Impact of Cosmetic Facial Surgery on Satisfaction With Appearance and Quality of Life

Objectives:Toassessperioperativequality-of-life(QOL) changesinafacialplasticsurgerypatientpopulationand toascertainfactorsdeterminativeofQOLchanges.Ano- tablepaucityofobjectivescientificmeasurementsofQOL exists within the facial plastic surgery literature. Methods: A 3-year prospective cohort study. The pa- tient population, which comprised a consecutive series of patients 16 years or older, undergoing cosmetic nasal or facialsurgery,wasobtainedfromtheseniorauthor's(P.A.A.) private surgical practice. All patients presenting for sur- gery were offered participation. The main outcome mea- surewasthe59-itemDerrifordAppearanceScale(DAS59), avalidandreliableinstrumentassessingpsychologicaldis- tress associated with self-consciousness of facial appear- ance. Three patient score subgroupings were established: group 1, the DAS59 scores for all patients; group 2, the DAS59scoreaccordingtosex;andgroup3,theDAS59score accordingtothemainsurgicalprocedure.Surveysweread- ministeredtoeligiblepatientsatthefinalpreoperativeclinic visit and at 3 months after surgery. Data from the case- controlgroupswereanalyzedbyablindedstatisticianwith appropriate t tests. Results: A total of 93 patients were enrolled with a 100% response rate (82 females (88%) and 11 males (12%)). The most common procedures were rhino- plasty (49%) and surgery for the aging face (51%). Marked differences in perioperative QOL were noted across all DAS59 domains for group 1 and for all females in group 2. Male patients in group 2 analysis experienced QOL improvement only from DAS59 domain 2 (General Self-consciousness of Facial Appearance). Rhinoplasty and surgery for the aging face improved patients' QOL but differed with respect to which DAS59 domains were affected.