Association of Face-lift Surgery With Social Perception, Age, Attractiveness, Health, and Success

Abstract

IMPORTANCE Evidence quantifying the influence of face-lift surgery on societal perceptions is lacking.OBJECTIVE To measure the association of face-lift surgery with observer-graded perceived age, attractiveness, success, and overall health. DESIGN, SETTING, AND PARTICIPANTSIn a web-based survey, 526 casual observers naive to the purpose of the study viewed independent images of 13 unique female patient faces before or after face-lift surgery from January 1, 2016, through June 30, 2016. The Delphi method was used to select standardized patient images confirming appropriate patient candidacy and overall surgical effect. Observers estimated age and rated the attractiveness, perceived success, and perceived overall health for each patient image. Facial perception questions were answered on a visual analog scale from 0 to 100, with higher scores corresponding to more positive responses. To evaluate the accuracy of observer age estimation, the patients' preoperative estimated mean age was compared with the patients' actual mean age. A multivariate mixed-effects regression model was used to determine the effect of face-lift surgery. To further characterize the effect of face-lift surgery, estimated ordinal-rank change was calculated for each domain. MAIN OUTCOMES AND MEASURES Blinded casual observer ratings of patients estimated age, attractiveness, perceived success, and perceived overall health. RESULTS A total of 483 observers (mean [SD] age, 29 [8.6] years; 382 women [79.4%]) successfully completed the survey. Comparing patients' preoperative estimated mean (SD) age (59.6 [9.0] years) and patients' actual mean (SD) age (58.4 [6.9] years) revealed no significant difference (t 2662 = −0.47; 95% CI, −6.07 to 3.72; P = .64). On multivariate regression, patients after face-lift surgery were rated as significantly younger (coefficient, −3.69; 95% CI −4.15 to −3.23; P < .001), more attractive (coefficient, 8.21; 95% CI, 7.41-9.02; P < .001), more successful (coefficient, 5.82; 95% CI, 5.05 to 6.59; P < .001), and overall healthier (coefficient, 8.72; 95% CI, 7.88-9.56; P < .001). The ordinal rank changes for an average individual were −21 for perceived age, 21 for attractiveness, 16 for success, and 21 for overall health. CONCLUSIONS AND RELEVANCEIn this study, observer perceptions of face-lift surgery were associated with views that patients appeared younger, more attractive, healthier, and more successful. These findings highlight observer perceptions of face-lift surgery that could positively influence social interactions.LEVEL OF EVIDENCE NA.

Correlation between facial attractiveness and facial components assessed by laypersons and orthodontists

“…Previous studies have shown the following points: 1. The face is the central contributor to physical attractiveness; 3 2. Each facial component may be related to facial attractiveness; 8 3.…”

“…An individual with a beautiful face may appear younger, healthier, more attractive and successful. 3 Discrimination is relatively frequent among people who are facially unattractive. 4 …”

Association Between Facial Rejuvenation and Observer Ratings of Youth, Attractiveness, Success, and Health

“…The multivariate mixed-effects regression model is one that has been used previously to study how face-lift surgery alters societal perceptions. 31 It was discovered that adding upper facial rejuvenation to the face-lift procedure yields a larger clinical effect size in the age domain (patients appeared more youthful when undergoing face-lift and upper facial procedures as compared with face-lift alone). These results are relevant even in the setting of an essential difference in the study designs; the face-lift study was conducted using only photographs of the best surgical results, whereas the present study contains photographs with a range of postoperative outcomes.…”

Facial Appearance and Psychosocial Features in Orthognathic Surgery: A FACE-Q- and 3D Facial Image-Based Comparative Study of Patient-, Clinician-, and Lay-Observer-Reported Outcomes

“…We have addressed the social aspects of face perception (e.g., attractiveness and emotional expressions) as they have consistently been recognized as fundamental to human social interaction [12,13,14,15,17,18,19,20,21,22,23,38,39,40,41,42,43,54,55,56,57]. However, research on the OGS population should be expanded to additional facial−perception−associated areas of interest, such as neuropsychological mechanisms, through a multidisciplinary research collaboration with groundbreaking engineering technologies (e.g., brain scanning, direct stimulation of the brain, visual adaptation, and single−cell recording) [58,59,60].…”

“…However, only a few OGS studies have adopted the FACE-Q tool [10,11]. In this setting, the impact of different surgical interventions, including OGS procedures, on facial aesthetic and social perceptions, has been demonstrated using the panel assessment tool, a metric that is centered on clinician-reported outcome (ClinRO, professionals using medical or dental judgments) and observer-reported outcome (ObsRO, judgments from laypersons with no formal training) principles [12,13,14,15,16,17,18,19,20,21,22,23].…”