Mary Lou Ray decided at age 65 that she had seen enough of the person in her mirror. "My life led up to this. I had been divorced for 13 years, my children were grown, and with the death of my mother—not to be unkind—I was finally free of criticism about things like dyeing my hair," she says. So last year she spent $13,000 on a face lift and other cosmetic procedures that proved rejuvenating. "I'm absolutely thrilled," says Ms. Ray, a real-estate agent in Roanoke, Va. "I think a lot of friends in my age bracket would like to try this, but they're afraid of getting that unnatural, yanked-up look. I don't have that; I still look like me."

Ms. Ray is part of the changing national profile of the typical first-time plastic-surgery candidate—a demographic group that's well past its first few sags and wrinkles. Elective cosmetic procedures among patients age 65 and older, both surgical and nonsurgical, rose 29 percent from 2005 to 2010, to more than 680,000, according to the American Society for Aesthetic Plastic Surgery. During that same period, cosmetic procedures among the overall population fell 17 percent.

In part, doctors say, the change reflects the fact that many Americans are working longer than they anticipated, because of depleted nest eggs, and believe that physical enhancements will make them more competitive with younger co-workers. Other patients simply "have the attitude: 'With people living longer, I want to do everything I can to enjoy the years I have left,' " says David Sarwer, associate professor of psychology at the University of Pennsylvania, who researches cosmetic procedures at the school's Center for Human Appearance.

Whatever the motivation, physicians say older patients should approach cosmetic surgery with greater-than-normal caution. Rates of healing, reactions to anesthesia, the potential for complications—all can be different, and perhaps more problematic, for those age 60-plus.