The most common procedure Dr. Andrew Jacono, a New York City-based plastic surgeon, performs is facelifts. After practicing for 14 years, Jacono started to notice that many patients were coming to him to fix what he calls "crises of low self-worth." These patients were hoping that the improved self-esteem a facelift would bring might help them get a new job, find more friends, be happier or even get a cheating spouse back.
"It doesn’t make sense when you think about it," Jacono told The Huffington Post. "Our self-esteem and self worth really come from a long developmental process that starts in childhood."
To confirm his hunch, Jacono partnered with Ryan P. Chastant, MD, and Greg Dibelius, MD, to perform a study that measured how patients' self-esteem changed, if at all, after getting a facelift. They had 50 patients between the ages of 37 and 73 (48 of whom were women) fill out the Rosenberg Self-Esteem Scale, a questionnaire social scientists use to measure self-esteem, just before they had the procedure done and again six months after the procedure. At the 6-month mark, they also asked patients how many years younger they thought they looked post-surgery.
After analyzing the results, Jacono's suspicions were confirmed: Overall, there was no statistically significant change in self-esteem for patients after getting a facelift, even though they believed that they looked an average of 8.9 years younger after the surgery.
Jacono and his colleagues did see some interesting trends when they looked at specific groups of patients. Those who started out with low self-esteem before surgery experienced a small bump in self-esteem six months after they got a facelift. Jacono said that this could be because these people probably did feel a little better about themselves if they felt like they looked more attractive, especially if they started out feeling so crummy. Those who started out with high self-esteem, however, saw a tiny decrease in self-esteem after getting a facelift. This puzzled Jacono, but after giving it some thought, he guessed that, if patients thought highly of themselves and had to admit they needed a procedure, it might have made them feel as if they're not as great as they thought.
But Jacono also thinks that, if you surveyed all of these people after a couple of years, they'd probably all be back to their pre-surgery self-esteem levels. The bottom line, he said, is that facelifts can only make you look younger -- they can't change your self-esteem.
Facelifts currently rank among the top five plastic surgery procedures in the U.S., with 128,266 facelifts performed in 2014 alone. Jacono stressed that it's important for people to go to their doctors with realistic expectations. In fact, he said that he's actually turned away patients who came to him for a facelift during one of those "crises of low self-worth," instead directing them to mental health professionals who could actually try to fix the issues underlying their low self-esteem.
"At the end of the day, they’ll be more unhappy after surgery if their expectations were not met or if you misrepresent the expectations of what plastic surgery can treat," Jacono said.
This study was published in the JAMA Facial Plastic Surgery journal.
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