A facelift may make patients look younger, but it won’t necessarily improve their self-esteem, according to a new study.

Surgeons asked 59 patients who were planning get face-lifts to answer 10 questions designed to assess their feelings of self-worth. The patients stated how strongly they agreed or disagreed with statements such as “I take a positive attitude toward myself,” “I feel I do not have much to be proud of” and “At times, I think I am no good at all.”

Possible scores on the overall test range from 0 to 30. Those scoring between 15 and 25 are considered normal; anything lower than 15 would be indicative of low self-esteem.

Fifty patients (48 women and two men) completed the questionnaire before their procedures and then repeated the task six months after their face-lifts, all of which were performed by a single surgeon in New York. Then the surgeon and two colleagues compared the results from before and after.

Before their rhytidectomies, the patients’ average self-esteem score was 24.3, at the high end of normal. After they had lived with their new faces for half a year, the average score had barely budged — to 24.6. The uptick was so small that it could have been due to chance, the researchers reported.

The second questionnaire also asked them how much younger they thought they looked after their surgeries. The average of the answers: 8.9 years. The patients’ ages ranged from 37 to 73.

Next, the researchers sorted the patients into three groups based on their pre-surgery self-esteem scores. Those classified as having low self-esteem had an average score of 18.3 before going under the knife; six months later, their average improved to 22. That difference was large enough to be statistically significant.

At the other end of the spectrum, the patients with high self-esteem started out with a near-perfect average score of 29.7. Six months later, that group’s average had dipped to 26.6 — a statistically significant drop.

For the patients in the middle group, the average self-esteem score increased by half a point after surgery. In other words, it didn’t budge.

In an effort to find some explanation for why the surgeries appeared to do so little for patients’ self-esteem overall, the researchers considered variables such as each patient’s age and body mass index, their history of psychiatric treatment and whether they had other work done at the same time. None of these was significantly related to post-operative self-esteem, they said.

“Patients exhibit a wide spectrum of psychological reactions after face-lift surgery,” they concluded. “This finding underscores the complex nature of the human psyche as it relates to aesthetic surgery.”

The study was published in the JAMA Facial Plastic Surgery