Objective assessment of perceived age reversal and improvement in attractiveness after aging face surgery.

IMPORTANCE: Primary reasons why patients pursue aesthetic facial surgery are to look younger and more attractive; however, there is minimal literature about the effect of aesthetic facial surgery on perceived age and attractiveness. OBJECTIVES: To objectively and quantitatively evaluate the degree of perceived age change and improvement in attractiveness following aesthetic facial surgical procedures. DESIGN: Prospective evaluation by independent raters of preoperative and postoperative photographs of 49 consecutive patients who underwent aesthetic facial surgery between July 4, 2006, and July 22, 2010. The photographs of these patients were presented to 50 blinded raters, each of whom was randomly assigned to 4 rater groups. Raters were asked to estimate the age of each patient in the photographs presented and to rate the patient's attractiveness on a scale of 1 to 10. SETTING: Facial plastic surgery private practice in Toronto, Ontario, Canada. PARTICIPANTS: Patient inclusion criteria consisted of primary facial surgical procedures with a minimum 6-month follow-up period, use of standardized photographs, and no cosmetic procedures in the intervening period. Raters were chosen from the province of Ontario, randomly assigned to 1 of 4 rater groups, and blinded to the objectives of the study. MAIN OUTCOMES AND MEASURES: The mean "years saved" (true age minus guessed age) and change in attractiveness scores after facial aesthetic surgery. RESULTS: The mean overall years saved following aesthetic facial surgery was 3.1 years (range, -4.0 to 9.4 years). There was a small but insignificant increase in attractiveness scores in postprocedural photographs relative to preprocedural photographs (P > .54). CONCLUSIONS AND RELEVANCE: In this study, aesthetic facial surgery was effective in reducing the apparent age of patients but did not consistently improve their attractiveness. LEVEL OF EVIDENCE: 4.

Midface alloplastic augmentation in the Asian and Latino patient.

The population of the United States is becoming increasingly more diverse as there is an ever expanding influx of various ethnic groups and races that comprise the general population. As a result, the singular concept of Nordic beauty that dominated the United States media throughout the middle of the twentieth century has given way to a more diverse multiracial aesthetic. There is also a growing trend in aesthetic surgery toward ethnic feature preservation and avoidance of a "westernized" look that was more popular in previous years. Today's facial plastic surgeon must be familiar with these trends and aesthetic goals within this rapidly growing patient population. This article describes the anatomy of the Asian and Latino face and describes the techniques of midface alloplastic augmentation.