Objective assessment of change in apparent age after facial rejuvenation surgery.

[BACKGROUND] 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.

[METHODS] 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.

[RESULTS] 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.

[CONCLUSIONS] 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.