Satisfaction with facial appearance and its determinants in adults with severe congenital facial disfigurement: A case-referent study

• Published in: Journal of plastic, reconstructive & aesthetic surgery Vol. 63; no. 10; pp. 1642 - 1649
• Main Authors: Versnel, S.L, Duivenvoorden, H.J, Passchier, J, Mathijssen, I.M.J
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01.10.2010; Elsevier
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Analysis of Variance; Biological and medical sciences; Body Image; Congenital; Craniofacial Abnormalities - psychology; Craniofacial Abnormalities - surgery; Cross-Sectional Studies; Educational Status; Facial appearance; Facial disfigurement; Facial Injuries - psychology; Facial Injuries - surgery; Female; Humans; Long-term outcome; Male; Medical sciences; Middle Aged; Patient Satisfaction; Plastic Surgery; Psychology; Satisfaction; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surveys and Questionnaires; Facial disfigurement; Long-term outcome; Congenital; Facial appearance; Psychology; Satisfaction; Human; Prognosis; Long term; Case study; Treatment; Surgery; Adult; Face
• ISSN: 1748-6815; 1878-0539
• DOI: 10.1016/j.bjps.2009.10.018

Summary Background Patients with severe congenital facial disfigurement have a long track record of operations and hospital visits by the time they are 18 years old. The fact that their facial deformity is congenital may have an impact on how satisfied these patients are with their appearance. This study evaluated the level of satisfaction with facial appearance of congenital and of acquired facially disfigured adults, and explored demographic, physical and psychological determinants of this satisfaction. Differences compared with non-disfigured adults were examined. Methods Fifty-nine adults with a rare facial cleft, 59 adults with a facial deformity traumatically acquired in adulthood, and a reference group of 201 non-disfigured adults completed standardised demographic, physical and psychological questionnaires. Results The congenital and acquired groups did not differ significantly in the level of satisfaction with facial appearance, but both were significantly less satisfied than the reference group. In facially disfigured adults, level of education, number of affected facial parts and facial function were determinants of the level of satisfaction. High fear of negative appearance evaluation by others (FNAE) and low self-esteem (SE) were strong psychological determinants. Although FNAE was higher in both patient groups, SE was similar in all three groups. Conclusion Satisfaction with facial appearance of individuals with a congenital or acquired facial deformity is similar and will seldom reach the level of satisfaction of non-disfigured persons. A combination of surgical correction (with attention for facial profile and restoring facial functions) and psychological help (to increase SE and lower FNAE) may improve patient satisfaction.