64 years old - When should I schedule my mommy makeover surgery? (Photos)

Question

I am 64.5 years old I I have lost 136 lb and and my current BMI is is 32. With my age and approaching medicare I am trying to decide when to schedule an appt. I am still losing weight but slowly at about 1lb per week. I would like to get a tummy tuck and breast lift but also would like insurance to cover at least some of the cost. I am concerned whether age restrictions or medicare will make this more difficult so looking for guidance on this. Thank you!

Gary M. Horndeski, MD · Answer

I would begin with your breasts using The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided and nipple sensation (in 95%) is maintained. After this has been completed, then you can consider a tummy tuck. You will most likely need a circumferential approach. The technique I recommend is abdominoplasty with mesh reinforcement. The mesh creates a more hourglass figure by compressing the abdominal wall resulting in early satiety and helps maintain a reduced weight. After this has been completed, then you can consider a posterior lift.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

James B. Depew, MD, FACS · Answer

Congratulation on your successful and ongoing weight loss journey! BMI should optimally be under 30 for a cosmetic procedure, but based on your individual presentation you may still be a candidate for surgery. For example, we have a hard stop at BMI 40 in our surgery center for all procedures and take into account the individual patient when offering surgery. It is unlikely that insurance will offer coverage for any part of either procedures, so don't worry so much about insurance or medicare. Age is only a part of the evaluation and your entire health picture should be optimized prior to surgery. I would recommend hitting your maximal weight loss goal with at least 3 months of stability before proceeding with surgery. 
Speak with your board-certified plastic surgeon for their best recommendations.

Johanna D'Agostino, MD · Answer

Congratulations on your weight loss journey!! 136lbs is very impressive! More important than your age, is to confirm that you are in good health to undergo an elective procedure such a breast lift or an abdominoplasty. During the consultation with your plastic surgeon, any risk factors can be identified and at that point, timing for surgery can be determined. It is important, that prior to undergoing any procedures, you have reach your weight loss goal and that your weight has remained stable for at least 6 months. Continuing to loose weight after surgery may lead to development of additional excess skin and suboptimal results. Good luck!!!!

Daniel Barrett, MD · Answer

Dear givmemo11,
generally speaking, you want to reach your goal weight before you consider a tummy tuck, otherwise your results will be suboptimal if you continue to lose weight after the surgery. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Thomas Trevisani, MD · Answer

Congratulations on your weight loss. Based on limited photos - you appear to be a good candidate for Extended abdominoplasty and extended breast lift. Keep in mind that Medicare does not cover Cosmetic Surgery procedures. I suggest that you save the money and once ready consult with an experienced Board Certified PS

Connie Hiers, MD, FACS · Answer

No insurance will cover the breast lift. That is always considered cosmetic. If you are close to your goal weight, consider doing the breast lift now. Once you are where you wish to be or are no longer losing weight, then discuss doing the tuck. Many surgeons do not take Medicare for the tummy tuck surgery since Medicare pays poorly.  If you want Medicare to cover this, you may need to go to a University Hospital.  You will need a medical clearance from your primary physician for both procedures. If Medicare does cover your tuck, do not do it at the same time as the breast surgery or they will deny payment. Also, Medicare does not give prior approval for surgery.

Joseph Batac, MD · Answer

Good day and thank you for your question! Your age alone should not be a restriction to pursuing surgery however if you do have significant medical issues that might. It is important to ensure that your weight has been stable before undergoing surgery. If you are still loosing weight, I would advise you to wait until you have achieved your desired weight goal and your weight is stable. A BMI of less than 30 would be ideal. I congratulate you for loosing the weight and wish you luck with the rest of your journey.
Cheers,Joseph Batac, M.D.
Double board certified Plastic surgeon

Camille Cash, MD · Answer

Congratulations on your impressive weight loss!  You should consider surgery after you have reached your goal weight and are able to maintain it.  Typically a tummy tuck and breast lift are considered cosmetic procedures and are not covered by insurance.  Your age will not eliminate your consideration for surgery if you are generally healthy and otherwise a good candidate for the procedures that interest you.  I've included a video I hope you find helpful.

Mark Eberbach, MD · Answer

Good for you. You must feel so much better.

The general rule is that you should be weight stable for a year. My limit is 6 months if testing demonstrates good nutritional reserves.

Eric W. Khairalla, MD · Answer

The internet is an excellent place to begin your research! When your ready, find a board certified plastic surgeon and start the process&mdash; have them evaluate you in person, make recommendations, and allow them to be a part of your exciting journey! It's never too early too get started and I hope I speak for my fellow surgeons when I say, we want to be a part of your process from start to finish! Wishing you a healthy and happy day. 
Sincerely, the team at bodze