Improvements in the perception of facial attractiveness following surgical aesthetic treatment; study based on online before and after photos.

Background: Aesthetic surgery procedures such as lip augmentation, eyelid correction, face-lifting, or Botox treatment for lines and wrinkles are an important part of cosmetic surgery.

Objectives: The aim of the study was to estimate improvement in appearance following plastic surgery using modern collective intelligence methods of validation.

Methods: A total of 108 photographs showing 54 patients prior to and following cosmetic surgery were downloaded from Internet web presentations of several unnamed plastic surgeons. The same number of photographs depicted each of the four investigated areas of treatment-26 lip enhancement, 26 blepharoplasty, 26 face-lift, 26 botulinum toxin injection. Attractiveness of depicted individuals was assessed by 167 observers. Each photograph was judged separately.

Results: Blepharoplasty produced the most remarkable improvement in attractiveness amounting to 32.79 (SD ± 26.35). Improvement following Botox treatment stood at 30.29 (SD ± 24.55), whereas face-lifting produces improvement of 28.70 (SD ± 22.76). Improvement following lip augmentation was estimated at 12.70 (SD ± 29.8). Highest Spearman's rank correlation coefficient was obtained for face-lift and Botox (0.24 and 0.22, respectively).

Conclusions: Blepharoplasty, face-lifting, and Botox deliver a significant improvement in facial attractiveness. Additionally, face-lifting and Botox are distinguished by a high level of reproducibility. Our results indicate that lip augmentation is a treatment with a statistically significant, but less marked improvement in attractiveness.