From the Plastic Surgery Section, Department of Surgery, Yale School of Medicine; and Division of Plastic and Reconstructive Surgery, University of Colorado Hospital, University of Colorado School of Medicine.
Plast Reconstr Surg. 2022 Jul 1;150(1):146-154. doi: 10.1097/PRS.0000000000009229. Epub 2022 May 17.
Recent studies suggest that orthognathic surgery can improve facial age and personality profiling. The authors expand on these findings by assessing the role of patient facial profile and sociodemographics on perceived changes following surgery.
Preoperative and postoperative images of 65 patients operated on by a single surgeon were randomly assorted and rated by 30 respondents. Patient facial profiles were categorized as convex, concave, or straight. Paired and unpaired t tests were used to assess differences preoperatively and postoperatively. Multivariate regression and post hoc receiver operating characteristic curve analyses were used to quantify the influence of various patient factors.
Significant decreases in perceived age were seen following orthognathic surgery overall (-1.31 years; p < 0.01) and in the straight (-1.10 years; p = 0.02) and convex (-1.80 years; p ≤ 0.01) subgroups. After controlling for patient sociodemographics, there were no significant differences in age change based on facial profile. Older age at the time of surgery was independently associated with greater perceived age changes ( p = 0.04); older patients (>26.5 years, determined by receiver operating characteristic curve) experienced greater net decreases in perceived age in comparison to younger patients (-2.0 years versus -1.2 years; p < 0.01). Improvements were seen in overall attractiveness ( p < 0.01) and in each tested personality characteristic following surgery ( p < 0.01). These differences were not significantly associated with different patient sociodemographics or facial profile.
The authors' data add to the growing base of evidence that orthognathic surgery improves patient-perceived age and personality. Significant decreases in perceived age are more likely to be gained by patients undergoing surgery at an older age.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, II.
最近的研究表明，正颌手术可以改善面部年龄和个性特征。作者通过评估患者面部轮廓和社会人口统计学因素对手术后感知变化的影响，进一步扩展了这些发现。
将一位医生为 65 名患者进行手术的术前和术后图像随机分组，并由 30 名受访者进行评分。患者的面部轮廓分为凸面、凹面或直面。采用配对和非配对 t 检验评估术前和术后的差异。采用多元回归和事后接收者操作特征曲线分析来量化各种患者因素的影响。
总体而言，正颌手术后感知年龄显著下降（-1.31 岁；p<0.01），直面（-1.10 岁；p=0.02）和凸面（-1.80 岁；p≤0.01）亚组也观察到显著下降。在控制患者社会人口统计学因素后，面部轮廓与年龄变化无显著相关性。手术时年龄较大与感知年龄变化较大独立相关（p=0.04）；与年轻患者（-1.2 岁）相比，年龄较大的患者（通过接收者操作特征曲线确定为>26.5 岁）感知年龄的净下降更大（-2.0 岁；p<0.01）。手术后整体吸引力（p<0.01）和每个测试的个性特征（p<0.01）均有所改善。这些差异与不同的患者社会人口统计学因素或面部轮廓无显著相关性。
作者的数据增加了越来越多的证据，表明正颌手术可以改善患者的感知年龄和个性。手术时年龄较大的患者更有可能感知到年龄的显著下降。
临床问题/证据水平：风险，II 级。
