Psychological Impact of Facial Aging: How Gender, Race, and Age Affect Self-Perception and Satisfaction

Self-Perception of Aging

Psychological Impact of Facial Aging: How Gender, Race, and Age Affect Self-Perception and Satisfaction

Changes in facial structure and appearance occur as the result of aging, gravity and underlying soft tissue repositioning. Approximately 15 million people in the United States seek cosmetic treatments per year, with eyelid surgery and facelifts among the top 5 surgical procedures. Of the approximate 13 million who seek minimally invasive procedures, facial rejuvenation procedures (Botulinum toxin type A, soft tissue fillers, chemical peels)1 account for nearly 80%. Although much of the gerontological research in dermatology has focused on the signs of aging, there is a paucity of quantitative data that describes the psychosocial impact of aging. The results of “Self-Perception of Aging: Results from a Global Survey Assessing the Psychological Impact of Facial Aging,” presented at the ISPOR 21st Annual International Meeting in May, describe the impact of facial lines in diverse adult populations across gender and varying racial/ethnic groups.

A cross-sectional, electronic web-based survey was conducted in Australia, Canada, the United Kingdom and the US from December 2013 to February 2014. A total of 4,086 respondents were included in the final analysis; mean age was 47.7 years (SD=16.1) and 80% of respondents were female. Psychosocial impact of facial aging was evaluated using the Self-Perception of Age (SPA) Questionnaire2, the Facial Line Satisfaction Questionnaire (FLSQ)3, and the Facial Line Outcomes (FLO-11) Questionnaire4.  Data were reported and evaluated by gender, by age, and by race/ethnicity.

Less than half of females perceived themselves as looking their current age and a little more than half perceived themselves as looking a mean of 9.7 [SD=6.8] years younger. Half of males perceived themselves as looking their current age and less than half perceived themselves as looking a mean of 9.6 [SD=6.4] years younger. Black participants perceived themselves as looking greater years younger than White participants (in all age cohorts) and Asian and Hispanic participants (in select age cohorts).

Over half of participants were ‘Mostly/Very Satisfied’ with the appearance of their face; satisfaction was highest in the younger cohorts (18-49 years) and decreased in the older cohort (50-75 years), with females being more negatively impacted by their facial aging in comparison to males.  White participants had the highest negative self- perception, while Black participants had the most favorable self-perception. Among females and males, White participants and participants aged 40–49 reported the greatest negative perception of their facial appearance.

This is the first multinational study to describe the psychosocial impact associated with facial lines in diverse populations. Participants generally reported a high overall positive outlook on their facial appearance, with Black participants reporting the highest levels of satisfaction.  Males generally reported less negative impact from their facial lines and a positive perception of facial appearance compared to females.  Data from this study demonstrates the unmet need of current dermatology products and can be used as a basis for future research.

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12014 Plastic Surgery Statistics Report. American Society of Plastic Surgeons. Available at: http://www.plasticsurgery. org/Documents/news-resources/statistics/2014-statistics/plastic-surgery-statsitics-full-report.pdf. Accessed on April 22, 2016.
2SPA: Allergan plc, unpublished questionnaire, copyright 2005.
3Pompilus F, Burgess S, Hudgens S, et al. Development and validation of a novel patient-reported treatment satisfaction measure for hyperfunctional facial lines: facial line satisfaction questionnaire. J Cosmet Dermatol 2015;14(4):274–285.
4FLO-11: Allergan plc, unpublished questionnaire, copyright 2003.