Patients over 65 chose facelifts more than any other surgery. Does age raise the risk?

Who this is for

This is for the physician or medical professional who owns a plastic surgery practice or med spa that treats patients over 65. It is also for the operations lead who decides which patients the practice markets to and how consults are booked and staffed.

What we found

In The Aesthetic Society's 2023 statistics, patients 65 and older had 199,284 cosmetic surgical procedures, 11.9% of the total. Facelift and eyelid surgery led by volume. Three studies of older facelift and cosmetic patients found complications did not rise with age. Two credit strict screening before surgery, which means not operating when a patient's screening results fall short.^1,2,3,4

How large is the 65-and-older patient group?

The U.S. Census Bureau counted 44.7 million people 65 and older on July 1, 2013, or 14.1% of the population.⁵ This population is projected to grow for decades. A 2020 bureau report puts the 65-and-older population at 49 million in 2016 and 95 million in 2060. By 2030, it says, "one in five Americans will be 65 years and older."⁶

It follows that older patients still make up a large share of cosmetic procedures, though Generation X makes up the largest. The American Society of Plastic Surgeons (ASPS) reported that baby boomers, ages 55 to 69, accounted for 30% of total cosmetic procedures in 2022. Patients over 70 accounted for 3%, and Generation X, ages 40 to 54, for 45%.⁷

The same release says patients spent "upwards of $26 billion" on minimally invasive and surgical procedures in the US that year.⁷

CareCredit, the patient financing card owned by Synchrony, cites surgical research by the society behind the 2023 statistics and CosmetAssure, a cosmetic surgery insurer. In its words, "almost 4 in 10 aesthetic surgical procedures (39.6%) performed in 2023 involved patients over the age of 50."⁸

Which procedures lead for patients 65 and older?

The society's 2023 statistics rank surgical procedures by age band. For patients 65 and older, facelift came first at 41,840 procedures, eyelid surgery second at 39,745 and liposuction third at 24,227. Patients 65 and older had 43.6% of all US facelifts that year.¹

For patients 51 to 64, liposuction led at 100,243, followed by eyelid surgery at 54,678 and tummy tuck at 50,773. Facelift came fourth for that group, at 46,457, which is more facelifts than patients 65 and older had.¹

Shifting to higher-volume, nonsurgical procedures for the wider picture: the International Society of Aesthetic Plastic Surgery (ISAPS) counts what its member surgeons report worldwide. In 2024 it counted 473,277 botulinum toxin injections in people 65 and older, and 1,861,557 in people 51 to 64.⁹ For what patients pay for those injections, see what patients pay for Botox.

Its full 2024 report puts eyelid surgery first among surgical procedures worldwide across all age groups, at 2,115,360.¹⁰

Does being over 65 raise the complication rate after a facelift?

No, it seems. Three studies, published from 2015 to 2026, found no rise in complications with age.

A 2026 study in the Aesthetic Surgery Journal followed 541 facelift patients of a single surgeon and compared complications across age groups.³

Its abstract reports major complications (unplanned admission, a return to surgery or lasting nerve injury affecting movement) in 0.4% of patients, with no difference by age. Minor complications, the ones managed without a hospital stay, occurred in 7.6% and were also not associated with age.³

For patients older than 75, the abstract gives an odds ratio of 1.82, with a 95% confidence interval of 0.51 to 5.19. That interval runs from below 1 to above 1. So it is plausible there is no difference in complication risk for those who undergo surgery, though the range also allows a higher risk.³

The abstract credits "strict preoperative screening and standardized management." It concludes that "chronological age alone is therefore not an independent predictor of adverse events after rhytidectomy," the clinical name for a facelift.³

A 2015 study in the same journal examined cosmetic procedures in older patients, including octogenarians, people in their eighties. Its abstract reports a complication rate of 2.2% in octogenarians, "not significantly different from the younger population." Hematoma and infection led complications in elderly patients.²

A 2021 review in Plastic and Reconstructive Surgery Global Open describes an earlier series of 216 consecutive facelifts in patients above and under 65. The older group had a higher American Society of Anesthesiologists (ASA) risk classification, a rating of health before anesthesia, and "no difference in minor or major postoperative complications." None exceeded ASA 3.⁴

The 2021 review also credits screening: "the elective nature of the procedure allows for strict preoperative screening to maintain a low complication rate."⁴ That suggests older patients at higher overall risk are likely discouraged or turned away before surgery. These low rates describe the patients surgeons accepted.

How are vendors pitching practices on patients over 65?

We reviewed two vendors pitching practices on older patients: a financing company and a practice software company.

The financing company's page points to disposable income and free time as likely reasons older adults book so many procedures. It credits "a greater amount of disposable income, extra time to focus on themselves," and a wish to age gracefully, in a piece written about empty nesters and retirees.⁸

Consentz, a practice software vendor, advertises list segmentation with the line "want to send marketing material to all your patients over 65?" Its page says targeted email and SMS campaigns "increase your conversion and retention rates."¹¹

Our suggestions, based on these sources, include the following. First, pull your share of consults from patients 65 and older, and how many of them book surgery over at least a year. Second, time the screening each older patient needs, since two of the three safety studies credit it for their low complication rates. Estimate how that extra time, and the chance a patient is not cleared, may affect your top line. Third, check whether your before-and-after gallery documents patients 65 and older, with an emphasis on facelifts, eyelid surgery and liposuction. Add a count of a year's facelift patients 65 and older. Together these show how this growing group and its choices affect the business.

About this review

We read 11 sources in October 2026. They were two U.S. Census Bureau publications, three peer-reviewed papers, four society statistics documents, and two vendor pages. Each data point is credited to its own publisher and kept apart from the others.

The US population and procedure data run from 2013 to 2023, with Census projections to 2060. The ISAPS surveys cover procedures reported by plastic surgeons worldwide in 2024. The 2026 and 2015 papers were read as abstracts. The 2026 study covers one surgeon's facelift patients. The sources cut age into different bands, from 55 to 69 in one survey to 65 and older in others, and each data point keeps its publisher's own band. The Aesthetic Society's age table gives 24,227 liposuctions for patients 65 and older; its ranking page gives 24,237.

Fractional Aesthetics is a growth strategy practice for aesthetic medical businesses.