Summary: A recent study published in JAMA Facial Plastic Surgery suggests that facial plastic surgery decreases a person’s perceived age but does little to affect apparent attractiveness.

beautiful woman's face


The Study

Conducted in a private plastic surgery practice in Toronto, 50 participants were selected from around Ontario. They were assigned to 1 of 4 groups at random and kept unaware of the study’s objectives. The individual groups looked at before-and-after photographs of 49 different patients who had undergone facial plastic surgery. Raters were instructed to guess each patient’s age and rate the patient’s attractiveness from 1 to 10.


The Results

The authors of the study compared the patient’s true ages to the ages guessed by raters and compared the before-and-after scores for attractiveness. Patients in the photos looked an average of 3.1 years younger than their actual age. As far as looking more attractive after facial surgery, the patients improved by an average rating of 0.54. The researchers concluded that facial plastic surgery can make you look noticeably younger, but it doesn’t necessarily translate to a more appealing appearance.

What We Can Learn

Despite the limitations of this study (particularly the small cross-section of participants and patients), there are some lessons we can take away.

The Eye of the Beholder

Attractiveness is based on more than numbers. Studies that evaluate physical attractiveness suggest that one’s outward appeal is based on a number of factors, such as symmetry, age, and proportion. Of course, personal preference can skew results, as well.

Not-So-Great Expectations

One thing surgeons and others in cosmetic medicine can learn from this study is the importance of managing expectations. The study’s results seem to imply that increased attractiveness is an inherent goal in cosmetic surgery, when really the goal is usually to effect subtle change on a small, specific area of concern on a patient’s body. Doctors tend to understand this because of the level of focus required for improving a single aesthetic concern, but societal understanding may be lacking. It is important, therefore, that surgeons make sure their patients understand during preoperative appointments what they can realistically expect from surgery.

The Limitations of Plastic Surgery

Another thing to take away from this study is that facial surgery doesn’t necessarily change the structural makeup of a person’s face. Facial surgery is primarily designed to address issues that result from age — volume loss, wrinkles, loose skin. It doesn’t usually drastically change the structures of the face — the position of the jawbone, cheekbones, or eyes. With that in mind, it makes sense that the people in the pictures looked younger without significant change in their physical attractiveness. Many doctors, such as Dr. Mahmood Kara, a plastic surgery specialist from Toronto who was not involved in the study, say surgery patients will still look like themselves after a procedure, just with a subtle correction of a certain concern, and this study confirms that.

Considering Self-Satisfaction

After this study was recently released, one major reaction from the large community of satisfied plastic surgery patients has involved confidence. They say their procedures helped them fix things that they didn’t like about their bodies, often things that had bothered them for many years. They became more self-accepting and confident, and their quality of life improved, they said. Their feelings of satisfaction had nothing to do with how others rated their ages or levels of attractiveness, as this study measured. Many patients have said a more valuable study would focus on patients’ own happiness.

What’s Your Motivation?

A final, and probably the most important, lesson to learn from this study is for potential patients:You should choose plastic surgery for yourself alone. You should not make the decision to undergo surgery of any kind to impress others, to satisfy the expectations or demands of others, or to fit current trends. This is something that your plastic surgeon should discuss with you.

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