Bater Kristin L, Ishii Lisa E, Papel Ira D, Kontis Theda C, Byrne Patrick J, Boahene Kofi D O, Nellis Jason C, Ishii Masaru
Johns Hopkins School of Medicine, Baltimore, Maryland.
Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
JAMA Facial Plast Surg. 2017 Sep 1;19(5):360-367. doi: 10.1001/jamafacial.2017.0126.
Surgical procedures for the aging face-including face-lift, blepharoplasty, and brow-lift-consistently rank among the most popular cosmetic services sought by patients. Although these surgical procedures are broadly classified as procedures that restore a youthful appearance, they may improve societal perceptions of attractiveness, success, and health, conferring an even larger social benefit than just restoring a youthful appearance to the face.
To determine if face-lift and upper facial rejuvenation surgery improve observer ratings of age, attractiveness, success, and health and to quantify the effect of facial rejuvenation surgery on each individual domain.
DESIGN, SETTING, AND PARTICIPANTS: A randomized clinical experiment was performed from August 30 to September 18, 2016, using web-based surveys featuring photographs of patients before and after facial rejuvenation surgery. Observers were randomly shown independent images of the 12 patients; within a given survey, observers saw either the preoperative or postoperative photograph of each patient to reduce the possibility of priming. Observers evaluated patient age using a slider bar ranging from 30 to 80 years that could be moved up or down in 1-year increments, and they ranked perceived attractiveness, success, and health using a 100-point visual analog scale. The bar on the 100-point scale began at 50; moving the bar to the right corresponded to a more positive rating in these measures and moving the bar to the left, a more negative rating.
A multivariate mixed-effects regression model was used to understand the effect of face-lift and upper facial rejuvenation surgery on observer perceptions while accounting for individual biases of the participants. Ordinal rank change was calculated to understand the clinical effect size of changes across the various domains after surgery.
A total of 504 participants (333 women, 165 men, and 6 unspecified; mean age, 29 [range, 18-70] years) successfully completed the survey. A multivariate mixed-effects regression model revealed a statistically significant change in age (-4.61 years; 95% CI, -4.97 to -4.25) and attractiveness (6.72; 95% CI, 5.96-7.47) following facial rejuvenation surgery. Observer-perceived success (3.85; 95% CI, 3.12-4.57) and health (7.65; 95% CI; 6.87-8.42) also increased significantly as a result of facial rejuvenation surgery.
The data presented in this study demonstrate that patients are perceived as younger and more attractive by the casual observer after undergoing face-lift and upper facial rejuvenation surgery. These procedures also improved ratings of perceived success and health in our patient population. These findings suggest that facial rejuvenation surgery conveys an even larger societal benefit than merely restoring a youthful appearance to the face.
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针对衰老面部的外科手术——包括面部提升术、眼睑成形术和眉提升术——一直位列患者寻求的最受欢迎的美容服务之中。尽管这些外科手术被广泛归类为恢复年轻外貌的手术，但它们可能会改善社会对吸引力、成功和健康的认知，带来比仅仅恢复面部年轻外貌更大的社会效益。
确定面部提升术和上半面部年轻化手术是否能提高观察者对年龄、吸引力、成功和健康的评分，并量化面部年轻化手术对每个单独领域的影响。
设计、地点和参与者：2016年8月30日至9月18日进行了一项随机临床试验，使用基于网络的调查，其中包含面部年轻化手术前后患者的照片。观察者被随机展示12名患者的独立图像；在给定的调查中，观察者看到的是每位患者的术前或术后照片，以减少启动效应的可能性。观察者使用一个从30岁到80岁的滑块条来评估患者年龄，滑块条可以以1岁的增量上下移动，他们使用100分的视觉模拟量表对感知到的吸引力、成功和健康进行排名。100分制量表上的条形从50开始；将条形向右移动对应于这些指标中更积极的评分，向左移动则对应于更消极的评分。
使用多元混合效应回归模型来了解面部提升术和上半面部年轻化手术对观察者认知的影响，同时考虑参与者的个体偏差。计算序数等级变化以了解手术后各个领域变化的临床效应大小。
共有504名参与者（333名女性、165名男性和6名未明确性别者；平均年龄29岁[范围18 - 70岁]）成功完成了调查。多元混合效应回归模型显示，面部年轻化手术后，年龄（-4.61岁；95%置信区间，-4.97至-4.25）和吸引力（6.72；95%置信区间，5.96 - 7.47）有统计学上的显著变化。面部年轻化手术还使观察者感知到的成功（3.85；95%置信区间，3.12 - 4.57）和健康（7.65；95%置信区间；6.87 - 8.42）显著增加。
本研究呈现的数据表明，接受面部提升术和上半面部年轻化手术后，普通观察者会认为患者更年轻、更有吸引力。这些手术还提高了我们患者群体中感知到的成功和健康评分。这些发现表明，面部年轻化手术带来的社会效益比仅仅恢复面部年轻外貌更大。
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