Can You Have a Breast Augmentation After age 50?

Breast augmentation remains among the most popular cosmetic surgery procedures worldwide with an estimated 2 million women having breast implants throughout the world every year. The average age for breast augmentation is 35 years old reflecting that many women have this procedure after their childbearing years.  Over 50% of women having this procedure are between the age of 18 and 34 while about 35% are between the ages of 35 and 50.  The percent of women having breast augmentation after age 50 is about 9%.  

Let us look at that population.  Why do women after age 50 decide upon this procedure? Clearly, age alone affects the appearance of the breast with many women complaining that the upper part of the chest now looks flat.  This is a consequence of childbirth as well as aging and it is the rare patient over 50 who has a full upper pole off the breast. The most common complaint is that they can't find clothes or bathing suits to fit properly.

There are a lot of factors influencing the decision after age 50.  In some cases, financial considerations come into play where women finally have the resources to afford the surgery.    In others, changes in marital status such as divorce or widowhood can lead to the desire to improve appearance of the aging breast.  Dr. Glenn Lyle often sees patients who state that they " just want to look better in their clothing " and it is not so much a consideration of their appearance without clothing.

Whatever the motivation, breast augmentation after age 50 can be a very safe and effective procedure.  Factors determining suitability include: health problems that may coexist- are you a good candidate? Some health conditions such as heart problems or diabetes may preclude the performance of this procedure.  This has to determined with consultation with the plastic surgeon and often the opinion of other health care providers such as your primary care physician. With 30 years of experience, Dr. Lyle is well suited to help women make that decision with a careful history and physical exam and review of medical records.  Also, personal history of breast cancer, strong family history or concerning mammograms may affect suitability. Although breast implants generally rarely interfere with detection of cancer- mammography must be done somewhat differently with special views to image the breast tissue. Prior lumpectomy or radiation will certainly affect outcomes. Surveillance for cancer should take top priority over cosmetic concerns.

Finally- what are the expectations? A severely ptotic or sagging breast will not be improved by implants alone.  Typically, women develop additional sagging of the breast tissues and may be better suited for mastopexy or mastopexy with augmentation.  Breast augmentation is not a great treatment for significant breast ptosis where the nipple starts to fall below the inframammary fold. 

 Other considerations such as implant location above or below the muscle should come into play. In general, positioning of the breast implant beneath the muscle is a more popular technique and it is felt that mammograms are somewhat more effective as there is less interface between the breast tissue and the implant. Technically, implants are never completely under the muscle. Most plastic surgeons use what is called "dual plane positioning" with approximately two thirds of the implant under the muscle and the lower portion under the inferior gland.

 Capsular contracture, which is abnormal scarring around the implant, is also less common with submuscular techniques.  However, as the breast descends on the chest, sometimes sub glandular or subfascial positioning overcomes the need to do a breast lift.  Other questions such as implant choice-silicone versus saline also should be considered.  Although saline implants do not feel as natural, they do have the advantage of early detection of a breast implant rupture which occurs with both implant types and is estimated to occur in 10% or more in women after 10 years.

Although breast implants have become safer with development of newer technologies, there are still significant complications that can occur, and implants are not designed to last a lifetime so ongoing monitoring of the breast with physical examination and imaging is recommended for all women.

This 71-year-old woman had a very active lifestyle and worked out in a gym on a regular basis.  She was very self--conscious with her appearance in her workout clothing and wished to have improvements in her chest.  She felt younger than her age and wanted to look the part, so she underwent submuscular positioning of 345 cc Allergan moderate profile silicone gel implants and was very happy with her new physique and her appearance in tighter fitting clothing. Despite being under the muscle, she had no problems resuming her vigorous workouts.

If you have been thinking about breast augmentation but worried that you are too old, it is recommended to have a thoughtful consultation with Dr. Glenn Lyle at Lyle Plastic Surgery Aesthetic Center.