Facelift Surgery Turns Back the Clock: Artificial Intelligence and Patient Satisfaction Quantitate Value of Procedure Type and Specific Techniques

Abstract

Background Patients desire facelifting procedures to look younger, refreshed, and attractive. Unfortunately, there are few objective studies assessing the success of types of facelift procedures and ancillary techniques. Objectives The authors sought to utilize convolutional neural network algorithms alongside patient-reported FACE-Q outcomes to evaluate perceived age reduction and patient satisfaction following various facelift techniques. Methods Standardized preoperative and postoperative (1-year) images of patients who underwent facelift procedures were analyzed by 4 neural networks to estimate age reduction after surgery (n = 105). FACE-Q surveys were employed to measure patient-reported facial aesthetic outcome. We compared (1) facelift procedure type: skin-only vs superficial musculoaponeurotic system (SMAS)-plication, vs SMAS-ectomy; and (2) ancillary techniques: fat grafting (malar) vs no fat grafting. Outcomes were based on complications, estimated age-reduction, and patient satisfaction. Results The neural network preoperative age accuracy score demonstrated that all neural networks were accurate in identifying our patients’ ages (mean score = 100.4). SMAS-ectomy and SMAS-plication had significantly greater age-reduction (5.85 and 5.35 years, respectively) compared with skin-only (2.95 years, P < 0.05). Fat grafting compared to no fat grafting demonstrated 2.1 more years of age reduction. Facelift procedure type did not affect FACE-Q scores; however, patients who underwent fat grafting had a higher satisfaction with outcome (78.1 ± 8 vs 69 ± 6, P < 0.05) and decision to have the procedure (83.0 ± 6 vs 72 ± 9, P < 0.05). Conclusions Artificial intelligence algorithms can reliably estimate the reduction in apparent age after facelift surgery. Facelift technique, like SMAS-ectomy or SMAS-plication, and specific technique, like fat grafting, were found to enhance facelifting outcomes and patient satisfaction.

Evidence-Based Medicine for Lower Facial Rejuvenation

“…10 Further, there was no difference on satisfaction scores between facelift techniques which correlates with other studies in the literature. 5,10 This level II study provides strong evidence for patient satisfaction, 10 yet additional studies with patient-reported outcomes are needed.…”

“…Patients utilizing a variety of facelift techniques were compared using FACE-Q scores and 77% of patients reported high levels of satisfaction and 85% of patients reported high satisfaction with their decision to have the procedure. 10 Further, there was no difference on satisfaction scores between facelift techniques which correlates with other studies in the literature. 5,10 This level II study provides strong evidence for patient satisfaction, 10 yet additional studies with patient-reported outcomes are needed.…”

Use of Micro Botulinum Toxin for a Face-lifting Effect: A Systematic Review

“…13 While studies have suggested that skin tone does not appear to influence the outcome of such computer analysis, 27 given the discordance with physician clinical assessments as shown in this study, perhaps, it is time to consider alternatives such as artificial intelligence, 28 patient-reported outcomes (e.g. FACE-Q surveys), 28 and even eye tracking technology 29 for more objective and valid (i.e. by the patients) assessments.…”

“…Vectra) and showed that there was a statistically significant ( p = .033) reduction in jawline volume between the injected half-face with XEO when compared with the other half with normal saline as control 12 and that such an effect persisted for up to 3 months. 13 While studies have suggested that skin tone does not appear to influence the outcome of such computer analysis, 27 given the discordance with physician clinical assessments as shown in this study, perhaps, it is time to consider alternatives such as artificial intelligence, 28 patient-reported outcomes (e.g. FACE-Q surveys), 28 and even eye tracking technology 29 for more objective and valid (i.e.…”

The Use of the FACE-Q Aesthetic: A Narrative Review

“…The FACE-Q adds a valuable perspective on the effectiveness of facelift procedures alongside traditional outcome measures such as morbidity and may provide the means to incorporate patient perspective and individualize our daily practice's algorithmic approach. For example, one study showed their artificial intelligence model to correctly estimate patients’ age reduction after different facelift techniques [ 60 ].…”