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DOI: 10.1055/s-0037-1598071
Psychology of the Facelift Patient
Publication History
Publication Date:
01 June 2017 (online)
Abstract
This paper presents an extensive literature review of the psychology of facelift patients as it has evolved over the past 50 years. Earlier studies revealed significant levels of pre and perioperative depression. Facelift patients generally exhibit emotional and social concerns about facial appearance that are higher than the general population. Many are undergoing midlife situational stresses and may lack the positive characteristics to deal with them. The most common diagnoses seen include depression, impulsivity, unstable personality, and passive dependence, albeit not necessarily serious. Improvement in body image is the major driver for surgery. Characteristics of female patients as defined by their age are described. These include the younger emotionally dependent group, the worker group of middle age, and the older grief group. Male patients are seen to have a higher level of psychological dysfunction, but a higher improvement in postoperative quality of life. Motivations for surgery include increasing self-esteem, making new friends, improving relationships, and getting better jobs. Overall patient satisfaction is more than 95%, with improvement seen in positive changes in their life, increased self-confidence and self-esteem, decreased self-consciousness about their appearance, and overall improvement in quality of life. Postoperative psychological reactions are seen in about half the patients, these primarily being anxiety and depression of varying degrees. Predictors of patient satisfaction include the desire for self-image improvement in contradistinction to a change in life situation. Negative predictors include male sex, young age, unrealistic expectations, relationship disturbances, and preexisting psychological pathology. The importance of good patient selection in achieving a satisfied patient is outlined and emphasized.
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References
- 1 American Society of Plastic Surgeon. New statistics reflect the changing face of plastic surgery. Available at https://www.plasticsurgery.org/news/press-releases/new-statistics-reflect-the-changing-face-of-plastic-surgery . Accessed October 15, 2016
- 2 Goin JM, Goin MK. Changing the Body: Psychological Effects of Plastic Surgery. Baltimore, MD: Williams & Wilkins; 1981
- 3 Karimi K, Adamson P. Patient analysis and selection in aging face surgery. Facial Plast Surg 2011; 27 (01) 5-15
- 4 Edgerton MT, Jacobson WE, Meyer E. Surgical-psychiatric study of patients seeking plastic (cosmetic) surgery: ninety-eight consecutive patients with minimal deformity. Br J Plast Surg 1960; 13: 136-145
- 5 Edgerton MT, Meyer E, Jacobson WE. Augmentation mammaplasty. II. Further surgical and psychiatric evaluation. Plast Reconstr Surg Transplant Bull 1961; 27: 279-302
- 6 Edgerton MT, Webb Jr WL, Slaughter R, Meyer E. Surgical results and psychosocial changes following rhytidectomy. Plast Reconstr Surg 1964; 33: 503-521
- 7 Baker Jr JL, Kolin IS, Bartlett ES. Psychosexual dynamics of patients undergoing mammary augmentation. Plast Reconstr Surg 1974; 53 (06) 652-659
- 8 Goin MK, Burgoyne RW, Goin JM, Staples FR. A prospective psychological study of 50 female face-lift patients. Plast Reconstr Surg 1980; 65 (04) 436-442
- 9 Goin MK, Rees TD. A prospective study of patients' psychological reactions to rhinoplasty. Ann Plast Surg 1991; 27 (03) 210-215
- 10 Wright MR, Wright WK. A psychological study of patients undergoing cosmetic surgery. Arch Otolaryngol 1975; 101 (03) 145-151
- 11 Meningaud JP, Benadiba L, Servant JM, Herve C, Bertrand JC, Pelicier Y. Depression, anxiety and quality of life: outcome 9 months after facial cosmetic surgery. J Craniomaxillofac Surg 2003; 31 (01) 46-50
- 12 Harris DL, Carr AT. The Derriford Appearance Scale (DAS59): a new psychometric scale for the evaluation of patients with disfigurements and aesthetic problems of appearance. Br J Plast Surg 2001; 54 (03) 216-222
- 13 Cook SA, Rosser R, Toone H, James MI, Salmon P. The psychological and social characteristics of patients referred for NHS cosmetic surgery: quantifying clinical need. J Plast Reconstr Aesthet Surg 2006; 59 (01) 54-64
- 14 Litner JA, Rotenberg BW, Dennis M, Adamson PA. Impact of cosmetic facial surgery on satisfaction with appearance and quality of life. Arch Facial Plast Surg 2008; 10 (02) 79-83
- 15 Webb Jr WL, Slaughter R, Meyer E, Edgerton M. Mechanism of psychosocial adjustment in patients seeking “face-lift” operations. Psychosom Med 1965; 27: 183-192
- 16 Goin MK, Burgoyne RW, Goin JM. Face-lift operation: the patient's secret motivations and reactions to “informed consent”. Plast Reconstr Surg 1976; 58 (03) 273-279
- 17 Plastic Surgery Portal. Plastic surgery demographics. Available at http://www.plasticsurgeryportal.com/articles/plastic-surgery-demographics . Accessed October 15, 2016
- 18 American Psychological Association. Data on behavioral health in the United States. Available at http://www.apa.org/helpcenter/data-behavioral-health.aspx . Accessed October 15, 2016
- 19 National Alliance on Mental Illness. Mental health by the numbers. Available at http://www.nami.org/Learn-More/Mental-Health-By-the-Numbers . Accessed October 15, 2016
- 20 Sarwer DB, Crerand CE. Psychological issues in patient outcomes. Facial Plast Surg 2002; 18 (02) 125-133
- 21 Franzoi SL, Koehler V. Age and gender differences in body attitudes: a comparison of young and elderly adults. Int J Aging Hum Dev 1998; 47 (01) 1-10
- 22 Fooken I. Sexuality in the later years--the impact of health and body-image in a sample of older women. Patient Educ Couns 1994; 23 (03) 227-233
- 23 Vamos M, White GL, Caughey DE. Body image in rheumatoid arthritis: the relevance of hand appearance to desire for surgery. Br J Med Psychol 1990; 63 (Pt 3): 267-277
- 24 Adamson PA, Chen T. The dangerous dozen--avoiding potential problem patients in cosmetic surgery. Facial Plast Surg Clin North Am 2008; 16 (02) 195-20 2, vii
- 25 Baker TJ. Patient selection and psychological evaluation. Clin Plast Surg 1978; 5 (01) 3-14
- 26 Leist FD, Masson JK, Erich JB. A review of 324 rhytidectomies, emphasizing complications and patient dissatisfaction. Plast Reconstr Surg 1977; 59 (04) 525-529
- 27 Sinno S, Schwitzer J, Anzai L, Thorne CH. Face-lift satisfaction using the FACE-Q. Plast Reconstr Surg 2015; 136 (02) 239-242
- 28 Jacono A, Chastant RP, Dibelius G. Association of patient self-esteem with perceived outcome after face-lift surgery. JAMA Facial Plast Surg 2016; 18 (01) 42-46
- 29 Alves MC, Abla LE, Santos RdeA, Ferreira LM. Quality of life and self-esteem outcomes following rhytidoplasty. Ann Plast Surg 2005; 54 (05) 511-514 , discussion 515–516
- 30 Friel MT, Shaw RE, Trovato MJ, Owsley JQ. The measure of face-lift patient satisfaction: the Owsley Facelift Satisfaction Survey with a long-term follow-up study. Plast Reconstr Surg 2010; 126 (01) 245-257
- 31 Liu TS, Owsley JQ. Long-term results of face lift surgery: patient photographs compared with patient satisfaction ratings. Plast Reconstr Surg 2012; 129 (01) 253-262
- 32 Herruer JM, Prins JB, van Heerbeek N, Verhage-Damen GW, Ingels KJ. Negative predictors for satisfaction in patients seeking facial cosmetic surgery: a systematic review. Plast Reconstr Surg 2015; 135 (06) 1596-1605
- 33 Castle DJ, Honigman RJ, Phillips KA. Does cosmetic surgery improve psychosocial wellbeing?. Med J Aust 2002; 176 (12) 601-604
- 34 Malick F, Howard J, Koo J. Understanding the psychology of the cosmetic patients. Dermatol Ther (Heidelb) 2008; 21 (01) 47-53
- 35 Honigman RJ, Phillips KA, Castle DJ. A review of psychosocial outcomes for patients seeking cosmetic surgery. Plast Reconstr Surg 2004; 113 (04) 1229-1237
- 36 Napoleon A. The presentation of personalities in plastic surgery. Ann Plast Surg 1993; 31 (03) 193-208
- 37 Gorney M. Cosmetic surgery in males. Plast Reconstr Surg 2002; 110 (02) 719
- 38 Rohrich RJ. The man as a cosmetic surgery patient: the weaker sex?. Plast Reconstr Surg 2001; 108 (07) 2098-2099
- 39 Dowling NA, Honigman RJ, Jackson AC. The male cosmetic surgery patient: a matched sample gender analysis of elective cosmetic surgery and cosmetic dentistry patients. Ann Plast Surg 2010; 64 (06) 726-731
- 40 Phillips KA, Dufresne RG. Body dysmorphic disorder. A guide for dermatologists and cosmetic surgeons. Am J Clin Dermatol 2000; 1 (04) 235-243
- 41 Phillips KA. Quality of life for patients with body dysmorphic disorder. J Nerv Ment Dis 2000; 188 (03) 170-175
- 42 Phillips KA, Diaz SF. Gender differences in body dysmorphic disorder. J Nerv Ment Dis 1997; 185 (09) 570-577
- 43 Buhler C. The curve of life as studied in biographies. J Appl Psychol 1935; 19: 405