Massive weight loss after bariatric surgery makes the body look thinner and the face look older, according to a study in the October issue of Plastic and Reconstructive Surgery (PRS).
Seven plastic surgeons analyzed photos of 65 bariatric surgery patient faces before and a year after surgery. Patient average perceived facial age before surgery was 40.8 years versus 43.7 years after weight loss surgery. Men older than 40 and people who lost the most weight in the study appeared to age most.
The authors note that compared to an average increase of 16.6 months in perceived facial age after surgery among women, men showed an average increase of 36.2 months. This might be because men are likely to have bariatric surgery when they’re older, with more advanced obesity and more complex comorbidities, the authors suggest.
Age also played a role in the degree of perceived facial aging. While plastic surgeons saw little change among patients younger than 40 years, they reported an average perceived facial aging increase of 34.2 months in those older than 40, which was significant.
The study results support the belief that a sudden change in body weight can cause facial aging, according to perceived age, which is based on the evaluation of others, according to the authors.
Among the study’s limitations: All the patients were Caucasian.
Commenting psychologically on the study, PRS Consulting Editor David B. Sarwer, Ph.D., writes that bariatric surgery holds great promise for many people who are 100 pounds above their recommended body weight. These patients typically lose 25% to 35% of their weight by 18 months post-surgery, according to Dr. Sarwer.
But while patients often emphasize their concerns about physical appearance and body image when considering the surgery, some continue to suffer after surgery from loose, sagging skin.
“In some respects, this finding is not surprising. Loss of facial volume is typically associated with an older-looking appearance,” Dr. Sarwer writes. “If the primary goal of bariatric surgery is to improve morbidity and mortality, with improvements in appearance and body image being secondary, would this information be an important element of the medical decision-making process? The answers to these questions would require further thought.”