06:42am Saturday 18 January 2020

Do Cosmetic Procedures Help Patients Feel Better? Penn Study Finds Limited Evidence that Facial Procedures Improve Quality of Life or Other Psychological Outcomes

PHILADELPHIA — Despite the rapid rise in facial cosmetic procedures, there are few studies that investigate their psychological impact on patients, especially among those who undergo minimally invasive procedures using botulinum toxin and fillers to address wrinkles. According to a systematic literature review by researchers with the Perel man School of Medicine at the University of Pennsylvania published in JAMA Dermatology, limited research does suggest that a number of psychosocial areas improve after patients undergo facial cosmetic procedures. However, those studies often lacked control groups or failed to follow patients over time, weakening the study validity.

Minimally invasive procedures account for an increasing majority of the more than 12 million facial cosmetic procedures being performed in the United States each year. Surgical procedures like nose jobs and eye lifts decreased nearly 40 percent over the past ten years, as botulinum toxin injections increased by 621 percent in the same time period.

“With the limited amount of well-performed studies, it is certainly premature to conclusively state that facial cosmetic procedures will not only make patients ‘look better’ but also ‘feel better’,” said senior study author Joseph F. Sobanko, MD, assistant professor of Dermatology. “We as dermatologic surgeons, plastic surgeons, dermatologists, and others in the appearance-based specialties need more rigorously performed studies so we can properly advise patients and provide evidence to help determine who is likely to benefit the most from these aesthetic procedures.”

Out of thousands of studies the researchers analyzed, only 16 studies met the authors’ strict inclusion criteria and reported on the psychological impact of facial cosmetic procedures. Half of the included studies combined results from facial and body contouring surgeries like breast augmentation. For surgical facial cosmetic procedures such as face lifts or nose jobs, quality of life and self esteem improved. The single study that investigated a non-surgical procedure revealed an increase in self-esteem and quality of life after botulinum toxin injections. And in the only study to look at a procedure-specific impact on body image, nose jobs significantly improved body image.

Dr. Sobanko noted that Penn is currently enrolling patients in a prospective large-scale study examining psychological changes in patients receiving soft tissue filler and botulinum toxin. 

The Penn Center for Human Appearance team includes Sotonye Imadojemu, MD, MBE, David B. Sarwer, PhD, Ivona Percec, MD, PhD, Jennifer E. Goldsack, MChem, Morgan Berman and Dr. Sobanko. Colleagues from Christiana Care Health System also contributed to the study. Many of the study authors will be speaking at the upcoming Appearance ∞ Identity Conference, on November 1-3 at Penn, for a discussion about issues of self and identity, the impact of appearance on individual and corporate success, medical advances in facial aesthetics, as well as ethical and psychological considerations regarding appearance interventions.


Penn Medicine is one of the world’s leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of the Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania (founded in 1765 as the nation’s first medical school) and the University of Pennsylvania Health System, which together form a $4.3 billion enterprise.

The Perelman School of Medicine has been ranked among the top five medical schools in the United States for the past 16 years, according to U.S. News & World Report‘s survey of research-oriented medical schools. The School is consistently among the nation’s top recipients of funding from the National Institutes of Health, with $398 million awarded in the 2012 fiscal year.

The University of Pennsylvania Health System’s patient care facilities include: The Hospital of the University of Pennsylvania — recognized as one of the nation’s top “Honor Roll” hospitals by U.S. News & World Report; Penn Presbyterian Medical Center; Chester County Hospital; Penn Wissahickon Hospice; and Pennsylvania Hospital — the nation’s first hospital, founded in 1751. Additional affiliated inpatient care facilities and services throughout the Philadelphia region include Chestnut Hill Hospital and Good Shepherd Penn Partners, a partnership between Good Shepherd Rehabilitation Network and Penn Medicine.

Penn Medicine is committed to improving lives and health through a variety of community-based programs and activities. In fiscal year 2012, Penn Medicine provided $827 million to benefit our community.

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