 40," she said. After months of research about cosmetic procedures, she concluded: "If I'm to have something done, now's the time. This is my last hurrah."
