Objective assessment of change in apparent age after facial rejuvenation surgery

Facial "rejuvenation" procedures make an implicit claim to provide a more youthful appearance. However, any benefit from such procedures has not been objectively evaluated and validated. This study was undertaken to investigate the effectiveness of facial rejuvenation using a deep-plane facelift and other cosmetic procedures.

Seventy-five patients were included in the study - 71 consecutive patients who met the study criteria and four controls. Inclusion criteria included at least 6 months' follow-up, standardized photos with no makeup or jewelry, and no subsequent cosmetic procedures. Simultaneous procedures included submental lipectomy, fat injection, laser skin resurfacing, blepharoplasty, endoscopic forehead lift, and chin/jowl augmentation. Photographs were judged by 198 independent members of the public who were asked to rate apparent age.

The mean reduction in apparent age for all surgical patients was 6.0 years (range 0.8-14.2 years) versus no change for the control patients (p < 0.01). The average reduction in apparent age after a facelift alone was 4.6 years. Laser resurfacing provided 2.5 years of apparent age reduction (p < 0.05). Eyelid surgery and an endoscopic forehead lift each contributed a 2-year reduction in apparent age (p < 0.05). There was no significant difference when patients were compared by gender, age, body mass index, or facial shape.

These findings provide the first objective evidence that cosmetic surgery (or any intervention, surgical or otherwise) is effective in providing a more youthful appearance. Facelift, laser resurfacing, blepharoplasty, and endoscopic forehead lift all significantly contribute to a reduction in apparent age.