Impact of Facial Regions on Perceived Age: A 3-Dimensional Modeling Study.

BACKGROUND

Perception studies in aesthetic plastic surgery help define ideals of attractiveness and youth that guide treatment planning. Although comprehensive facial rejuvenation yields superior and longer-lasting results, real-world constraints often require prioritizing interventions. The relative contribution of different facial regions to perceived age remains unclear.

OBJECTIVES

This study aimed to determine the relative contributions of the perioral, periocular, midface-lower face, and neck-jawline regions to perceived youth.

METHODS

An aged female 3-dimensional head-and-neck model was digitally sculpted to create 1 baseline young model and 4 variants, each featuring isolated rejuvenation of a single region: eyes, lips, midface-lower face, or neck-jawline. Region-specific changes simulated outcomes of common aesthetic surgical procedures while preserving overall identity. Each variant was rendered as a standardized animated sequence. Participants viewed all animations and ranked them from youngest to oldest. Associations between regions and perceived age were statistically analyzed.

RESULTS

A total of 101 participants completed the survey. The neck-jawline was most frequently ranked as youngest (n = 54), whereas the perioral was most often ranked as oldest (n = 71). Mean ranks differed significantly among regions (neck-jawline 1.8, midface-lower face 2.2, periocular 2.6, and perioral 3.6; P < .001). Pairwise comparisons were significant, except between periocular and midface-lower face (P = .4).

CONCLUSIONS

The neck-jawline exerted the greatest influence on perceived youth, followed by midface-lower face, periocular regions, and perioral region. These findings suggest that structural cues defining facial contour play a dominant role in age perception and may help guide prioritization of facial rejuvenation strategies.

LEVEL OF EVIDENCE: 4 (THERAPEUTIC): For image description, please refer to the figure legend and surrounding text.