The high cost of looking young

Who wants to look old?

A nip here and a tuck there, and voila! You’ve discovered the fountain of youth.

But cosmetic plastic surgery isn’t cheap. And it’s usually not covered by insurance, unless there is some reconstructive purpose. So if you really want to go through with this rather radical way to improve your appearance, be prepared to pay out of pocket.

Here are 10 of the most popular, mostly cosmetic, procedures that people older than 50 choose. The list includes how many people got the procedure done in 2011 (you aren’t alone in wanting to look younger), what the procedure involves, and the average cost of each.

The list is courtesy of the American Society of Plastic Surgeons, with additional information from New York City-based plastic surgeon Dr. Darrick E. Antell, who says plastic surgery is good for overall health. “We change people on the outside, so they feel better on the inside,” he says.

Bankrate also talked to Dr. Tom D. Wang, president of the American Academy of Facial Plastic and Reconstructive Surgery, who has a surgical practice based in Oregon.

If you elect to get any of these procedures done, be sure to do your homework and select a plastic surgeon with plenty of experience and a blemish-free record to protect yourself from bungled operations.

Touch-up wrinkle remover

Touch-up wrinkle remover

  • Procedure: Botox injections
  • Total number in 2011: 5.7 million
  • Average cost: $365

Got crows’ feet? A lot of people think Botox is the answer. New York City plastic surgeon Antell says he regularly has Botox, or botulinum toxin, injected between his eyebrows. “It makes me look more relaxed,” he says. The American Society of Plastic Surgeons says this popular procedure is also good for getting rid of skin bands on the neck. A Botox procedure doesn’t last very long, but it can be repeated every four or five months.

If you only can afford to have it done once, it’s a good special-occasion pick-me-up — like when you’re going to an event where your ex-husband is sure to show up.

Don’t hide age spots, terminate them!

Don't hide those age spots: Terminate them!

  • Procedure: Chemical peel, microdermabrasion and laser skin resurfacing
  • Total number in 2011: 2.5 million
  • Average cost:
    Chemical peel: $653Microdermabrasion: $141Laser skin resurfacing: $1,223 to $2,169

If you really hate those “liver spots,” technically known as “solar lentigines,” a chemical peel is one solution. The cheapest option is microdermabrasion, which sands off the top layer of your skin so it looks younger and smoother. Mild chemical peels take off the top layer of skin and give you a healthy glow. Stronger peels will reduce lines on the upper lip. Sun exposure should be minimized after getting this done.

The next step up is laser skin resurfacing. The surgeon uses a laser to send pulsating beams of light at irregular skin. He can remove one layer at a time, getting rid of everything from wrinkles to enlarged pores and skin discolored by too much time in the sun. Nevertheless, Antell prefers peels to laser skin resurfacing. “(The) chemical peel has been around a lot longer than (the) laser, and I feel like I have more control,” he says.

Rid frown lines, highlight happiness

Eradicate frown lines, highlight happiness

  • Procedure: Soft-tissue fillers
  • Total number in 2011: 1.9 million
  • Average cost: Ranges from $468 to $1,658, depending on the procedure

If you’ve got your groove on, a plastic surgeon can fill it. Plastic surgeons call dermal fillers “liquid face-lifts” because they offer many of the benefits of a surgical face-lift without extensive surgery. This sort of procedure won’t get rid of lots of saggy skin, but it can make an aging face look much younger. The most common procedure eliminates the trough between your nose and the corner of your mouth. “As we get older, our faces sag and deflate. These injectable fillers restore the fullness of the face,” says Wang.

Wang says soft-tissue fillers are a good entry point for someone experimenting with enhancements. “It’s done in the office with no down time, and you see the results fast. Patients really find the results to be appealing and attractive.”

But you can’t count on it to last forever. Just like road repair, erosion wins in the end, and you’ll have to have the procedure repeated — at least once per year.

Mustache no more

Mustache no more

  • Procedure: Laser hair removal
  • Total number in 2011: 1.1 million
  • Average cost: $358

Mustaches look pretty good on a guy, but they don’t look so good on a woman. Of course, men have to worry about those ugly stray hairs that maturity can bring to a nose or ear. Laser hair removal uses beams of highly concentrated light to penetrate the hair follicles. The laser destroys the hair within the follicle. The procedure is very precise, and it doesn’t damage surrounding skin. The procedure has a high degree of success: 90 percent of the time, hair doesn’t come back after a treatment or two.

If you’re a blonde, this procedure won’t work as well. Of course, if you’re a blonde, those stray hairs are probably almost invisible.

Love not those love handles

Love not those love handles

  • Procedure: Liposuction
  • Total number in 2011: 204,702
  • Average cost: $2,859

Looking to get rid of those love handles, eradicate your tummy or excise that double chin? Liposuction sucks out the fat — permanently — and then the skin shrinks. Sometimes, the surgeon may tuck up any loose skin.

Don’t wait too long to opt for this procedure. At some point — probably by the time you are in your 60s — your skin won’t be elastic enough for liposuction to be effective.

Patients undergoing cosmetic liposuction or abdominoplasty (“tummy tuck”) procedures report significant improvements in self-esteem and quality of life, according to a study in a recent issue of Plastic and Reconstructive Surgery, the official journal of the American Society of Plastic Surgeons. The report found that 86 percent of people who had the procedure said they were happier after the surgery.

Wake up and smell the coffee

Wake up and smell the coffee

  • Procedure: Eyelid surgery
  • Total number in 2011: 196,286
  • Average cost: $2,741

When your eyelids droop, you look tired. Combine that with under-eye puffiness, and you can look 10 years older than you really are.

If you’re sick of people asking you if you’re sleepy, eyelid surgery is an option. This form of surgery could be covered by insurance if your droopy eyelid(s) affects your vision. Upper-eyelid surgery can remove puffiness there. Sagging skin that creates folds in the upper eyelid, sometimes impairing vision, can be lifted. Under-eye bags also can be eliminated.

A big bonus is that eyelid surgery is generally long-lasting. “Eyelid tucks make the eyes look bigger and less cluttered,” says Wang. “In terms of bang for the buck — the surgery that gives the best result at the least cost — this is it, the best.”

Put on a happy face

Put on a happy face

  • Procedure: Face-lift
  • Total number in 2011: 119,026
  • Average cost: $6,426

When gravity gets the best of your facial muscles, a face-lift is one way to shore them up. The best results are from surgery on people between the ages of 40 and 60. If you wait too long, you may not be as pleased with the results, and the lift is unlikely to last the 10 years surgeons say it should, according to a recent study reported by Plastic and Reconstructive Surgery.

Another study in the Archives of Facial Plastic Surgery reported in February 2012 that a face-lift makes observers think you are six to eight years younger than you are.

Suck it in!

Suck it in!

  • Procedure: Tummy tuck
  • Total number in 2011: 115,902
  • Average cost: $5,279

Have a baby or two, and your belly will never be the same again. And drinking too much beer can have the same effect on anyone. The skin and muscles stretch, and no amount of exercise will make your paunch go away. But a surgical tummy tuck can do it.

The surgeon makes a horizontal incision in the area between the pubic hairline and navel. Through the incision, he repairs the weakened abdominal muscles and removes excess fat and skin. After the swelling and bruising subside, you’ll have your body back — lump- and bump-free.

Defying gravity

Defying gravityc

  • Procedure: Breast lift
  • Total number in 2011: 90,679
  • Average cost: $4,286

If your bosom and your belly are getting to be close friends, a breast lift could be the answer. The surgeon makes an anchor-shaped incision below each nipple, then raises and reshapes the breasts — adding and subtracting to make the result more youthful. He also chops away excess skin. You are a good candidate for breast-lift surgery if you are physically healthy and not severely overweight. The surgery can correct breasts that are pendulous. It can also even out breasts when one is higher than the other. Over time, gravity will still take its toll. But as long as you don’t gain a lot of weight, your bosoms will still look more youthful.

Keep your chin up

Keep your chin up

  • Procedure: Chin augmentation
  • Total number in 2011: 20,680
  • Average cost: $1,851

Chin surgery reshapes the chin either by using an implant to make it appear more dominant or by removing part of the bone to make it less imposing. Strong, authoritative chins lengthen executive careers for both men and women, suggests Antell. “People associate stronger chins with leadership, confidence, authority and honesty,” he says.

When you age, the chin and jawline are the first to go. And there’s not much you can do about it yourself. As Antell says, “If you have a small chin, there is no way that diet and exercise will make it better.”

Antell says double chins are more involved and take longer to fix, but if you have a witch’s chin, he says he can fix it in less than an hour. “It’s a good fix for both for men and women,” he says.