title: Nonsurgical Facial Rejuvenation Procedures in Patients Under 50 Prior to Undergoing Facelift: Habits, Costs, and Results.
abstract: Facial rejuvenation in patients younger than 50 years of age has experienced an unprecedented growth with multimodality nonsurgical and less invasive rhytidectomy techniques.
  
  
  
  To analyze the nonsurgical treatment habits of patients prior to undergoing rhytidectomy at <50 years of age.
  
  
  
  Retrospective study to enlist patients who underwent primary rhytidectomy at age <50 years between January 1, 2003 and December 31, 2013 by the senior author (AAJ) to complete a survey.
  
  
  
  One hundred and fifty-seven patients were surveyed. Patients had nonsurgical rejuvenation starting at an average age of 37 years and rhytidectomy at an average age of 44 years. Thirty-two percent of responders had injectable treatments prior to their facelift, reporting a mean of 7 rounds of injectable treatments prior to pursuing rhytidectomy. Sixteen percent of responders had laser skin resurfacing undergoing 4 separate treatments prior to rhytidectomy, and 10% had energy-based facial tightening treatments one time prior to their rhytidectomy. Average expenditure on nonsurgical treatments prior to rhytidectomy was $7000 cumulatively. Fifty-nine percent of patients who went on to rhytidectomy did not report regret over this cost expenditure. Patients reported that they appeared 4 years younger after nonsurgical intervention, and 8 years younger after their facelift, a statistically significant difference (P = .048).
  
  
  
  Patients undergoing rhytidectomy <50 years old begin less invasive facial rejuvenation treatments at an even earlier age. The majority of these patients did not regret the costs associated with noninvasive treatments, even though they saw that rhytidectomy provided a greater rejuvenation effect. Rhytidectomy surgeons should incorporate nonsurgical techniques into their practice to best serve the needs of the modern aging face patient.
authors.affiliation: Section Head, Facial Plastic and Reconstructive Surgery, North Shore University Hospital, Manhasset, NY, USA.|Assistant Clinical Professor of Facial Plastic Surgery, New York Eye and Ear Infirmary and Albert Einstein College of Medicine, New York, USA.
authors.forename: Andrew A
authors.initials: AA
authors.lastname: Jacono
authors.affiliation: Assistant Professor, Division of Facial Plastic Surgery, Albert Einstein College of Medicine, New York, USA.
authors.forename: Melanie H
authors.initials: MH
authors.lastname: Malone
authors.affiliation: Medical Student, New York Institute of Technology, College of Osteopathic Medicine, New York, USA.
authors.forename: Thomas John
authors.initials: TJ
authors.lastname: Lavin
mesh_terms: D000328:Adult; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage / Q000191:economics; D000067548:Dermal Fillers / Q000008:administration & dosage / Q000191:economics; D005145:Face / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006184:Habits; D006301:Health Services Needs and Demand; D006801:Humans; D007279:Injections, Subcutaneous; D053685:Laser Therapy / Q000191:economics / Q000523:psychology*; D008875:Middle Aged; D009042:Motivation; D017060:Patient Satisfaction; D012060:Rejuvenation / Q000523:psychology*; D012189:Retrospective Studies; D015361:Rhytidoplasty / Q000379:methods / Q000523:psychology*; D015595:Skin Aging; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D000067548:Dermal Fillers; D019274:Botulinum Toxins, Type A