Even though we are taught to “never judge a book by its cover,” a new study suggests people make immediate judgments about someone’s character based on his or her appearance.

The study suggests women who underwent facial rejuvenation surgery were perceived to be not only more attractive, but also more likeable, to have better social skills and be more feminine than people without surgery.

The types of surgery the study looked at included: facelifts, necklifts, browlifts, upper and lower eyelid lifts and chin implants.
The study, published in the journal JAMA Facial Plastic Surgery, suggests people perceive others to be happier or more likeable simply based on their resting facial expression- facial profiling.
“The judgments we make about people are based on how closely their resting facial expressions resemble the expression associated with a known emotion,” said Dr. Michael Reilly, a head and neck surgery at Georgetown University, who conducted the study.
The people leading the study showed 170 participants photos of 30 Caucasian women before and after plastic surgery. The reviewers rated their perception of personality traits in the woman featured in the photos. Both a patient’s preoperative and postoperative photos were not shown to the same reviewer. The individuals rated each photograph for aggressiveness, extroversion, likability, trustworthiness, risk seeking, social skills, attractiveness and femininity.
Of the eight traits tested, the study showed a statistically significant improvement in the scores for likeability, social skills, attractiveness and femininity for the postoperative photos compared to the preoperative photos.

“The femininity and attractiveness findings are likely more directly related to the perception of these traits being associated with a more youthful appearance,” said Dr. Michael Reilly, “the improved trustworthiness findings most likely relate to the eyes appearing more open and less tired.”

Dr. Pablo Prichard, senior partner at Advanced Aesthetic Association and chief of plastic surgery at HonorHealth, formerly John C. Lincoln Hospital, said that certain surgeries, such as a face lift, amass more change in personality traits than others. A face lift smooths out your jawline Prichard said, which is a younger feature and youthfulness is often associated with likability and attractiveness.

“When you lift the contours of the face with a facelift to reverse the trend toward a resting frown, they look happier and therefore more likeable,” Reilly said, “When you make someone look more relaxed or less tired by removing the bags under their eyes, they look more  sociable.”

The results of this study challenge the notion that femininity and attractiveness, usually linked with sexual desirability, are an adequate measure for assessing the outcomes of cosmetic surgery, Reilly said. He find this very interesting because most facial rejuvenation surgery is done on older patients.

Reilly says he hopes that both patients and physicians will be more aware of the other dimensions of an individual’s sense of person  that may be changed through surgery and to incorporate it into the  surgical decision making conversation.