The Contribution of the Lower Third of the Face to Perceived Age: Do Masks Make You Appear Younger?

Abstract

Background Extrinsic factors like smoking, alcohol use, and sun exposure have been shown to accelerate facial aging. There is evidence that changes to the midface and lower third of the face in isolation contribute significantly to one’s perception of overall facial age. With data suggesting that facial coverings are effective against the spread of the respiratory virus COVID-19, mask wearing has become commonplace. To date, there have been no studies that explore how covering the lower third of the face impacts an observer’s perception of age. Objectives We hypothesize that covering the lower third of the face with a mask will make a person appear younger. Methods One hundred consecutive plastic surgery patients were photographed in a standardized fashion, both masked and unmasked. A questionnaire for factors known to contribute to facial aging was administered. These photographs were randomized to 6 judges who estimated the patients’ age and also quantified facial rhytids with the validated Lemperle wrinkle assessment score6. Data were analyzed using PROC MIXED analysis. Results Masked patients on average appeared 6.17% younger (mean difference = 3.16 years, 95% CI = 2.26-4.06, P < 0.0001). Wrinkle assessment scores were 9.81% lower in the masked group (mean difference = 0.21, 95% CI = 0.10-0.32, P = 0.0003). All subgroups appeared younger in a mask except for patients aged 18-40 years chronological age (P = 0.0617) and patients BMI>35 (P = 0.5084). Conclusions The mask group appeared younger and had lower overall and visible wrinkle assessment scores when compared to the unmasked group. This has implications for our understanding of the contributions of the lower third of the face to overall perceived facial age.

Smiling makes you look older, even when you wear a mask: the effect of face masks on age perception

“…As we noted in the introduction, however, the contradictory biases could have resulted from item-specific effects due the small number of items used in these studies. Our results are also in odds with the results of another recent study that suggested that masked faces of middle-aged adults are perceived as younger than unmasked faces of the same individuals (Nicksic et al, 2021 ). As we noted previously in the introduction, this study suffered from substantial methodological problems preventing any firm conclusions to be made.…”

“…One recent study that looked at the effect of masks on direct age evaluations reported that masked faces of middle-aged adults were perceived as younger than unmasked faces of the same individuals (Nicksic et al, 2021 ). This study was limited, however, by serious methodological confounds (e.g.…”

Surgical face masks do not impair the decoding of facial expressions of negative affect more severely in older than in younger adults

“…Face masks are physical barriers that cover a substantial part of the face (Carbon, 2020 ). While surgical face masks effectively reduce the transmission of airborne pathogens between individuals and thereby significantly lower the individual risk of getting infected with SARS-COV-2 during the current COVID-19 pandemic (Catching et al, 2021 ; Sommerstein et al, 2020 ), they also reduce the flow of information between individuals (Carbon, 2020 ; Bani et al, 2021 ; Cohn et al, 2021 ; Carbon & Sorreno, 2021 ; Gori et al, 2021 ; Grundmann et al, 2021 ; Kastendieck et al, 2022 ; Nicksic et al, 2021 ; Noyes et al, 2021 ). The threat of getting seriously ill after infection with SARS-COV-2 increases with age (Verity et al, 2020 ), suggesting that face masks should be worn especially during face-to-face contact with and between older people.…”