Perceived Age, Health, Attractiveness and Likeability Following Submental Liposuction and Associated Anthropometric Changes

Goals/Purpose: Patients seek submental liposuction to remove excess fat and fullness under the jawline and achieve a more youthful appearance. However, few studies have examined the effect of neck liposuction on perceived age, health, attractiveness, and likeability. The purpose of this study was to quantify the changes in these perceived parameters following submental liposuction and to identify anthropometric changes that correlate with perceived ratings.

Methods/Technique: This study was a retrospective evaluation of 3D preoperative and postoperative photographs of patients who underwent submental liposuction alone or with other facial rejuvenation procedures by the senior author (DS) between 2014 and 2019. The preoperative and postoperative photographs of patients were split into 2 surveys. The pre and post-operative images were randomized, and the same patient’s images were not included in the same survey to avoid recall bias. A total of 148 survey responses were obtained from laypersons with each individual rating perceived age, health, attractiveness, and likeability. Photogrammetric assessment of patient images was completed using 3D VECTRA software (Canfield, Fairfield, NJ). Differences between pre- and postoperative labiomental angle, cervicomental angle, chin-throat distance, and facial angle were recorded. Paired t-tests were used to assess differences pre- and post-operatively. Multivariate regression was utilized to identify the influence of photogrammetric changes on perceived ratings.

Results/Complications: Twelve patients met the study criteria. All received submental liposuction, 67% received concurrent genioplasty, and 33% received simultaneous neck and face-lift. After surgery, the cervicomental angle decreased by 7.3º (p = 0.0171), chin-throat distance increased by 3.9 mm (p < 0.001), and the facial angle increased by 3.6º (p = 0.001). Decreases in perceived age (-2.43 years, p = 0.028) relative to the post-operative true age was seen in all patients. After controlling for other concurrent procedures, larger decreases in perceived age were seen among patients who, in addition to submental liposuction, received neck lift (p = 0.010). After controlling for other facial angle changes, greater decreases in age were associated with greater decreases of the labiomental (-0.33 years per degree decrease, p = 0.024) and cervicomental (-0.31 years per degree decrease, p = 0.04510) angles (R2 = 0.7348). There was a small but insignificant increase in health following surgery (p = 0.086). No statistically significant difference was noted for attractiveness (p = 0.49) or likeability (p = 0.803).

Conclusion: Submental liposuction is effective in reducing perceived patient age. This effect is more pronounced when preformed with neck lift. Furthermore, decreases in labiomental and cervicomental angle are associated with decreased perceived age.