Let’s be honest, most of us wish we could be living well into our 80s and beyond with our 30-year-old bodies. The aches, pains, and maladies of our elder years replaced by joints full of healthy cartilage and comparatively new organs. We all can appreciate how our bodies age over time. If we are luckier than many we ease into our elder years with minor concerns avoiding the larger pitfalls of life such as persistent pain, recurrent illness, chronic disease, and immobility. While the vigor of youth is a fading but tender memory there are many that still wish to retain, nay even recapture, the beauty of their youth. If not the beauty of youth, perhaps recapturing a more pain free existence and circumventing other maladies of aging.
As adult children the thought of our parent undergoing any surgical procedure is, at best, slightly terrifying. Of course, some surgeries are unfortunately unavoidable and indisputably necessary. An increasing number of seniors are undertaking surgeries that are not so much life-saving, yet medically beneficial and life-enhancing. What is the appeal for our aging loved one to go under the knife for a seemingly supplementary procedure? Do the purported benefits outweigh the risks?
With the vast spectrum of procedures available, let’s make a clear distinction (for the purposes of this read). There is surgery that can be deemed medically necessary/permissible and there is surgery that is determined to be strictly elective/optional. Further complicating the matter is the verbiage and semantics used by insurance companies and medical professionals which don’t always see eye to cosmetically enhanced eye. Is a knee replacement medically necessary/permissible because it would ensure one’s mobility and quality of life or is it elective/optional because it is not an emergency procedure or life-saving?
Procedures that are deemed medically necessary/permissible must improve the health and/or function of a person’s body. Many of these procedures can also be cosmetic as a collateral result and a secondary function of the procedure(s). While the aim of the surgery would be to restore or improve upon previous function or health of the body, an improved cosmetic appearance can also be accumulated and accounted for in such surgeries.
Elective/optional cosmetic surgery does not fulfill the qualifications of being necessary to improve the health or function of a person’s body. Cosmetic surgery deemed to be elective/optional would be strictly for aesthetics, trying to outmaneuver the forces of mother nature to capture one’s ideal desired look. There are the plastic surgery extremes like Joan Rivers, most of the Jackson musical family, and plenty of others that serve as a cautionary tale of overindulgence. There are both patients and doctors that embody what is wrong with elective/optional surgery, yet many other exemplifications of how certain procedures can undoubtably help improve the lives of their recipients both in function and form.
Often medically necessary/permissible procedures and cosmetic procedures are not mutually exclusive. Many procedures are dual in their function to help the body perform in the best way possible and improve a person’s appearance. It is well documented that plastic surgery can boost self-confidence and self-esteem leading to improved mental health. In turn, this is significantly impactful to a person’s overall health and recovery especially when healing from accidents, injury, or disease.
Common medically necessary/permissible procedures with a cosmetic component include reconstructive surgery after disease or injury. If a person has been badly injured in an accident or some other traumatic incident, surgery is used to help restore function and appearance to what it was pre-injury or perhaps even improving function and/or aesthetics. Restoring one’s body to its original or better condition is deemed necessary for the body part(s) to function properly individually and as part of the collective whole. Reconstructive surgery covers a wide range of procedures on a variety of body parts from the tip of one’s head to the tip of one’s toes. Breast reconstruction is often utilized after a mastectomy, skin reconstruction for patients suffering from burns or other scarring injuries.
Excess skin from major weight loss is a medical concern as it can cause physical pain and negatively impact personal hygiene. It can also affect mobility and limit physical activity which can be detrimental to maintaining one’s healthy weight goals, after having recently lost excessive weight. Excess skin removal (panniculectomy) is surgery to remove the extra skin remaining after significant weight loss. When this surgery is to correct or relieve physical symptoms associated with excess skin (such as pain or repeat skin infections), it is considered reconstructive and a medically necessary/permissible procedure.
Correction of a deviated septum is common whether nose is damaged due to accident/injury or as a birth defect. A deviated septum can cause difficulty breathing, chronic sinus infections, and/or sleep apnea. Correction of a deviated septum is often combined with a cosmetic component to ensure the nose looks correct after surgery.
Breast reduction surgery is a common medically necessary/permissible procedure as breasts that are unnaturally large can cause physical strain to one’s body resulting in back, neck, and shoulder pain. Eyelid procedures (eye lifts, eye revitalization) are often medically necessary/permissible as significant eyelid drooping causes skin to hang down into or over the eyelashes, affecting a person’s ability to see. This impacts many aspects of life including reading, driving, utilizing a computer, and more. Wearing glasses or contact lenses can also be difficult with drooping eyelids further impacting already compromised vision.
Bunion removal (bunionectomy) is another common surgery. Bunions are bony bumps on the joint at the base of a toe which pushes one toe against another. Occasionally this pressure may even cause the toes to overlap. Sometimes bunions are a result of improper footwear, other times they are unavoidable due to any number of other factors. Very often bunions are painful. Pain and functional limitations are qualifying factors for medically necessary/permissible surgery regardless if the bunions are the result of genetics or a lifetime of high heeled shoes.
Varicose veins are often associated with pain and functional limitations. When varicose veins are associated with symptoms that are unable to be alleviated with non-surgical, non-invasive therapies (support stockings, massage therapy, acupuncture, etc.) then varicose vein surgery can also qualify as medically necessary/permissible.
The removal of beauty marks, or moles, are another dual medical and cosmetic procedure that may be deemed medically necessary/permissible. Suspicious moles are often removed and biopsied as a precaution to circumvent potential skin cancer. “Suspicious” moles have a wide range of qualifying characteristics including moles that have grown or shrunk, or otherwise changed shape and/or size. Moles that have uneven edges, are asymmetrical, those with large diameters, moles that bleed and/or itch are also all suspect and prone for removal. The removal and biopsy of a mole is a standard procedure and considered medically necessary/permissible. However, depending on a variety of factors its removal may result in scarring. If it does turn out to be cancerous however, reconstructive medical procedures to correct scarring may be permissible as a medially necessity instead being deemed elective.
As our aging loved ones elect to partake in medically necessary/permissible procedures, we must remember that the functional and cosmetic aspects of surgery are not mutually exclusive. Many procedures are both necessary to help the body function in the best way possible and serve to improve a person’s appearance post procedure. Grandma is not looking to get the breast implants of a 20-something centerfold, Grandpa isn’t giving up his daily golf game and getting liposuction. After careful consideration they are opting to have a procedure that can improve their body’s function and their quality of life without coming home looking like Frankenstein with scars and mismatched body parts. Since intrapersonal health is so intricately intertwined with one’s appearance and self-acceptance, the cosmetic component of medically necessary/permissible surgeries are still important even as we grow older and wiser. Let’s be supportive of our elderly loved ones as they look to improve their body, mind, and overall health.
Leah Felderman is a proud alumnus of University of Central Florida (BA) and San Diego State University (MA). She has worn many occupational hats including teaching, hospitality management, government contractor and non-profit organizer. She is an intrepid international traveler having visited over 60 countries before happily settling down into her new life chapter of domesticity as a mom and Coast Guard wife.
