# Epidemiological and Economic Factors in Facelift Surgery in the USA: A Retrospective Multi-center Analysis

## TL;DR

This study analyzes trends in facelift surgeries in the USA, highlighting demographic patterns, economic factors, and regional disparities.

## Contribution

The paper provides a comprehensive retrospective multi-center analysis of facelift surgery epidemiology and economics using national inpatient data.

## Key findings

- Facelift patients were predominantly female, White, and self-paying with high-income status.
- Minimally invasive procedures were more common among higher-income individuals.
- Facial feminization was an indication in 12.3% of cases, showing a growing trend.

## Abstract

The demand for surgical facial rejuvenation procedures, such as facelifts, has risen in recent decades. However, limited research has addressed the epidemiological and economic aspects of these procedures. This study examines trends in facelift surgeries using data from the Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample (NIS) database.

The HCUP-NIS database, which includes all-payer inpatient cases in the USA, was analyzed for facelift procedures identified through ICD-10 codes from 2016 to 2020. A total of 723 patients met the inclusion criteria. Patient demographics, hospitalization details, and procedural characteristics were evaluated using descriptive statistics. Exploratory comparisons were made across the three surgical technique subgroups, as allocated in ICD-10 procedural coding: open, percutaneous, and percutaneous endoscopic.

The cohort included 723 patients, with a mean age of 56.7 ± 16.2 years, predominantly female (79.4%) and White (81%). Most patients were self-paying (63.2%) and of high-income status (50.8%). Higher-income individuals were more likely to undergo minimally invasive procedures. The average hospital stay was 1.7 ± 1.6 days, with total costs averaging $85,259.60 ± $63,152.80. The most common indication was plastic surgery due to cosmetic reasons. Facelift was also performed for gender dysphoria indications in 12.3% of the cases. Hypertension (18.8%) and nicotine abuse (13.7%) were the most frequent comorbidities.

The results highlight the complex epidemiological and economic environment of inpatient facelift surgery. Procedures are subject to significant regional and socioeconomic disparities. The growing role of facial feminization and heterogenous surgical access warrants further research on emerging trends in esthetic facial surgery.

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