Objective <p>This study aims to assess the impact of age on psychological expectations and postoperative satisfaction in facial aesthetic surgery patients.</p> Methods <p>We retrospectively analyzed data from 248 patients who underwent facial rejuvenation surgery between January 2024 and January 2025. Patients were grouped by age and evaluated using the FACE-Q tool.</p> Results <p>Younger patients had significantly higher preoperative expectations and appearance-related stress than older patients (<i>P</i> &lt; 0.001). While both groups showed improved postoperative satisfaction, younger patients had lower overall satisfaction (<i>P</i> &lt; 0.001). Age and preoperative expectations were found to be independent risk factors for dissatisfaction.</p> Conclusion <p>Younger patients had higher preoperative expectations but lower postoperative satisfaction. Age and psychological expectations significantly influence satisfaction, highlighting the need for better expectation management in younger patients to improve outcomes.</p> Level of Evidence II <p>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors <a href="http://www.springer.com/00266">www.springer.com/00266</a>.</p>