While the literature is replete with articles about body contouring after bariatric surgery, little information exists regarding the outcomes of facelift following massive weight loss (MWL). A case report and a technique article are the only sources available addressing this issue. The purpose of this pilot study is to objectively examine the effects of MWL in the cervicofacial region and outcomes after facelift.
A retrospective review of seven patients who underwent facelift after MWL (>100 pounds) was performed. Patient’s change in appearance was objectively evaluated using an apparent-age model. Forty blinded reviewers assessed pre- and post-operative photographs of seven MWL and eleven non-MWL patients. The mean preoperative and postoperative actual age of the MWL and non-MWL group were compared to their preoperative and postoperative apparent age, respectively. Apparent age reduction was calculated to evaluate the effect the facelift procedures on the two comparative groups. Because the actual age differed between the preoperative and postoperative photographs, the formula (postoperative apparent age - postoperative actual age) – (preoperative apparent age – preoperative actual age) was utilized to account for the time lapse. Reduction in apparent-age was calculated by comparing patient’s apparent-age against actual-age.
The mean BMI at time of facelift surgery of the MWL group was 26.4, and for the non-MWL patients was 22.9 kg/m2 (p>0.05) ( Table 1). The pre-operative apparent-age of MWL patients was 5.1 years older than their actual-age (p<0.02) compared to the increased pre-operative apparent-age of 1.2 years in non-MWL subjects (p>0.05); suggesting MWL patients appear older than their actual-age (Table 2). Post-operatively, the apparent-age reduction in MWL patients was 6.0 years; their apparent-age after surgery was 0.9 year less than their actual-age (p>0.05) (Table 3). Contrastingly, the control group exhibited an apparent-age reduction of 5.4 years and a post-operative 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), suggesting that both groups of patients derived a similar apparent age reduction following surgery. Age and follow-up were similar between groups (p>0.05).
MWL appears to accelerate apparent cervicofacial aging. Facelift following MWL enhances cervicofacial appearance and significantly reduces apparent age (Figure 1,2). We hope this investigation stimulates further interest in the study of facial aesthetics in this increasing population.