Am I Still 
That Girl? Middle-aged Women & Plastic Surgery

A middle-aged woman has years of experience. It can be an asset 
and as a curse when it shows on her face and on her body.

Plastic surgery can lessen worry lines and uplift sagging breasts, however, before undergoing any type of procedure, area plastic surgeons say expectations of the results must be reasonable.

“I won’t operate unless I know there will be good results or if the patient’s goal is unrealistic,” says Dr. Adam Billet, a board-certified plastic surgeon with Plastic Surgery Associates 
of Tidewater in Chesapeake, Virginia.

For instance, someone who is in her 50s and wants her teenage body back, he says.

Determining Candidacy

A poor candidate is also someone who is having 
the surgery to please another person.

“If they come to me and say their boyfriend wants them to have bigger breasts, but they think their breasts are fine, then they are not a good candidate. 
A woman should only do it if she wants to have the work done,” says Dr. Johnstuart Guarnieri, a board- certified plastic surgeon with Williamsburg Plastic Surgery in Williamsburg, Virginia.

For those who are good candidates, a stomach bulge combined with sagging breasts are troubled spots due to child-bearing and child caring.
“This is when a mommy makeover is often recommended. It reduces the belly and lifts the 
breasts,” Guarnieri says.

Billet recommends liposuction in the stomach because it removes the fat and tightens the stomach muscles. But if a woman is considered obese, 
Billet says it is best to lose weight prior to surgery because of health concerns and risk of disappointment with the aftermath.

“If a woman is 5-foot-2-inches and 200 pounds, 
I tell her she needs to lose weight first because she 
is not going to have good results,” he says.

Some women opt for breast implants when having a breast lift, but Billet cautions that it takes more care because it is a medical device.

While weight loss is a good thing if needed, when a middle-aged woman does so, it can result in sagging skin. Guarnieri says tightening loose skin, such as on the neck, is possible.

A facelift is a surgical procedure that reduces the signs of aging by tightening the muscles and removing excess skin to give a more youthful appearance. Billet says most women do not want to change their overall appearance but rather improve what they have.

Many times, a woman can have a mini facelift which can be done in the office with a local anesthesia, he says.

“We can pull things up and tighten. The idea is to 
get a more youthful look without looking like 
a different person. Most women do not want to look like a different person,” Billet says.

He cites actress Renee Zellweger, 
whose recent plastic surgery came under fire in the media remarking that her overall appearance changed.

“She looks like a different person 
and it is not natural,” he says.

Guarnieri says some women 
opt not to do an entire facelift 
but instead receive Botox injections. Adding filler to 
the face is also an option.

“Putting volume to a face that has fallen is like putting a pole on a tent that has fallen down,” Guarnieri says.

In some cases, plastic surgery can be covered 
by medical insurance.

Billet says that if vision 
is impaired by sagging upper eye lids or brows, insurance should 
pay for it. This can improve vision 
as well as looks.
Women with large breasts that are beginning to sag can have breast reduction surgery.

“If they have such problems as backaches, 
chafing, and the bra straps are cutting into their shoulders, then it can be justified for insurance to cover,” Guarnieri says.

Both doctors agree that self-esteem increases after having plastic surgery.

“It is because they look better, they feel better. 
They become more outgoing and are able to do things like land that special job because their self-esteem has increased. It is not the flat tummy that got them the job, but that they are more confident because they have 
a flat tummy,” Billet says.

Guarnieri says that many times 
a spouse or partner tries to talk 
a woman out of plastic surgery.

“A husband might say you look good to me. But it is not just about looking good to her husband but rather looking good overall that she wants,” he says.

About the author

Susan Smigielski Acker

Susan Smigielski Acker is a freelance journalist and editor. Previously, she was a newspaper reporter in Georgia, a feature writer on the U.S. Army Kwajalein Atoll, Marshall Islands, and worked at NASA Langley Research Center. She resides in Newport News, Virginia, with her husband and two daughters.