Before and after pictures of women undergoing “facial rejuvenation surgery” have been rated in a controlled study against six personality traits – aggressiveness, extroversion, likeability, trustworthiness, risk-seeking and social skills – and the results suggest that the perceptions of people around those who have had plastic surgery go beyond the question of how much “youthfulness” has been achieved.
The aim of the study, published in JAMA Facial Plastic Surgery, was to “introduce the concept of facial profiling to the surgical literature and to evaluate and quantify the changes in personality perception that occur with facial rejuvenation surgery.”
The relationship between facial features and personality traits has been explored “by social scientists for many years” but so far left out of the journals read by surgeons.
Attractiveness is a complex phenomenon – but the conversation about how it relates to cosmetic facial surgery, the authors write, “has focused primarily on the trait of youthfulness, which is only one element of a much larger picture.” Their study “broadens” the discussion about beauty to more “nuanced” perceptions of the face.
The perceived level of “femininity” achieved by the women’s nips and tucks is the other rating that the researchers say they have gone beyond with the six traits relevant to social interaction.
Preoperative and postoperative photographs of 30 white female patients were included in the evaluation by plastic surgeon Dr. Michael Reilly, of the MedStar Georgetown University Hospital, Washington, DC, and coauthors. Between 2009 and 2013, the women had facial plastic surgery that included:
- Facelift
- Upper and lower eyelid surgery
- Eyebrow-lift
- Neck-lift and/or chin implant.
When all the facial plastic surgery procedures were evaluated together, the results given by the raters – of pictures before and after surgery, standardized and controlled for bias – showed there was, in addition to more attractiveness and femininity:
- A significant improvement for likeability and social skills between preoperative and postoperative scores
- An improvement, but not a statistically significant one, in scores for the other personality traits (aggressiveness, extroversion, trustworthiness and risk-seeking).
The study concludes:
“The comprehensive evaluation and treatment of the patient who undergoes facial rejuvenation requires a broader understanding of the many changes in perception that are likely to occur with surgical intervention.
The face is not defined by youth alone.”
Dr. Samuel Lam, a cosmetic plastic surgeon in Plano, TX, writing a commentary article about the study in the same issue of the journal, says:
“I judge my work the moment I walk through the door to greet my patient to see if I think the person looks better to me.”
Dr. Lam is talking about an aim he subscribes to, of achieving a better “blink” – working to the perceptual cues that “render an immediate judgment about the person being observed, before the cues enter the observer’s conscious awareness.”
People seeking facial changes do not always appreciate the importance of this, Dr. Lam says – many patients he sees “want to change aspects of their faces that I do not believe would have merit in improving their ‘blink,’ such as fine lip lines that are unobservable to a bystander at a casual distance.”
Such goals of a cosmetic plastic surgeon, which he acknowledges are not always achieved, are why Dr. Lam commends the study that “squarely addresses these broader psychosocial perceptual renderings.” He adds the caveat that future research could further iron out the effects of bias that can be introduced by such studies asking people to rate images.
Dr. Lam ends by commenting on “striving” for more evidence-based medicine in the field of cosmetic facial surgery – “even when investigating matters that would otherwise seem elusive, such as perception and emotion.”