The JAMA Facial Plastic Surgery, published by American Medical Association, came out with the results of an intriguing study today. It suggested that after aesthetic facial plastic surgery the average number of apparent years “saved” in appearance was 3.1 years.
Since my specialty, cosmetic dermatology, is closely aligned to elective plastic surgery, I’m going to weigh in on this. And it’s true; to the objective observer, despite our dearest, deepest desires, turning back the clock on one’s looks is only achievable in increments, not decades. If you are 50, you are never going to look 20 again. Ever.
That said, I look upon these results with quite a few grains of salt. Here’s why:
The study was small, only 49 subjects total with an age range of 42 to 73 years old, not nearly enough to offer definitive proof of anything. Also, the study does not name the surgeons who performed the work but my guess is that they were top-notch. Yet even the most skilled physician can only perform the cosmetic surgery procedures they know. The news is that we are looking at aging faces from a completely different perspective that takes into account aging across different levels of the face not addressed by traditional surgery.
The observers who made the “objective assessments” were physicians and their associates who are professionals when it comes to looking at age. Since these experts have spent their careers doing so, their conclusions are going to be a lot more accurate and a lot more unforgiving that those of the average Jane or Joe on the street.
The subtext of the study and the one that the media will have a field day with, is that rejuvenation procedures are essentially useless. Obviously, I couldn’t disagree more. But let’s take a look at these results at face value. Given the news that plastic surgery and cosmetic dermatology can only “give back” three years, will patients still elect to go ahead with the procedures? Absolutely. Here’s why:
- Younger isn’t necessarily better
No question, youth is beautiful. A young woman at 20 is going to attract more attention than the same woman at 45. This is not just a cultural construct made up by a cabal of evil advertising executives either; it’s hardwired in our reptile brains. It has do with reproduction. But this doesn’t at all mean that youth is the only kind of physical beauty there is out there. Women of all ages today can attain and maintain the facial symmetry, skin smoothness, evenness of pigment and lovely contours that proclaim beauty without needing to be 20-something.
- Look to the positive feedback loop
Most of the women I see today want to be comfortable with the reflection they see in the mirror. Any “work” they do is for themselves. Studies have shown the existence of the positive feedback loop between your appearance and your mood-state, self-confidence and your self-esteem.
A patient of mine in her 50s who has had surgery as well as cosmetic derm fine tuning said, “I do this for myself because I want to look the best I can for as long as I can, not because I care that some random dude at 7-11 is going to think I am a teenager.”
- Listen to Karl
There’s absolute age, true, but when it comes to the perception of beauty there’s a huge amount of wiggle room too. Factor in carriage, style, attitude, character and luck and the picture gets better by the minute. You could do worse than heed the sage advice of the inimitable fashion designer Karl Lagerfeld, “There comes a moment in life when the idea of youth and beauty has to give way to style and elegance. That’s how it is,” he writes in The Karl Lagerfeld Diet book. “If you are over thirty-five, don’t set yourself up to be compared with young people; rather, try to find something in yourself that they will be able to use as an example when their time comes to be expelled from the ‘paradise’ of youth.”
To which I would add that life happens but what shows on your skin is open to negotiation.
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