A new study has shown that Patients who get facial plastic
surgery and assume that they will look younger and more appealing afterward are
wrong. In the reasearch, the first to try to quantify attractiveness after a face-lift, brow-lift
or eyelid surgery, found only a tiny, insignificant increase in attractiveness.
The study, published online in JAMA
Facial Plastic Surgery on Thursday, also found that patients looked,
on average, only three years younger, as judged by independent viewers who
assessed photos of patients before and after cosmetic surgery.
The
findings will probably provide scant comfort to the more than 120,000 American
men and women who last year got face-lifts, a procedure that marketing efforts
often claim can turn the clock back a decade.
Dr.
A. Joshua Zimm, the lead author of the study and a facial plastic
surgeon at Lenox Hill Hospital in Manhattan, said, “I don’t want people to
think, ‘Oh, if I get a face-lift, I’ll only look three years younger.’ This
study includes people who just had an eyelift or a brow lift.”
For
the study, 50 raters looked at randomly assigned binders of 49 patients, ages
42 to 73, who had undergone cosmetic procedures with Dr. Peter A. Adamson, a
surgeon in Toronto. No one rater saw pre- and postoperative shots of the same
person, lest they deduce the study’s aim, and at a six-month follow-up,
patients were excluded if they had had a nose job or injections of anti-wrinkle
medicines like Botox.
The
raters estimated patients’ ages to be about 2.1 years younger, on average, than
their chronological age before surgery, and 5.2 years younger after surgery, an
overall difference of 3.1 years, with minimal changes in attractiveness. A 2012
study of Dr. Adamson’s patients had
found, on average, a seven-year reduction in perceived age, but that study used
less rigorous criteria.
Several
plastic surgeons credited the researchers for the rigor of the current study,
including the use of blinded raters.
“It’s
a big deal that a study is presenting a negative finding,” said Dr. Eric
Swanson, a plastic surgeon in Leawood, Kan., who was not involved in the current
research. In 2011, he conducted
the first of only a handful of studies that have sought to quantify apparent
age change after facial surgery. “They are saying that patients didn’t have a change
in attractiveness.”
Dr.
Zimm, the lead author, said he was surprised by the “insignificant finding for
attractiveness.” He noted that 60 percent of raters scored patients between 4
and 6 on a scale of 1 to 10, with 10 being the most comely, so there was not
much variation in overall attractiveness scores. He guessed that future
research “will show a difference in attractiveness, if we have a larger sample
size, and just analyze attractiveness alone.”
The
very nature of what we consider “old” today also played a role in the results,
said Nancy Etcoff, a psychologist at Harvard Medical School and the author of “Survival of the Prettiest: The
Science of Beauty.” This study looked only at surgical results, and
didn’t use laser resurfacing to address brown splotches and or fat injections
to add volume. But a loss of plumpness in a face reads old, as do wrinkles or
age spots, she said.
“They’re
looking at a face that looks older in some ways, and younger in some ways,” she
said. “It’s difficult for the raters, and confusing.”
Dr.
James M. Stuzin, a Miami plastic surgeon who specializes in face-lifts, thought
the study’s findings had limited generalizability. “A lot of patients show
better improved perceived age and attractiveness than what was noted in this
study,” he said. The study did not include pictures and, without them, “we
don’t know what technique was utilized,” he said. “Definitely technique and a
surgeon’s skill level influences results.”
Dr.
Val Lambros, a plastic surgeon in Newport Beach, Calif., lauded the
researchers’ conscientiousness and their good-faith effort to quantify
perceived age improvement and attractiveness after surgery. ‘It’s remarkably
hard to do a study like this,” he said.
However,
he cautioned, “assigning numbers has an incredible potential to be misused.”
Imagine the competing advertisements, he said, with one surgeon saying, “My
operation makes people look 4.2 years younger” and another crowing, “Mine makes
patients look like Girl Scouts.”
Allan
Imbraguglio, a 55-year-old information technology specialist in
Washington, got upper and lower eyelid surgery in April. He wasn’t looking “to
shave off five years or three years of my age,” he said. “I just wanted to feel
better about myself.” He said that eliminating his “tired look” helped him
project the image of someone “up for the work of a younger person.”
That
said, he hardly complained when a colleague told him he looked 50.
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