Facelifts Can Hurt Self-Esteem

A study by a Manhattan plastic surgeon found that while patients thought they looked much younger after a facelift, their self esteem tended to drop if had been relatively high before the surgery. It improved if self-esteem was low prior to surgery.

People who turn to plastic surgery to enhance their sense of well-being may not get what they want.

Writing in JAMA Facial Plastic Surgery, Andrew Jacono MD, a Manhattan plastic surgeon and colleagues there and in Louisiana evaluated the self-esteem of patients who had rhytidectomy at a Jacono's private practice from July 1 to Oct. 31 2013.

Of the 59 patients, 50 completed a questionnaire given six months after their surgery. The psychological assessment was done through the Rosenberg Self-Esteem Scale.

Compared to baseline scores there was an improvement post-surgery only in patients with low self-esteem. Patients who had high self-esteem before surgery showed a drop in those feelings while patients who had average self-esteem showed no change in scores.

That did not mean the surgeries were not successful.

Patients thought they looked 8.9 years younger.

The mean age was 58, and most patients were women. They were not overweight with a mean BMI of 23. Only six were smokers and only 7 patients had suffered a recent traumatic event.

About half had more than one procedure , such as blepharoplasty and carbon dioxide laser treatment. Only two of the patients had a psychiatric history.

The most perplexing result of the study was the drop in self-esteem in some patients.

"We believe this finding may support the theory that patients with average of above average self esteem do not require improvement in their self esteem and are undergoing facelift surgery simply to look younger, not feel emotionally more whole," they noted in the article.

Their findings underscore "the complex nature of the human psyche as it relates to aesthetic surgery and demonstrates that patients exhibit a wide spectrum of psychological reactions after face-lift surgery," they concluded.