Homescientific articlesAesthetic Surgery in Older Patients: Risk Factors and Clinical Outcomes – Evidence From Systematic Reviews and Meta-Analyses
Published on: 17/08/2026
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Aesthetic Surgery in Older Patients: Risk Factors and Clinical Outcomes - Evidence From Systematic Reviews and Meta-Analyses
Edited by Dr. Skerdi Faria, with the contribution of the Scientific Committee of the KEIT Day Hospital.
Increasing life expectancy and improvements in general health have led to growing demand for aesthetic surgery procedures among older patients. Although advanced age is associated with a higher prevalence of comorbidities and physiological changes that may affect healing, age alone does not represent an absolute contraindication to aesthetic surgery. This review examines the available PubMed-indexed evidence, with particular attention to factors associated with surgical risk, post-operative complications, aesthetic outcomes, and the safety of procedures in older patients.
Table of Contents:
PubMed search strategy and evidence selection criteria
A targeted PubMed search was conducted for this review, including systematic reviews, meta-analyses, and comparative clinical studies evaluating plastic and aesthetic surgery outcomes in older patients. Studies were selected if they assessed post-operative complications associated with advanced age, major individual and surgical risk factors, clinical and aesthetic outcomes, and the safety profile of aesthetic procedures in older patients compared with younger age groups. Priority was given to publications reporting pooled quantitative data, comparisons between age groups, and objective assessments of surgical outcomes in order to define more accurately the relationship between age, procedural risk, and post-operative outcomes.
Influence of advanced age on surgical risk in aesthetic surgery
The available evidence indicates that advanced age may be associated with an increased risk of certain complications, mainly because of the higher prevalence of associated systemic conditions and age-related physiological changes in tissues. The main factors that may influence outcomes include: – Reduced skin elasticity; – Altered tissue healing; – Higher prevalence of cardiovascular and metabolic disease; – Concomitant medication use; – Reduced tissue regenerative capacity. However, systematic reviews emphasise that risk does not depend solely on chronological age, but primarily on overall health status and appropriate patient selection.
Post-operative complications in older patients undergoing aesthetic surgery
Available meta-analyses suggest that older patients may have a higher risk of certain complications than younger patients, although this difference is strongly influenced by the presence of comorbidities. The main complications considered include: – Surgical site infections; – Hematomas and seromas; – Wound-healing problems; – Thromboembolic complications; – Need for surgical revision. Appropriate pre-operative assessment can, however, significantly reduce overall risk.
Role of comorbidities in risk assessment
In older patients undergoing aesthetic surgery, risk assessment should be based primarily on overall clinical status and the presence of associated comorbidities rather than on chronological age considered in isolation. The main factors that may influence peri-operative risk include: – Diabetes mellitus, because of its potential impact on wound healing and infection risk; – Poorly controlled hypertension, associated with increased cardiovascular risk; – Cardiovascular disease, which may affect tolerance of surgery; – Obesity, associated with an increased risk of surgical complications and impaired healing; – Coagulation disorders or anticoagulant therapy, with a potential increase in bleeding risk; – Compromised nutritional status, which may delay tissue repair processes. The available evidence suggests that, in carefully selected older patients who are appropriately optimised before surgery, surgical outcomes may be comparable with those observed in younger patients. Age should therefore be considered as one element of risk assessment, but not as an exclusive criterion for exclusion from aesthetic surgery.
Aesthetic outcomes and satisfaction in older patients
In older patients, aesthetic surgery is not aimed exclusively at improving physical appearance, but may also contribute to greater body satisfaction and overall psychological well-being. The available evidence indicates that aesthetic outcomes and post-operative satisfaction may be high in appropriately selected patients, provided that tissue quality, individual clinical conditions, and realistic expectations regarding the achievable result are taken into account. Clear communication before surgery is essential to align the patient’s goals with the limitations of the procedure. Overall, advanced age does not appear to represent an absolute barrier to the aesthetic and psychological benefits of surgery when the indication is appropriate and the patient is properly assessed.
Aesthetic procedures most frequently performed in older patients
In older patients, the aesthetic surgical procedures most frequently evaluated in the literature primarily involve facial rejuvenation, body contouring, and interventions aimed at improving age-related tissue changes. The procedures most commonly considered include: – Facial surgery, including facelift and blepharoplasty, for the treatment of skin laxity and soft-tissue changes; – Breast surgery, performed to correct age-related changes, volume variations, or ptosis; – Body contouring procedures, often associated with changes in fat distribution and skin quality; – Soft-tissue procedures aimed at improving body contour and overall harmony. The risk profile does not depend exclusively on the type of procedure, but on the interaction between procedural complexity, the patient’s clinical condition, and the quality of the pre-operative assessment.
Strategies to improve safety and surgical outcomes
The safety of aesthetic surgery in older patients depends primarily on individualised risk assessment and careful management throughout all stages of the surgical pathway. The most relevant strategies include: – Comprehensive pre-operative medical assessment to identify potential risk factors and clinical conditions requiring optimisation; – Management of modifiable comorbidities to reduce peri-operative risk; – Selection of the most appropriate procedure based on anatomical characteristics, aesthetic goals, and the patient’s general condition; – Careful peri-operative management, with particular attention to complication prevention; – Individualised follow-up to monitor healing and identify potential problems at an early stage. Overall, the evidence suggests that chronological age is only one of the factors to consider: the best outcomes are achieved through appropriate patient selection, adequate pre-operative preparation, and individualised surgical management.
Clinical implications of aesthetic surgery in older patients
Aesthetic surgery in older patients can provide satisfactory outcomes and meaningful benefits when performed in appropriately selected individuals with careful risk assessment and realistic expectations. The main clinical implications include: – Individualised assessment of surgical risk, taking into account overall health status and associated factors; – Careful management of comorbidities to optimise peri-operative safety; – Selection of the most appropriate procedure, tailored to the patient’s anatomical characteristics and goals; – Clear and transparent communication, which is essential for establishing realistic outcomes and improving post-operative satisfaction. Overall, the evidence indicates that advanced age should not be considered an absolute exclusion criterion for aesthetic surgery. Patient selection, rather than chronological age, is the principal determinant of safety, clinical outcomes, and final satisfaction.
Bibliography: PubMed evidence on aesthetic surgery in older patients
"To offer patients an approach based on excellence, safety, and innovation in the field of aesthetic surgery, with high-level protocols and natural, harmonious results."
Education and Specializations:
• Degree in Medicine and Surgery (1995)
• Specialization in Public Health (2002, with honors, La Sapienza University, Rome)
• Specialization in Anesthesia and Resuscitation (2009, with honors, Tor Vergata University, Rome)
• PhD in Hospital Infections (2005, with honors, La Sapienza University, Rome)
Career and Recognition:
• Founder and Director of KEIT Day Hospital (since 2011)
• Author of numerous scientific studies published on PubMed and Google Scholar
• Expert in aesthetic surgery, hospital infections, and advanced anesthesia protocols
• Gold Medal (1989, Ministry of Public Education – Albania), Energie per Roma (2025, European Center for Cultural Studies – Rome) and others.
Media and Public Recognition:
Dr. Skerdi Faria has been recognized as one of the most influential doctors in the field of aesthetic surgery and has been interviewed and cited by major media outlets in Albania and Italy, including:
• Italy: Rai 1, Rai 2, Rai 3, Mediaset, La7, Corriere della Sera, Il Sole 24 Ore, Il Messaggero, La Gazzetta del Mezzogiorno, Il Tempo, Adnkronos.
• Albania: Top Channel, Klan TV, Vizion Plus, Shqiptarja.com, Panorama, Gazeta Express.
info@keit.al
Tirana: +355 68 20 00 622
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