Sunday, October 25, 2009 - 10:35 AM
16578

Measuring Quality of Life and Satisfaction in Facial Aesthetic Surgery: Development of a New Patient-Reported Outcome Measure

Andrea L. Pusic, MD, MHS, Anne F. Klassen, DPhil, Stefan Cano, PhD, Amie Scott, BSc, Colleen McCarthy, MD, MS, Haideh Hirmand, MD, Alexes Hazen, MD, David A. Hidalgo, MD, Nick Carr, MD, Frances Jang, MD, Nancy Van Laeken, MD, Jennifer Klok, BSc, Laura Snell, MD, Patrick Reavey, MD, and Peter G. Cordeiro, MD.

Purpose: Few studies have rigorously examined patients’ perceptions of their appearance following facial cosmetic procedures.  In aesthetic surgery, the assessment of patient-reported outcomes is especially pertinent to clinicians because patient satisfaction and improved quality of life are the predominant considerations determining success. In order to appropriately measure the impact of these procedures, well-developed and validated questionnaires are needed.  The objective of this study was to develop a new patient-reported outcome measure (PROM) to evaluate patient satisfaction and quality of life following facial cosmetic procedures (surgical and non-surgical). 
Method: We conducted a qualitative study with three components: 1) systematic literature review; 2) expert panels and 3) in-depth, semi-structured interviews with 50 patients who had undergone elective facial cosmetic procedures. The interviews were recorded, transcribed, and analyzed thematically.  A conceptual model was developed based on the major themes in the interviews.  Patient statements from the interviews were organized within sub-themes of the conceptual model.  Preliminary versions of the questionnaire were piloted to clarify ambiguities in item wording, and to confirm appropriateness, acceptability, and completion time. 
Results: A conceptual model for the impact of aesthetic facial treatment was developed that included core scales relevant to all patients, as well as scales specific to facial areas.  The 5 core scales included the following: (1) satisfaction with facial appearance overall (2) satisfaction with outcome (3) psychological well-being (4) social well-being and (5) satisfaction with consultation and treatment experience.  Scales specific to each facial area included (1) satisfaction with aesthetic outcome and (2) recovery/physical sequelae of surgery.
Conclusions: This new PROM, named the FACE-Q, will provide essential information about the impact and effectiveness of facial aesthetic procedures from the patients' perspective. It will provide surgeons with an important tool to evaluate satisfaction, allow comparisons between various techniques, and aid in identifying groups at risk for dissatisfaction.

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