Knoedler Leonard, Lellouch Alexandre G, Aguglia Raffaele, Sadati Kevin, Knoedler Samuel, Kehrer Andreas, Cetrulo Curtis L, Rendenbach Carsten, Heiland Max, Fenske Jakob
Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
Division of Plastic and Reconstructive Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Aesthetic Plast Surg. 2025 Sep 2. doi: 10.1007/s00266-025-05221-z.
BACKGROUND: The demand for surgical facial rejuvenation procedures, such as facelifts, has risen in recent decades. However, limited research has addressed the epidemiological and economic aspects of these procedures. This study examines trends in facelift surgeries using data from the Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample (NIS) database. METHODS: The HCUP-NIS database, which includes all-payer inpatient cases in the USA, was analyzed for facelift procedures identified through ICD-10 codes from 2016 to 2020. A total of 723 patients met the inclusion criteria. Patient demographics, hospitalization details, and procedural characteristics were evaluated using descriptive statistics. Exploratory comparisons were made across the three surgical technique subgroups, as allocated in ICD-10 procedural coding: open, percutaneous, and percutaneous endoscopic. RESULTS: The cohort included 723 patients, with a mean age of 56.7 ± 16.2 years, predominantly female (79.4%) and White (81%). Most patients were self-paying (63.2%) and of high-income status (50.8%). Higher-income individuals were more likely to undergo minimally invasive procedures. The average hospital stay was 1.7 ± 1.6 days, with total costs averaging $85,259.60 ± $63,152.80. The most common indication was plastic surgery due to cosmetic reasons. Facelift was also performed for gender dysphoria indications in 12.3% of the cases. Hypertension (18.8%) and nicotine abuse (13.7%) were the most frequent comorbidities. CONCLUSION: The results highlight the complex epidemiological and economic environment of inpatient facelift surgery. Procedures are subject to significant regional and socioeconomic disparities. The growing role of facial feminization and heterogenous surgical access warrants further research on emerging trends in esthetic facial surgery. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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