Background: The longevity of face-lift surgery is a key question that has not been adequately addressed by previous studies. No study has used standardized photographs, objective measurements, or validated subjective scoring systems.
Methods: From 2001 to 2011, photographs were standardized in this institution. Fifty primary face-lift patients were assessed 5.5 years after surgery using objective measurements from standardized photographs, a region-specific subjective assessment (Scale Summit II scores), and an overall subjective assessment (Global Aesthetic Improvement Scores).
Results: For the first outcome measure, the jowl elevated in vertical height by 6 mm after face-lift surgery, with a relapse of 21 percent at 5.5 years. Jowl correction was maintained at 5.5-year follow-up (p < 0.0001). Cervicomental angle decreased by 13 degrees after face-lift surgery, with partial relapse of 69 percent at 5.5 years. For the second outcome measure, scores showed significant improvement in all areas following a face lift (jowl, nasolabial, and marionette, p < 0.0001; neck, p = 0.0007). At 5.5 years, no subjective worsening of any area was noted except the neck. For the third outcome measure, scoring suggested that 76 percent of patients will still appear younger 5.5 years after a face lift than they did before the face lift.
Conclusions: This study indicates that differential regional aging occurs after face lifting, with the jowl, nasolabial, and marionette areas remaining well corrected at 5.5 years but with partial relapse of neck correction. Long-term global aesthetic assessment remains positive in the vast majority of patients. This study provides strong evidence that face-lift surgery can provide significant long-term aesthetic gains.
Clinical question/level of evidence: Therapeutic, IV.