Couto Rafael A, Waltzman Joshua T, Tadisina Kashyap K, Rueda Steven, Richards Bryson G, Schleicher William F, Marten Esteban, Larson Jeffrey D, Rotemberg S Cristina, Zins James E
Department of Plastic Surgery, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
Aesthetic Plast Surg. 2015 Dec;39(6):847-55. doi: 10.1007/s00266-015-0540-6. Epub 2015 Aug 27.
While the literature is replete with articles about body contouring after bariatric surgery, little information exists regarding the outcomes of facelift following massive weight loss (MWL). A case report and a technique article are the only sources available addressing this issue. This pilot study objectively examines the effects of MWL in the cervicofacial region and results after facelift.
A retrospective review of seven patients who underwent facelift after MWL (>100 pounds) was performed. Patient's change in appearance was objectively evaluated using an apparent age model. Forty blinded reviewers assessed pre- and postoperative photographs of seven MWL and eleven non-MWL female patients. The reviewers estimated the apparent age for each subject. Reduction in apparent age was calculated by comparing patient's apparent age against actual age.
The preoperative apparent age of MWL patients was 5.1 years older than their actual age (p < 0.02) compared to the increased preoperative apparent age of 1.2 years in non-MWL subjects (p > 0.05); suggesting MWL patients appear older than their actual age. Post-operatively, the apparent age reduction in MWL patients was 6.0 years; and their apparent age after surgery was 0.9 year less than their actual age (p > 0.05). In contrast, the control group exhibited an apparent age reduction of 5.4 years and a postoperative apparent age 4.2 years younger than their actual age (p < 0.01). Apparent age reduction was not significantly different for the two groups (p > 0.05). Age, BMI, and follow-up were similar between groups (p > 0.05).
MWL may accelerate apparent cervicofacial aging. Facelift following MWL enhances cervicofacial appearance and significantly reduces apparent age. We hope this study stimulates further interest in the study of facial esthetics in this increasing population.
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虽然关于减肥手术后身体塑形的文章大量存在，但关于大量体重减轻（MWL）后面部提升效果的信息却很少。一篇病例报告和一篇技术文章是仅有的涉及该问题的资料来源。这项初步研究客观地考察了MWL对面颈部区域的影响以及面部提升后的效果。
对7例MWL（体重减轻超过100磅）后接受面部提升手术的患者进行回顾性研究。使用表观年龄模型对面部外观变化进行客观评估。40名不知情的评审人员评估了7例MWL患者和11例非MWL女性患者的术前和术后照片。评审人员估计每位受试者的表观年龄。通过将患者的表观年龄与实际年龄进行比较来计算表观年龄的降低值。
MWL患者术前的表观年龄比其实际年龄大5.1岁（p<0.02），而非MWL受试者术前表观年龄增加1.2岁（p>0.05）；这表明MWL患者看起来比实际年龄更大。术后，MWL患者的表观年龄降低了6.0岁；术后其表观年龄比实际年龄小0.9岁（p>0.05）。相比之下，对照组的表观年龄降低了5.4岁，术后表观年龄比实际年龄小4.2岁（p<0.01）。两组的表观年龄降低值无显著差异（p>0.05）。两组间的年龄、体重指数和随访情况相似（p>0.05）。
MWL可能加速面颈部的表观衰老。MWL后的面部提升可改善面颈部外观并显著降低表观年龄。我们希望这项研究能激发人们对这一不断增加的人群面部美学研究的进一步兴趣。
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