【 文献重点摘要 】
 

Importance: Surgical procedures for the aging face—including face-lift, blepharoplasty, and brow-lift—consistently rank among the most popular cosmetic services sought by patients. Although these surgical procedures are broadly classified as procedures that restore a youthful appearance, they may improve societal perceptions of attractiveness, success, and health, conferring an even larger social benefit than just restoring a youthful appearance to the face.

Objectives: To determine if face-lift and upper facial rejuvenation surgery improve observer ratings of age, attractiveness, success, and health and to quantify the effect of facial rejuvenation surgery on each individual domain.

Design, Setting, and Participants: A randomized clinical experiment was performed from August 30 to September 18, 2016, using web-based surveys featuring photographs of patients before and after facial rejuvenation surgery. Observers were randomly shown independent images of the 12 patients; within a given survey, observers saw either the preoperative or postoperative photograph of each patient to reduce the possibility of priming. Observers evaluated patient age using a slider bar ranging from 30 to 80 years that could be moved up or down in 1-year increments, and they ranked perceived attractiveness, success, and health using a 100-point visual analog scale. The bar on the 100-point scale began at 50; moving the bar to the right corresponded to a more positive rating in these measures and moving the bar to the left, a more negative rating.

Main Outcomes and Measures: A multivariate mixed-effects regression model was used to understand the effect of face-lift and upper facial rejuvenation surgery on observer perceptions while accounting for individual biases of the participants. Ordinal rank change was calculated to understand the clinical effect size of changes across the various domains after surgery.

Results: A total of 504 participants (333 women, 165 men, and 6 unspecified; mean age, 29 [range, 18-70] years) successfully completed the survey. A multivariate mixed-effects regression model revealed a statistically significant change in age (–4.61 years; 95% CI, –4.97 to –4.25) and attractiveness (6.72; 95% CI, 5.96-7.47) following facial rejuvenation surgery. Observer-perceived success (3.85; 95% CI, 3.12-4.57) and health (7.65; 95% CI; 6.87-8.42) also increased significantly as a result of facial rejuvenation surgery.

Conclusions and Relevance: The data presented in this study demonstrate that patients are perceived as younger and more attractive by the casual observer after undergoing face-lift and upper facial rejuvenation surgery. These procedures also improved ratings of perceived success and health in our patient population. These findings suggest that facial rejuvenation surgery conveys an even larger societal benefit than merely restoring a youthful appearance to the face.

重要：衰老面部的外科手术-包括面部拉皮、眼睑成形术和眉毛拉皮-一直是患者寻求的最受欢迎的美容服务之一。虽然这些外科手术被广泛地归类为恢复年轻面貌的手术，但它们可能会改善社会对吸引力、成功和健康的看法，带来比仅仅恢复年轻面容更大的社会效益。

目的：确定面部除皱术和上面部年轻化手术是否能提高观察者对年龄、吸引力、成功和健康的评分，并量化面部年轻化手术在各个领域的效果。

设计、地点和参与者：2016年8月30日至9月18日进行了一项随机临床实验，使用基于网络的调查，以患者面部年轻化手术前后的照片为特色。观察者被随机展示12名患者的独立图像；在给定的调查范围内，观察者观看每个患者的术前或术后照片，以减少启动的可能性。观察者使用滑动条评估患者的年龄，滑动条的年龄从30岁到80岁不等，可以每1年向上或向下移动，他们使用100分的视觉模拟标尺对感知的吸引力、成功和健康进行排名。100分制的条形图开始于50分；在这些衡量标准中，将条形图向右移动对应的是更积极的评级，而将条形图移动到左边，则是更负面的评级。

主要结果和指标：采用多因素混合效应回归模型，在考虑参与者个体偏见的同时，了解整容和上颌面年轻化手术对观察者知觉的影响。为了了解手术后不同领域变化的临床效果大小，计算了顺序秩变化。

结果：共有504名参与者(333名女性，165名男性，6名未指明；平均年龄29[范围，18-70岁])成功完成调查。多因素混合效应回归模型显示面部年轻化手术后年龄(-4.61岁；95%CI，-4.97~-4.25)和吸引力(6.72；95%CI，5.96~7.47)有统计学意义的变化。观察者感知的成功(3.85；95%CI，3.12-4.57)和健康(7.65；95%CI；6.87-8.42)也因面部年轻化手术而显著增加。

结论和相关性：这项研究中提供的数据表明，在接受了面部提升和上面部年轻化手术后，临时观察者认为患者更年轻、更有吸引力。在我们的患者群体中，这些程序也提高了感知成功和健康的评级。这些发现表明，面部年轻化手术比仅仅恢复面部年轻面貌更能带来更大的社会效益。