Skip to main content

Advertisement

SpringerLink
Log in

Perception of Age, Attractiveness, and Tiredness After Isolated and Combined Facial Subunit Aging

  • Original Article
  • Aesthetic
  • Published:
Aesthetic Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

Patients often seek help to redress aging that affects various regions of the face (subunits). The purpose of this study was to determine how aging of different facial subunits impacts perception of age, attractiveness, and tiredness.

Method

Frontal and lateral view facial photographs of a middle-aged woman were modified using imaging software to independently age different facial features. Sixty-six subjects were administered with a questionnaire, and presented with a baseline unmodified picture and others containing different individual or grouped aging of facial subunits. Test subjects were asked to estimate the age of the subject in the image and quantify (0–10 scale) how “tired” and “attractive” they appeared. Facial subunits were organized following rank assignment regarding impact on perception of age, attractiveness, and tiredness.

Results

The correlation coefficient between age and attractiveness had a strong inverse relationship of approximately −0.95 in both lateral and frontal views. From most to least impact in age, the rank assignment for frontal view facial subunits was full facial aging, middle third, lower third, upper third, vertical lip rhytides, horizontal forehead rhytides, jowls, upper eyelid ptosis, loss of malar volume, lower lid fat herniation, deepening glabellar furrows, and deepening nasolabial folds. From most to least impact in age, the rank assignment for lateral view facial subunits was severe neck ptosis, jowls, moderate neck ptosis, vertical lip rhytides, crow’s feet, lower lid fat herniation, loss of malar volume, and elongated earlobe.

Conclusion

This study provides a preliminary template for further research to determine which anatomical subunit will have the most substantial effect on an aged appearance, as well as on the perception of tiredness and attractiveness.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10
Fig. 11
Fig. 12
Fig. 13
Fig. 14
Fig. 15
Fig. 16
Fig. 17
Fig. 18
Fig. 19
Fig. 20
Fig. 21

Similar content being viewed by others

References

  1. Romo T, Yalamanchili H, Sclafani AP (2005) Chin and prejowl augmentation in the management of the aging jawline. Facial Plast Surg 21(1):38–46

    Article  CAS  PubMed  Google Scholar 

  2. Baker DC (1997) Lateral SMASectomy. Plast Reconstr Surg 100(2):509–513

    Article  CAS  PubMed  Google Scholar 

  3. Carruthers JD, Glogau RG, Blitzer A, Facial Aesthetics Consensus Group F (2008) Advances in facial rejuvenation: botulinum toxin type a, hyaluronic acid dermal fillers, and combination therapies—consensus recommendations. Plast Reconstr Surg 121(5 Suppl):5S–30S quiz 1S–6S

    Article  CAS  PubMed  Google Scholar 

  4. Hamra ST (1990) The deep-plane rhytidectomy. Plast Reconstr Surg. 86(1):53–61 discussion 2–3

    Article  CAS  PubMed  Google Scholar 

  5. Hamra ST (2004) The role of the septal reset in creating a youthful eyelid-cheek complex in facial rejuvenation. Plast Reconstr Surg 113(7):2124–2141 discussion 42–44

    Article  PubMed  Google Scholar 

  6. Michelow BJ, Guyuron B (1997) Rejuvenation of the upper face. A logical gamut of surgical options. Clin Plast Surg 24(2):199–212

    CAS  PubMed  Google Scholar 

  7. Morganroth GS (2005) Combining chin-jowl implants with local anesthesia facial rejuvenation. Skin Therapy Lett 10(6):6–9

    CAS  PubMed  Google Scholar 

  8. Isse NG (1997) Endoscopic facial rejuvenation. Clin Plast Surg 24(2):213–231

    CAS  PubMed  Google Scholar 

  9. Wolfort FG, Gee J, Pan D, Morris D (1997) Nuances of aesthetic blepharoplasty. Ann Plast Surg 38(3):257–262

    Article  CAS  PubMed  Google Scholar 

  10. Little JW (2002) Applications of the classic dermal fat graft in primary and secondary facial rejuvenation. Plast Reconstr Surg 109(2):788–804

    Article  PubMed  Google Scholar 

  11. American Society of Aesthetic Plastic Surgery (2013) Cosmetic Surgery National Data Bank Statistics 2012

  12. Swanson E (2011) Objective assessment of change in apparent age after facial rejuvenation surgery. J Plast Reconstr Aesthet Surg 64(9):1124–1131

    Article  PubMed  Google Scholar 

  13. Motulsky HJ, Brown RE (2006) Detecting outliers when fitting data with nonlinear regression—a new method based on robust nonlinear regression and the false discovery rate. BMC Bioinform 7:123

    Article  Google Scholar 

  14. Wright SP (1992) Adjusted P-values for simultaneous inference. Biometrics 48:1005–1013

    Article  Google Scholar 

  15. Ekman P (1993) Facial expression and emotion. Am Psychol 48(4):384–392

    Article  CAS  PubMed  Google Scholar 

  16. Calder AJ, Burton AM, Miller P, Young AW, Akamatsu S (2001) A principal component analysis of facial expressions. Vis Res 41(9):1179–1208

    Article  CAS  PubMed  Google Scholar 

  17. Kirkpatrick SW, Bell FE, Johnson C, Perkins J, Sullivan LA (1996) Interpretation of facial expressions of emotion: the influence of eyebrows. Genet Soc Gen Psychol Monogr 122(4):405–423

    CAS  PubMed  Google Scholar 

  18. Scomacao IR, Graf RM, Maluf I Jr, Forte AJ, da Silva Freitas R (2013) Evaluation of photographic variables in patients with indication for facial rejuvenation. Aesthet Plast Surg 37(6):1114–1119

    Article  Google Scholar 

  19. Zimm AJ, Modabber M, Fernandes V, Karimi K, Adamson PA (2013) Objective assessment of perceived age reversal and improvement in attractiveness after aging face surgery. JAMA Fac Plast Surg 15(6):405–410

    Article  Google Scholar 

  20. Chauhan N, Warner JP, Adamson PA (2012) Perceived age change after aesthetic facial surgical procedures quantifying outcomes of aging face surgery. Arch Fac Plast Surg 14(4):258–262

    Google Scholar 

  21. Kwart DG, Foulsham T, Kingstone A (2012) Age and beauty are in the eye of the beholder. Perception 41(8):925–938

    Article  PubMed  Google Scholar 

  22. Sezgin B, Findikcioglu K, Kaya B, Sibar S, Yavuzer R (2012) Mirror on the wall: a study of women’s perception of facial features as they age. Aesthet Surg J 32(4):421–425

    Article  PubMed  Google Scholar 

  23. Gierloff M, Stohring C, Buder T, Gassling V, Acil Y, Wiltfang J (2012) Aging changes of the midfacial fat compartments: a computed tomographic study. Plast Reconstr Surg 129(1):263–273

    Article  CAS  PubMed  Google Scholar 

  24. Coleman SR, Grover R (2006) The anatomy of the aging face: volume loss and changes in 3-dimensional topography. Aesthet Surg J 26(1s):S4–S9

    Article  CAS  PubMed  Google Scholar 

  25. Gosain AK, Klein MH, Sudhakar PV, Prost RW (2005) A volumetric analysis of soft-tissue changes in the aging midface using high-resolution MRI: implications for facial rejuvenation. Plast Reconstr Surg. 115(4):1143–1152 discussion 53–55

    Article  CAS  PubMed  Google Scholar 

  26. Little JW (2000) Volumetric perceptions in midfacial aging with altered priorities for rejuvenation. Plast Reconstr Surg. 105(1):252–266 discussion 86–89

    Article  CAS  PubMed  Google Scholar 

  27. Axelsson J, Sundelin T, Ingre M, Van Someren EJ, Olsson A, Lekander M (2010) Beauty sleep: experimental study on the perceived health and attractiveness of sleep deprived people. BMJ 341:c6614

    Article  PubMed Central  PubMed  Google Scholar 

  28. Knoll BI, Attkiss KJ, Persing JA (2008) The influence of forehead, brow, and periorbital aesthetics on perceived expression in the youthful face. Plast Reconstr Surg 121(5):1793–1802

    Article  CAS  PubMed  Google Scholar 

  29. Leung WC, Harvey I (2002) Is skin ageing in the elderly caused by sun exposure or smoking? Br J Dermatol 147(6):1187–1191

    Article  PubMed  Google Scholar 

  30. Koh JS, Kang H, Choi SW, Kim HO (2002) Cigarette smoking associated with premature facial wrinkling: image analysis of facial skin replicas. Int J Dermatol 41(1):21–27

    Article  PubMed  Google Scholar 

  31. Just M, Ribera M, Monso E, Lorenzo JC, Ferrandiz C (2007) Effect of smoking on skin elastic fibres: morphometric and immunohistochemical analysis. Br J Dermatol 156(1):85–91

    Article  CAS  PubMed  Google Scholar 

  32. Raschke GF, Rieger UM, Bader RD, Schaefer O, Guentsch A, Dammeier MG et al (2014) Perioral aging—an anthropometric appraisal. J Craniomaxillofac Surg 42(5):e312–e317

    Article  PubMed  Google Scholar 

  33. Fink B, Neave N (2005) The biology of facial beauty. Int J Cosmet Sci 27(6):317–325

    Article  CAS  PubMed  Google Scholar 

  34. Fink B, Bunse L, Matts PJ, D’Emiliano D (2012) Visible skin colouration predicts perception of male facial age, health and attractiveness. Int J Cosmet Sci 34(4):307–310

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Section of Plastic and Reconstructive Surgery, Yale School of Medicine, 330 Cedar Street, 3rd Floor Boardman Building, New Haven, CT, 06520, USA

    Antonio Jorge Forte, Tom W. Andrew, Cesar Colasante & John A. Persing

Authors
  1. Antonio Jorge Forte
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tom W. Andrew
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Cesar Colasante
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. John A. Persing
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to John A. Persing.

Ethics declarations

Conflicts of interest

The authors declare that they have no conflicts of interest to disclose.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Forte, A.J., Andrew, T.W., Colasante, C. et al. Perception of Age, Attractiveness, and Tiredness After Isolated and Combined Facial Subunit Aging. Aesth Plast Surg 39, 856–869 (2015). https://doi.org/10.1007/s00266-015-0553-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00266-015-0553-1

Keywords

Search

Navigation