People undergo plastic surgery for a multitude of reasons. A common one is to combat signs of aging — wrinkles, sagging, and loss of elasticity. Some believe looking more youthful will make them happier or improve their self-esteem. As with any kind of plastic surgery, a decision to undergo face-lift surgery in particular relies heavily on psychosocial factors. A new article published by JAMA Facial Plastic Surgery suggested that patient self-esteem measures seem to be unconnected to positive face-lift outcomes.

A facelift, or rhytidectomy, is a surgical procedure designed to reduce the signs of aging on the face and neck. This includes wrinkles, “laugh lines,” excess fatty deposits that create the look of a double chin, and sagging or droopy skin around the eyes.

Understanding all of the psychosocial effects of face lifts is increasingly important, since the popularity of the procedure has increased by nearly 30 percent since 1997. According to the American Society for Aesthetic Plastic Surgery, eyelid surgery (an important part of a face lift) was among the top five surgical procedures for men and women in 2014, and botulinum Toxin (Botox) was the number one nonsurgical procedure. A team of researchers from the New York center for Facial plastic and Laser Surgery, New York, used a self-esteem scale to examine the outcome of face-lift surgery as an association between self-esteem before and after a successful aesthetic facial rejuvenation.

The study included 59 patients undergoing face-lift surgery during 2013. Fifty of the patients completed a six-month postoperative questionnaire. The mean age of the patients was 58 years, and 48 of the patients were women. Patients with low self-esteem reported a statistically significant increase in self-esteem after surgery, while patients with high self-esteem before surgery showed a significant decrease in self-esteem scores. Those with average presurgery self-esteem showed a nonsignificant increase, according to the results. Overall, the difference between the average before and after self-esteem levels was not statistically significant.

Patients reported feeling as if they looked about nine years younger, but that perceived change in appearance didn’t end up correlating with changes in self-esteem, said the report, written by Dr. Andrew Jacono, of the New York Center for Facial Plastic and Laser Surgery and coauthors.

“These 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,” the study concluded.

Source: Jacono A, Chastant R, Dibelius G. Association of patient Self-esteem With Percieved Outcome After Face-lift Surgery. JAMA Facial Plastic Surgery. 2015.