Facial plastic surgery improves perception of femininity, personality, attractiveness

Facial rejuvenation surgery may not only make you look younger, it may improve perceptions of you with regard to likeability, social skills, attractiveness and femininity, according to a report published online by JAMA Facial Plastic Surgery.

The relationship between facial features and personality traits has been studied in other science fields, but it is lacking in the surgical literature, according to the study background.

Michael J. Reilly, M.D., of the MedStar Georgetown University Hospital, Washington, and coauthors measured the changes in personality perception that happen with facial rejuvenation surgery.

The study included preoperative and postoperative photographs of 30 white female patients who had facial plastic surgery from 2009 through 2013. The procedures included face-lift, upper and lower eyelid surgery, eyebrow-lift, neck-lift and/or chin implant. Individual raters scored the photographs for six personality traits (aggressiveness, extroversion, likeability, trustworthiness, risk seeking and social skills), as well as attractiveness and femininity. The same patient's preoperative and postoperative photographs were not included in any single group to avoid any recall bias.

There was statistically significant improvement between preoperative and postoperative scores for likeability, social skills, attractiveness and femininity when all the facial plastic surgery procedures were evaluated together. Improvement in scores for the other traits was not statistically significant, according to the results.

"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," the study concludes.

In a related commentary, Samuel M. Lam, M.D., of Lam Facial Plastics, Plano, Texas, writes: "Accordingly, I believe it is important to be artistic and to help patients try to look better not only to themselves but also, even more important (in my opinion), to others. This goal is why I commend the article in this issue by Reilly et al that squarely addresses these broader psychosocial perceptual renderings that truly should underscore the reason why we as surgeons do what we do."

"My only criticism would be that pairing words describing physical traits, such as attractiveness and femininity, with words describing emotional traits, such as trustworthiness and aggressiveness, might have created an unconscious bias in the respondent. The respondent may see attractiveness and trustworthiness and pair the two traits in his or her mind and thereby link a more attractive person with being trustworthy," the author continues.

"As we continue to strive for more evidence-based medicine in our field, I contend that we should still be able to achieve this rigorous standard even when investigating matters that would otherwise seem elusive, such as perception and emotion," Lam concludes.