Can Facial Surgery Shape Men's Perceived Personalities?

Face lifts, neck tucks, and nose jobs improved external perceptions of male personality traits, a small survey found.

Based on 145 survey responses to before-and-after plastic surgery images, any facial cosmetic procedure -- such as a face, brow, and neck lift; rhinoplasty; or blepharoplasty (eyelid surgery) -- was associated with significant score increases in attractiveness (0.29, 95% CI 0.13-0.46), likeability (0.41, 95% CI 0.24-0.57), social skills (0.25, 95% CI 0.08- 0.40), and trustworthiness (0.27 95% CI 0.11-0.44), reported Michael Reilly, MD, of Georgetown University, and colleagues.

However, facial procedures had less of an impact on scores for perceived extroversion (0.11, 95% CI −0.06 to 0.27), risk seeking (−0.01, 95% CI −0.17 to 0.15), aggressiveness (−0.14, 95% CI −0.30 to 0.02), or masculinity (0.13, 95% CI −0.03 to 0.30), they wrote in JAMA Facial Plastic Surgery.

While prior research has established that facial procedures can enhance patients' perceived attractiveness, the impact of cosmetic surgery on other personality traits has not been as well-established, Reilly told MedPage Today.

"The impacts I see on my patients are way more than physical attractiveness," Reilly said. "Especially when you're talking about a 75-year-old, is the goal really to make them look dimorphically, sexually more attractive, or is your goal to make them look more relevant and engaged and interested? Those [traits] have never really been discussed -- it's always about making them look younger and more attractive."

Reilly said the findings may be attributable to the over-generalization theory, which states that "personality perceptions are drawn from inferences based on the hint of dynamic expression."

"Facial profiling," or the idea that certain facial qualities evoke positive or negative subconscious reactions, may also be at play, he and colleagues noted. For example, when someone is thought to be attractive, they are more likely to be perceived as social, dominant, happy, and successful.

"What's happening is the changes made to these people's faces are probably changing the cornerstone of emotional expressions," Reilly said. "The eyes and the corners of the mouth are the crux of facial expression. Those are being manipulated through surgeries and are likely enhancing those particular character traits."

For example, eye shape has been linked to alertness and vitality, which may explain why patients undergoing upper blepharoplasty in this study had improved likeability and trustworthiness postoperatively, Reilly and colleagues noted.

As far as the nose goes, patients who underwent rhinoplasty had significantly improved perceptions of attractiveness and likeability, in line with another recent study, which went further to say that a ski-slope shaped nose in men, specifically, was associated with attractiveness, while noses without dorsal humps were associated with youth, approachability, and femininity.

The study at hand follows prior research by the same group that similarly found females had improved likeability, social skills, attractiveness, and femininity after facial surgery, but perceptions regarding trustworthiness, aggressiveness, extroversion, and risk seeking remained unchanged.

Interestingly, the present study showed men with face-lifts had improved perceived likeability and trustworthiness, but the prior study found women who underwent face-lifts had improved perceptions of femininity, social skills, attractiveness, and likeability.

"Overall, the data suggest that the current repertoire and execution of facial cosmetic procedures for men are likely not as gender-enhancing as they are for women," the authors wrote.

For this study, a web-based survey tool was used to distribute pre- and post-operative photos of 24 white, male patients (mean age of around 49) who underwent facial cosmetic surgery performed by Reilly and an additional co-author. Six surveys -- each including only one photo of each patient to reduce bias -- were created from these photos and distributed to at least 36 laypersons who rated their internal criticisms of the patients on a 7-point scale. The response rate was about 55% and a minimum of 24 responses were collected for each survey.

Three-quarters of respondents were white (76%), about half were men (56%), most were young (ages 25-34), and almost all had at least a bachelor's degree (95%). All respondents were blinded to the purpose of the survey and physicians or other professionals working in fields related to facial analysis were excluded.

Chin augmentation -- or creating a traditionally more masculine jawline -- was the only surgery not associated with attractiveness, masculinity, or personality, the authors noted, though they attributed this to a small sample size in the subgroup (4 men).

Lastly, patients who underwent lower blepharoplasty were less often perceived as risk-seeking, while brow-lifts were associated with increased risk-seeking, as well as extroversion, Reilly and his team reported.

Reilly emphasized that this study involves a relatively small group of patients from only two surgeons, and thus its findings may not be generalizable. Also, selection bias may have affected the results since the participating patients elected to have their photos sent out and personality differences among raters participating in the survey may also exist. Finally, these findings don't estimate effect sizes and thus may not be translatable to the individual, the authors concluded.

Comment