Autologous Biological Vitamin-C-added (ABC) Filler for Facial Volume Restoration

Measuring the Impact of Surgical and Non-surgical Facial Cosmetic Interventions Using FACE-Q Aesthetic Module Scales: A Systematic Review and Meta-Analysis

Background: The FACE-Q Aesthetic module measures patient-important outcomes following surgical and non-surgical facial cosmetic procedures. Objective: The primary aim of this systematic review was to summarize the pre- to post-intervention mean differences of facial aesthetic interventions that evaluate outcomes using the FACE-Q Face Overall, Psychological, and Social scales. Methods: Ovid Medline, Embase, Cochrane, and Web of Science databases were searched on December 20, 2022 with the assistance of a health-research librarian (CRD42023404238). Studies that examined any surgical or non-surgical facial aesthetic intervention in adult patients and used FACE-Q Aesthetics Face Overall, Psychological, and/or Social scales to measure participants before and after treatment were included for analysis. Results: Of 914 potential articles screened, 35 studies met the inclusion criteria. Most studies evaluated surgical (n = 22, 62.9%) versus non-surgical facial cosmetic interventions (n = 13, 37.1%). Rhinoplasty [37.0 points, 95% CI 24.7-49.3, P < 0.01] demonstrated the largest weighted increase in Face Overall scores, whereas the largest increase in Psychological [67.1 points, 95% CI 62.9-71.3, P < 0.01] and Social [63.9 points, 95% CI 53.2-74.6, P < 0.01] scores was demonstrated by a single study evaluating surgical forehead lifts, respectively. Conclusions: This meta-analysis leverages FACE-Q Aesthetic module scoring to present the expected mean differences in Face Overall, Psychological, and Social scale scores for various surgical and non-surgical facial cosmetic interventions. The findings from this review may be used to indirectly compare interventions and contribute to sample size calculations when planning future studies.

Best Practices for FACE-Q Aesthetics Research: A Systematic Review of Study Methodology

BACKGROUND

The FACE-Q Aesthetics module is a validated patient-reported outcome measure (PROM) that evaluates perspectives on facial aesthetic treatments. Improper administration and poor study methodology can compromise the validity and interpretation of this PROM.

OBJECTIVES

This systematic review sought to evaluate the administration and scoring of the FACE-Q Aesthetics scales within the literature.

METHODS

A search of Ovid Medline, Embase, Cochrane, and Web of Science was performed on December 20, 2022, with the assistance of a health-research librarian (CRD42022383676). Studies that examined facial aesthetic interventions using the FACE-Q Aesthetics module as a primary or secondary outcome measure were included for analysis.

RESULTS

There were 114 studies included. The Face Overall (n = 52, 45.6%), Psychological (n = 45, 39.4%), and Social (n = 43, 37.7%) scales were most frequently reported. Errors in FACE-Q administration were identified in 30 (26.3%) studies. The most common error was the presentation of raw ordinal scores rather than the converted Q score (n = 23). Most studies reported a time horizon for their primary analysis (n = 76, 66.7%); however, only 4 studies provided a rationale for this selection. Sample size calculations for the primary outcome were rarely performed (n = 9, 7.9%).

CONCLUSIONS

There continues to be limitations in PROM administration and the quality of articles that report FACE-Q Aesthetic scale data. The authors suggest that future investigators using the FACE-Q refer to the User's Guide regarding administration and scoring of this scale, report a rationale for the study time horizon, and provide an a priori sample size calculation for the primary outcome of interest.