Over the years, the demographics of facelift surgery have experienced significant change regarding sex, age, ethnicity, and socio-economic status. This change has created a need for both surgeons and the medical community to understand these shifts as they relate to proper planning for surgery, maximizing results, and achieving patient satisfaction. The goal of the article is to examine how the evolving demographics of facelift surgery will impact the procedure based on a review of literature, expert opinion from industry colleagues, and experience in practice.
How Facelift Patient Profiles Are Changing
The rise in age ranges for patients receiving facelift surgery is one of the most notable changes that has taken place over the years. Traditionally, candidates were usually female and in their 50’s to 70’s; however, today, many individuals (both boys and girls), between the ages of 35-40, and even some in their early 30’s have begun to explore the idea of having a facelift procedure. Younger patients are typically looking to correct early signs of facial aging before they become too advanced by undergoing “mini-facelift” procedures or utilizing non-surgical methods for restoring their facial appearance.
Additionally, the growing usage of social media has contributed to heightened awareness regarding facial aesthetics and has also allowed for people to see more and more images of facial enhancement. Many younger patients are also motivated to pursue facial rejuvenation as it provides them with a competitive advantage, both personally and professionally. There are many ways in which a young man or woman can achieve a facelift, from very minor contouring alone to extensive surgical, minimally invasive, or non-invasive procedures or a combination of all three. There is an evolution of men’s grooming and appearance toward more natural-looking and professional-like results rather than being overtly feminine.
Men’s anatomy is different from women’s and therefore will have different surgery approaches; i.e., thicker skin, different subcutaneous fat distribution, and more pronounced/stronger jawlines. As such, surgeons must modify surgical techniques to maintain the male characteristics of the face, but still rejuvenate the facial features.
Ethnicity and culture will need to play a role in the planning of the facelift. Most techniques have been predominately designed for Caucasian males and will be focusing on facial contouring vs skin tightening for lighter toned skin. However, there are now many more men with different ethnicities who have become interested in facial rejuvenation. The surgeon must take into consideration both the anatomical differences and differences in aesthetic ideal based on the patient’s ethnicity.
For example:
-Asian men may desire more mid-facial lift and/or jawline definition while still appearing very natural.
-Black/African American men will require that the surgeon take into account thicker dermal layers and different fat placement on the face and neck in order to achieve the desired results.
Therefore, the surgeon will need to take into account the ethnic and cultural aesthetic values and perceptions prior to performing the surgery in order to achieve an aesthetic result that is pleasing to the patient and free of over-corrected results.
Socioeconomic Status
Even though there are currently more facelift surgery options available, cost will still be an important consideration for many patients. The historical view for facelift surgery has been that it was for wealthy people, and thus, lower-income people have limited access to plastic surgical services. Therefore, many patients may be limited by their financial resources when considering a facelift and/or when following through with their post-operative care.
Surgeons can help to resolve these disparities by providing clear communication and action while maintaining high quality results.
The Influence of Social Media & Technology
Patients are flooded with digitally altered images, celebrity transformations, and beauty as a result of social media tools like Instagram, TikTok, and YouTube. These images create an unrealistic standard of beauty and, therefore, heightened awareness of even minor imperfections on a person’s face. As a result of this “selfie effect,” there has been an increase in patients wanting to achieve a more natural look with less-invasive procedures.
In addition to being unrealistic, many patients have very specific expectations. Therefore, it is the surgeons’ responsibility to manage patient expectations, educate the patient on what results can realistically be achieved, and to meet patients’ needs through the provision of individualized consultations.
The Effects of Social and Professional Pressures
Social and professional environments shape a large part of the motivation for undergoing plastic surgery. For example, youth is often viewed as an indicator of energy, health, and vitality; therefore, people view those who appear younger than them as indicators of their ability to compete professionally with others who may be younger. With friends undergoing surgical procedures, people now see surgery as a normal outcome, which has contributed to the increasing societal acceptance of aesthetic procedures by both males and females, as well as by people of all social and ethnic backgrounds.
The growing acceptance of aesthetic procedures results in people perceiving these procedures as a process of self-investment and self-improvement rather than as a means of self-promotion. As such, it is the surgeons’ responsibility to understand their patients’ motivations for seeking an aesthetic procedure and to practice patient-centered care that supports their patients’ self-confidence.
The Role of Imaging, Simulation, and Non-Surgical Adjuncts
As a result of the growth in technology, surgeons are able to utilize preoperative imaging and simulation software to help increase a patient’s confidence that will ultimately lead to surgical satisfaction.
Non-surgical adjuncts (i.e., Botox, fillers, energy-based skin tightening, and PRP) offer patients the opportunity to gradually improve their face, attracting patients who may be hesitant to have full surgical procedures. Additionally, these types of products allow for patients to gradually improve their expressions while providing a means of creating a customized experience for each patient.
Psychological and Emotional Factors
Patients are empowered to pursue facial aesthetic improvements as a growing number of people view these types of procedures as normal. Given that these changes are rapidly taking place, however, surgeons must be vigilant and assess their patients for unrealistic expectations, body dysmorphic tendencies, and/or social media-driven motivations.
Preoperative consultations should include a thorough assessment of psychological issues when indicated, as it allows a patient to seek facial plastic surgery for self-improvement rather than for external validation. By educating patients about what results are possible, patients are more likely to have a successful outcome after surgery and are less at risk for postoperative disappointment.
Post-Operative Care and Cultural Considerations
Patients undergoing aesthetic surgery often expect to quickly recover from surgery, as many of them want to resume normal activities shortly after undergoing surgery due to their work and/or their social life. Additionally, cultural differences create additional challenges with respect to different patient expectations with regard to postoperative care, including the results of postoperative directions concerning how to care for surgical wounds, as well as differing opinions with regard to activity restrictions and the need for follow-up appointments.
Therefore, surgeons’ ability to effectively provide individualized recommendations that satisfy the needs of the different patients they treat is essential to ensure each patient’s surgery can be performed safely, with the best outcome.
Conclusion
The patient demographics associated with facelift surgery have changed significantly in recent years. The patient population for facelift surgery is no longer just older women but includes younger patients; an increase in the number of male patients; increased ethnic diversity within patients seeking facelift surgery; and a reduction in the socioeconomic status of patients seeking facelift surgery. As a result of these changes, lasers and other new technological advancements will likely continue to be among the most popular non-invasive alternatives to traditional facelifts, while the widespread use of social media, changing cultural standards, and accelerated acceptance of aesthetic procedures are causing a number of people to pursue aesthetic surgery procedures.
To meet the needs of an ever-evolving patient demographic, plastic surgeons must be willing to adapt their communication styles, surgical technical skills, and understanding of cultural diversity. By utilizing their surgical expertise while educating their patients on the options available for non-surgical adjunct procedures, and by developing a patient-specific surgical treatment plan for each patient they treat, surgeons will continue to provide safe, effective, and culturally competent care for all patients who undergo aesthetic surgery in the years to come.
