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Influence of Massive Weight Loss on the Perception of Facial Age: The Facial Age Perceptions Cohort

Valente, Denis Souto, M.D., Ph.D.; Braga da Silva, Jefferson, M.D., M.Sc., Ph.D.; Cora Mottin, Claudio, M.D., M.Sc., Ph.D.; Benzano Bumaguin, Daniela, M.Sc.; Santos Rossi, Daniele dos, M.S.; Grimaldi Lerias, Aline, M.S.; Souto Valente, Sibelie, M.Sc.; Vontobel Padoin, Alexandre, M.D., M.Sc., Ph.D.

Plastic and Reconstructive Surgery: October 2018 - Volume 142 - Issue 4 - p 481e-488e
doi: 10.1097/PRS.0000000000004738
Cosmetic: Special Topics
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Psychosocial Insights

Background: Knowledge is scarce about the role of massive weight loss in facial age perception. The aim of this study was to verify whether there is a change in the perception of facial age when comparing people with morbid obesity before surgery and 1 year after the procedure.

Methods: Patients with morbid obesity have been analyzed, through a prospective cohort, before and 1 year after undergoing bariatric surgery. Seven plastic surgeons estimated the age of each subject.

Results: Seventy patients participated. Five patients were excluded because of the exclusion criteria. There was no drop-off among the subjects participating in this cohort. Before surgery, the mean facial age perception was 40.8 years; after surgery, mean facial age perception was 43.7 years (95 percent CI, 0.58 to 2.95; p = 0.004). Men older than 40 years, with a preoperative body mass index between 40 and 49.9 kg/m2, weight greater than 127.65 kg before surgery, and percentage of excess weight lost greater than 75.13 percent demonstrated greater perceived facial aging.

Conclusion: Massive weight loss appears to produce facial aging.


Psychosocial Insights for this Article are on Page 486e.

Porto Alegre, Rio Grande do Sul, Brazil

From the Graduate Program in Medicine and Health Sciences, School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul; and the Hospital de Clinicas.

Received for publication July 23, 2017; accepted April 17, 2018.

This trial is registered under the name “Facial Age Perception Alterations following Bariatric Surgery” (Alterações na percepção da idade facial após cirurgia bariátrica) Brazilian National Health System number 39494914.1.0000.5336.

Disclosure:The authors declare that they do not have any commercial associations or financial disclosures that might pose or create a conflict of interest with information presented in this article. There are no conflicts of interest in this research.

A “Hot Topic Video” by Editor-in-Chief Rod J. Rohrich, M.D., accompanies this article. Go to and click on “Plastic Surgery Hot Topics” in the “Digital Media” tab to watch.

Denis Souto Valente, M.D., Ph.D., Antônio Carlos Berta 475, 7th Floor, Porto Alegre, Rio Grande do Sul, Brazil, 91340-020,

Copyright © 2018 by the American Society of Plastic Surgeons