50, 60, 70 is the New….

by Dr. Alissa M. Shulman

Dr. Alissa M. Shulman is a board-certified plastic surgeon who founded her solo practice, Sovereign Plastic Surgery, in Sarasota, in 2009. Long before she became a cosmetic plastic surgeon, Dr. Shulman wholeheartedly pursued her passion for art. The unique combination of outstanding medical credentials and an in-depth artistic background truly sets Dr. Shulman apart from most other plastic surgeons.

Let’s face it, we are living longer, are more active, and continue to redefine what “old” is. As a plastic surgeon, I’m frequently asked “Doctor, am I too old for this procedure?” Rather than looking at the patient’s birth date, I look at their list of medications and medical conditions. This is the “age” that truly counts for elective surgery of any kind.

Now, I will also consider different factors for the “over 60” prospective surgery patient. Is the person on blood thinners? Is the surgery worth the risk of being off their medications for the necessary time before surgery? If this situation is part of the equation, I recommend the patient discuss this with their cardiologist before we proceed.

How long will the actual surgery take? After two or three hours of general anesthesia, the after-effects start building up. I think older patients do better with multiple shorter procedures — well-spaced. Virtually all surgeries for patients over 50 require a request be sent to their primary doctor for “surgical clearance.” As a surgeon, I also want to make sure that the doctor handling their overall health is kept in the loop.

Another (often ignored) factor to consider is help at home. Many older patients are living alone and do not want to bother their friends, thinking that they will be fine the next day. I try to make sure we have addressed this assumption thoroughly before surgery; I prefer someone stay with them at least a day after surgery. If there is truly no one available, my office can help connect the patient with one of the many wonderful nursing services in our area.

While I consider these factors with all my patients, it is doubly important for the more mature ones. Every potential surgery patient needs to ask themselves:  Is the risk of surgery worth the potential reward? Are the expected scars worth the risk? Are my expectations realistic?

I often meet two or more times with the patient to talk about the surgery plan. I have been known to change the plan after further consideration, and always want the patient to understand that there are many ways to address the same issue. This is not a simple mathematical formula with one solution; the initial consult is only the beginning.

Some of the most common procedures for my mature patients are breast lifts (mastopexy), old implant removal (+/- lift), abdominoplasty, and liposuction. Liposuction is the one I tend to be most cautious of, as the skin does not spring back very well after the age of 50. These patients need to expect excess skin (which could be removed with a separate surgery). Each of these surgeries is less than three hours.

Suffice it to say, age is more than just a number!

Sovereign Plastic Surgery is located at 1950 Arlington Street, Suite 112 in Sarasota. For an appointment, visit SovereignPS.com or call 941.366.LIPO (5476).