Massive Weight Loss Patients Appear Significantly Older than They Are Prior to Facial Surgery

SEPTEMBER 14, 2015
Bill Schu
Massive weight loss (MWL) provides obvious health benefits, including reducing morbidity and mortality risks, but it brings some medical and psychological challenges as well. MWL patients are often left with excessive amounts of sagging skin, particularly in the thighs, under the arms, around the abdomen, and around the face. A study in Aesthetic Plastic Surgery examined the aging impacts of MWL, with or without accompanying plastic surgery.
There has been a fair amount of research about body contouring after bariatric surgery, but relatively little about outcomes of facelift following MWL. This is a growing and ongoing concern, given that the number of weight loss surgeries in the US continues to rise, and along with it the number of procedures specifically associated with it, including face lifts, tummy tucks, thigh and best lifts, and upper arm lifts. Having excess skin can be psychologically difficult for MWL patients, and it can make them appear older than they are.
The study was a retrospective review of 7 patients who underwent facelift after weight loss of greater than 100 pounds. Patient’s change in appearance was objectively evaluated using an apparent age model.
Forty blinded reviewers assessed photographs of 7 MWL and 11 non-MWL female patients, both before and after they underwent facial plastic surgery. The reviewers estimated the apparent age for each subject. Reduction in apparent age was calculated by comparing patient’s apparent age against actual age.
The preoperative apparent age of MWL patients was 5.1 years older than their actual age (p < 0.02) compared to the increased preoperative apparent age of 1.2 years in non-MWL subjects (p > 0.05). Although this is a small sample, it suggests that MWL patients appear older than their actual age.
Post-operatively, the apparent age reduction in MWL patients was 6.0 years; and their apparent age after surgery was 0.9 year less than their actual age (p > 0.05). In contrast, the control group exhibited an apparent age reduction of 5.4 years and a postoperative apparent age 4.2 years younger than their actual age (p < 0.01).
Apparent age reduction was not significantly different for the two groups (p > 0.05). There were no significant differences in age, BMI, and follow-up treatment between the two groups.
The study authors suggest that facelift following MWL enhances cervicofacial appearance and significantly reduces apparent age. These benefits could potentially ameliorate some of the lingering psychological impact for MWL patients.

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