Most people have facial plastic surgery because they’re hoping to shave a decade or so off their perceived age. But a new study published in JAMA Facial Plastic Surgery has found that the average amount of “years saved” is only three —and we’re not talking dog years.
“Typically, we tend to tell patients they’ll look less tired and more refreshed and try not to overpromise and say ‘You’ll look X years younger,’ because we don’t want to create unrealistic expectations,” says Dr. A. Joshua Zimm, a Manhattan plastic surgeon and one of the co-authors.
The study, he says, was an attempt to “scientifically quantify the degree of change in someone’s age as perceived by a lay person.”
In other words, they were looking for the brutal honesty of strangers.
Toward that end, Zimm and four colleagues tracked 204 facial plastic surgery patients, all of whom had opted for primary facial surgical procedures such as face-lifts, neck-lifts, upper or lower blepharoplasty (eye-lifts) and brow-lifts at the same Toronto plastic surgery clinic.
Out of the 204, 12 men and 37 women met the criteria for the study. These 49 subjects, who ranged in age from 42 to 73, had a series of photos taken before and after their surgery. Makeup and jewelry, which the study refers to as “confounding variables,” were not allowed in either the before or after shots.
Photos were all taken by lead author Dr. Peter Adamson, who also performed the plastic surgery, using the same standardized background, the same camera and the same type of photography techniques.
A group of 50 “raters,” primarily made up of hospital workers and lay people recruited from the community, were then asked to estimate and record the age of the patients in the before and after photographs. They were also asked to rate the patient’s attractiveness on a scale of 1 to 10, with 10 being the top ranking (as always).
On average, raters estimated the patients’ age to be about 2.1 years younger than their chronological age before surgery and 5.2 years younger than their real age after surgery. There also was a small, “insignificant” increase in attractiveness scores in the after photos.
While the average improvement of 3.1 years isn’t earthshaking, Zimm says the study’s findings are still positive for those considering age-related plastic surgery.
“The takeaway is that patients will definitely appear younger after aging facial surgery on average,” he says. “There’s a range—the highest level was a patient who looked 9.4 years younger. I think it’s going to help with regard to communicating with patients. We can say to them you will look younger— we’ve shown it in studies.”
But three years isn’t much of a difference, points out Michigan-based plastic surgeon, Dr. Anthony Youn.
“If all I removed from my patients was three years of aging, I would have a waiting room full of unhappy patients,” he says. “Removing three years is more in the territory of spa treatments, not plastic surgery. We strive for much more than this.”
Youn also points out a study published last year that found face-lifts result in a person looking on average seven years younger.
“The big question for me is why does one study show a seven-year reduction versus this one that shows only a three-year reduction?” he asks. “Studies like this are based on opinions, which can vary depending on the rater. Also, this study looked at the results of just one surgeon. If that surgeon was conservative then this could show in the results.”
Zimm agrees that additional studies with multiple surgeons pooling their results would be ideal. He also says the inconsistent findings between the two studies might have to do with the types of procedures performed.
“In our study, we had 18 patients who didn’t have face-lifts but just had a brow-lift or an eye-lift,” he says. “You’re not going to get the same kind of results in terms of age reduction or attraction really when you’re looking at just that alone.”
A peek at the numbers seems to back this up. Patients who had the most plastic surgery—i.e., upper and lower facial rejuvenation—did score the highest marks for “years saved,” from -2.9 to 9.4 (as compared to -1.6 to 7 for those who had lower facial rejuvenation only).