What happened
On September 1, 2026, the American Society of Plastic Surgeons released its 2025 Procedural Statistics Report, and the number that traveled furthest was not the overall 7 percent growth in cosmetic surgery but the age breakdown behind it. Patients 66 and older recorded a 24 percent rise in procedure volume, the largest gain of any age group, while procedures among patients under 36 fell and the 18 to 25 group dropped 9 percent. The Wall Street Journal ran the figure on September 4 under the headline that plastic surgery is booming with boomers, noting double-digit growth in facelifts, tummy tucks, arm lifts, thigh lifts, and breast augmentation among the over-66s. The Daily Beast reported the same day that the most requested procedure in that group was eyelid surgery, and quoted a former ASPS president saying these patients are not trying to look thirty again. ASPS itself framed the year around restoration after life changes, and reported that 82 percent of its member surgeons had received consultation requests related to GLP-1 weight loss. I am writing about this because the same shift is visible in my own consultations: a growing share of the people who send me photographs are in their sixties and seventies, and they ask different questions from the patients I saw ten years ago.
The common misconception
The assumption is that surgery after 65 is either vanity or a different, riskier kind of surgery. Neither holds. The older patients driving this growth are not asking for a new face. They are asking for the face and body they had before a decade of change, weight loss, or a bereavement took it away, and the operations they choose are the same operations everyone else has, done with more preparation and more honest expectations. The growth is not a fad. It is what happens when people work into their seventies, lose weight in their sixties, and stop accepting that the mirror should match a birth certificate.
The clinical reality
What older patients ask for is restoration, and the procedure list shows it. ASPS put restoration after life changes at the top of its list of motivations for 2025, ahead of enhancement. In the over-66 group the procedures that grew were lifts, eyelids, and the body operations that follow weight loss. Eyelid surgery leads for a reason: heavy upper lids are the one aging change that is both visible and functional, narrowing the upper field of vision and producing the tired look that patients describe more often than any wrinkle. The second most common request I hear from this group is the neck, and the third is the “I look angry” combination of brow descent and hooded lids. None of these is a request to look young. They are requests to look rested, awake, and like themselves.
Weight loss in later life has created a new group of patients, and it is the same group in every age bracket. The ASPS figure that 82 percent of surgeons fielded GLP-1-related consultations does not carry an age split, but the arm lifts, thigh lifts, and tummy tucks growing among the over-66s are the operations that weight loss creates, whether the weight was lost with medication, after bariatric surgery, or through illness. A 68-year-old who has lost 25 kilograms has the same loose arms and the same empty face as a 45-year-old who has, and less skin elasticity to recover with. I cover the facial side of this on the page about facelift timing after rapid weight loss; the principle is the same for the body.
The safety data support the trend, with one exception. A 2015 analysis in the Aesthetic Surgery Journal drew on the CosmetAssure insurance database, covering 183,914 cosmetic procedures, of which 6,786 were performed on patients aged 65 and older. The overall complication rate was not significantly different between older and younger patients; the most common problems in the older group were hematoma and infection, the same as at any age. The one exception was abdominoplasty, where the elderly had a higher complication rate. Patients aged 80 and over had a complication rate of 2.2 percent, again not significantly different from younger patients. For the facelift specifically, a 2011 series in Plastic and Reconstructive Surgery compared 216 consecutive operations from one surgeon, 68 of them in patients 65 and older with an average age of 70: the older patients had more comorbidities and more previous facelifts, and complication rates that matched the younger group, 2.9 versus 2.0 percent major and 5.9 versus 6.1 percent minor, with no deaths. The authors’ phrase was “carefully selected elderly patients”, and the selection is the point.
What multiplies risk is the combination, not the candle count. The same CosmetAssure database was used in 2017 to examine 31,010 liposuction patients. Liposuction alone had a major complication rate of 0.7 percent; combined with other procedures in the same session the relative risk rose almost fivefold, to 4.81. Age was an independent predictor too, but at a relative risk of 1.01 per year it was a small effect beside the combination effect. This is the variable I plan around for older patients, and the line I draw is between regions, not between procedures. The face is one region: a facelift, eyelids, a neck lift, a brow lift, and fat grafting belong to one plan, one anesthetic, and one recovery, and I do them together at 70 as I do at 50. What I do not combine is a facelift with body surgery. The older patient who has lost weight and wants the face and the arms or abdomen done has two operations on two dates, and the body session itself follows the same limits I apply to every patient: at most three major lifts, and liposuction added only where it does not stretch the operating time.
Older tissue changes the technique and the timeline, not the indication. Skin in the seventies is thinner and less elastic, the deep structures have descended further, and healing runs slower. That changes how I operate: more work in the deep layer, less reliance on skin tension, a lighter hand with fat grafting, and a conservative approach to eyelid skin where the lid margin has less support. It changes what I promise: a good result at 72 is a rested, natural face that ages on from there, not the face of a 50-year-old. And it changes the recovery conversation. The timeline on the facelift swelling page runs at the slower end of the range in older patients, and I tell them so in advance.
My position is that these are the same operations with one extra layer of preparation, and I do not skip that layer for anyone. Every patient over 65 who comes to me for elective surgery has a cardiology assessment and an anesthesia consultation before I confirm a date, with an ECG and blood work at minimum and further testing if the cardiologist wants it. Blood thinners, blood pressure tablets, and diabetes medication each need a plan, coordinated with the patient’s own doctor at home. When I have declined an older patient, the reason has been an uncontrolled medical condition, a smoker who would not stop, or an expectation no operation could meet. It has never been the age. The growth ASPS is reporting is, in my view, overdue, and the right response from surgeons is not to celebrate it but to prepare for it properly.
The practical takeaway for patients
If you are over 65 and thinking about surgery, start with your own doctor, not a surgeon. Ask for a current medication list, a recent ECG, and your latest blood work. Then send photographs: for the face, front, both sides, and both three-quarter views, without makeup, in daylight; for the body, front, back, and both sides, standing. Tell me the one or two things that bother you most, because that decides what I do first and what I stage. Ask any surgeon whether they operate on patients your age routinely, what their medical clearance involves, and how they decide what to combine in one session. The surgery readiness check walks through the medical questions I ask before confirming a date, and the recovery planner shows a realistic timeline for a facelift or eyelid surgery.
Honest limits
The ASPS figures are US procedure counts from member surgeons, not a global survey, and a 24 percent rise in a smaller age group is a large percentage on a modest base. The CosmetAssure data cover insured patients treated by board-certified surgeons, which is a screened population; the results describe well-prepared older patients, not all of them. Abdominoplasty carried higher risk in the elderly in that database, and I treat it as the one operation where age itself changes my threshold. The facelift series is a single surgeon’s cases, not a trial. And none of this applies to the patient with heart failure, a recent stroke, poorly controlled diabetes, or dementia, where the answer is no regardless of the mirror. Fitness for surgery is a medical judgment, not a birthday.
If you are in your sixties or seventies and want a frank opinion, send your photographs and a note on your health and medications to +90 544 772 0772 on WhatsApp. The surgical team reviews photographs the same day and I reply with what I would recommend, what I would stage, and what I would not do.
Dr. Mustafa Aydınol is a plastic, reconstructive and aesthetic surgeon in Istanbul and a member of ISAPS.
Sources
- American Society of Plastic Surgeons. Lift Procedures Led Growth as Demand for Restoration Drove Plastic Surgery in 2025, New ASPS Report Reveals. 2025 Procedural Statistics Report; cosmetic surgery up 7 percent, patients 66 and older up 24 percent, ages 18 to 25 down 9 percent, 82 percent of member surgeons reporting GLP-1-related consultations. Press release, September 1, 2026. Link
- The Wall Street Journal, via Yahoo Finance. Plastic surgery is booming with boomers. Here’s how to cash in on the antiaging craze. Double-digit growth in facelifts, tummy tucks, arm lifts, thigh lifts and breast augmentation among patients 66 and older. September 4, 2026. Link
- The Daily Beast. Baby Boomers Are Flocking to This Plastic Surgery Procedure. Eyelid surgery the most requested procedure in the 66 and older group. September 4, 2026. Link
- Yeslev M, Gupta V, Winocour J, Shack RB, Grotting JC, Higdon KK. Safety of Cosmetic Procedures in Elderly and Octogenarian Patients. CosmetAssure database, 183,914 procedures, 6,786 patients aged 65 and older; no overall difference in postoperative complications, abdominoplasty the exception, 2.2 percent in patients 80 and over. Aesthetic Surgery Journal, 2015. DOI
- Martén E, Langevin CJ, Kaswan S, Zins JE. The safety of rhytidectomy in the elderly. 216 consecutive facelifts, 68 patients aged 65 and older; major complications 2.9 versus 2.0 percent, minor 5.9 versus 6.1 percent, no deaths. Plastic and Reconstructive Surgery, 2011. DOI
- Kaoutzanis C, Gupta V, Winocour J, et al. Cosmetic Liposuction: Preoperative Risk Factors, Major Complication Rates, and Safety of Combined Procedures. CosmetAssure database, 31,010 patients; major complications 0.7 percent for liposuction alone, relative risk 4.81 when combined with other procedures, age RR 1.01 per year. Aesthetic Surgery Journal, 2017. DOI
