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While historical growth in rates of surgery in this population is commonly attributed to financial incentives and technological innovations, the shifts in thought that underpinned the spread of surgery among the U.S. elderly remain largely unexplored. We examined changing perspectives on aging over time in American surgery through two case studies: the expansion of general surgical procedures among older U.S. adults between 1945 and 1965, and the spread of coronary artery bypass grafting (CABG) among the U.S. elderly between 1975 and 1995.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>For this article, we used close readings of historical journal articles, textbook excerpts, survey reports, and government documents related to surgery and aging.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>Similar perspectives on aging informed the spread of both general surgical procedures among older adults after World War II and CABG in the elderly from the mid\u20101970s onward. In each case, surgeons argued against earlier views that surgery was contraindicated in old age using rhetoric that negated the relevance of age to medical decisions. Furthermore, surgeons elevated other types of information\u2014such as the presence or absence of chronic diseases\u2014to supplant age as an explanation for the high operative mortality rates seen among older patients. By stressing the modifiability of operative risk in the elderly, surgeons\u2019 arguments positioned old age itself as a new surgical \u201cfrontier.\u201d<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Surgeons\u2019 arguments for the expansion of surgery among the U.S. elderly over time worked to negate the relevance of age to medical decisions and to portray the wider use of surgery in the elderly as uniformly beneficial. While potentially promoting broader access to surgical care, such perspectives may also have contributed to ongoing health policy challenges by normalizing surgery at any stage in the life\u2010course, with implications for current patterns of surgical utilization and medical spending.<\/jats:p><\/jats:sec>","DOI":"10.1111\/milq.12014","type":"journal-article","created":{"date-parts":[[2013,6,13]],"date-time":"2013-06-13T05:15:13Z","timestamp":1371100513000},"page":"288-315","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["The Redefinition of Aging in American Surgery"],"prefix":"10.1111","volume":"91","author":[{"given":"MARK D.","family":"NEUMAN","sequence":"first","affiliation":[{"name":"University of Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"CHARLES L.","family":"BOSK","sequence":"additional","affiliation":[{"name":"University of 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