title: Perceived age change after aesthetic facial surgical procedures quantifying outcomes of aging face surgery.
abstract: OBJECTIVE
  To quantify the degree of perceived age change after aesthetic facial surgical procedures to provide an objective measure of surgical success.
  
  
  METHODS
  Sixty patients undergoing various aging face surgical procedures were randomly chosen for analysis. Preoperative and postoperative photographs were evaluated. Raters were presented with photographs in a random assortment and were asked to estimate the age of the patient. Perceived age difference was defined as the difference between the chronological age and the estimated age, and the change in this value after surgery was the chief outcome of interest. Statistical models were designed to account for any effects of interrater differences, preoperative chronological age, rater group, photograph order, or surgical procedure performed.
  
  
  RESULTS
  Our patient population was divided into the following 3 groups based on the surgical procedure performed: group 1 (face- and neck-lift [22 patients]), group 2 (face- and neck-lift and upper and lower blepharoplasty [17 patients]), and group 3 (face- and neck-lift, upper and lower blepharoplasty, and forehead-lift [21 patients]). Adjusted means demonstrated that patient ages were estimated to be 1.7 years younger than their chronological age before surgery and 8.9 years younger than their chronological age after surgery. The effect was less substantial for group 1 patients and was most dramatic for group 3 patients, who had undergone all 3 aging face surgical procedures.
  
  
  CONCLUSIONS
  Our study is novel in that it quantifies the degree of perceived age change after aging face surgical procedures and demonstrates a significant and consistent reduction in perceived age after aesthetic facial surgery. This effect is more substantial when the number of surgical procedures is increased, an effect unrelated to the preoperative age of a patient and unaffected by other variables that we investigated. The ability to perceive age correctly is accurate and consistent.
authors.affiliation: Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology–Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada. dr.nitinchauhan@dreamcaremedical.com
authors.forename: Nitin
authors.initials: N
authors.lastname: Chauhan
authors.forename: Jeremy P
authors.initials: JP
authors.lastname: Warner
authors.forename: Peter A
authors.initials: PA
authors.lastname: Adamson
mesh_terms: D000367:Age Factors; D000368:Aged; D004954:Esthetics; D005260:Female; D005546:Forehead / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000601:surgery; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D010465:Perception / Q000502:physiology*; D010781:Photography; D011184:Postoperative Period; D057234:Preoperative Period; D011446:Prospective Studies; D012060:Rejuvenation; D015361:Rhytidoplasty / Q000379:methods*; D015595:Skin Aging / Q000502:physiology*; D013518:Surgery, Plastic / Q000379:methods