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Salehi PP, Shah HP, Torabi SJ, Heiser A, Salehi P, Peng GL, Nassif P, Lee YH, Azizzadeh B. Characterizing the Rhinoplasty Outcomes Most Important to Patients, Surgeons, and the General Population. J Craniofac Surg 2024:00001665-990000000-01481. [PMID: 38688025 DOI: 10.1097/scs.0000000000010150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 01/24/2024] [Indexed: 05/02/2024] Open
Abstract
Understanding rhinoplasty characteristics important to patients, physicians, and society is essential for evaluating outcomes and designing optimal treatment plans. The authors aimed to elucidate specific rhinoplasty-related outcomes that are most important to patients, surgeons, and the general population. A cross-sectional survey comprising 11 rhinoplasty-specific characteristics, was distributed to patients, facial plastic surgeons, and the general population. Adult patients presenting for rhinoplasty consideration or follow-up after undergoing rhinoplasty were recruited. Characteristics rankings were compared between the 3 respondent groups using Spearman's rank correlation coefficient (ρ). Responses from 150 surgeons, 111 patients, and 102 lay individuals from the general population were included for analysis. When ranking rhinoplasty-specific characteristics in order of importance, patients and the general population ranked "ability to breathe through nose while awake" first and "overall appearance of nose" as second. Surgeons ranked "overall appearance of nose" first and "ability to breathe through nose while awake" second. There were strong correlations between patients' and surgeons' rankings (Spearman's ρ=0.836, P=0.002), between patients' and the general population's rankings (Spearman's ρ=0.773, P=0.007), and between surgeons' and the general population's rankings (Spearman's ρ=0.782, P=0.006). Our results highlight a significant correlation between characteristics of the "ideal" nose as determined by patients, surgeons, and the general population.
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Affiliation(s)
- Parsa P Salehi
- Department of Facial Plastic Surgery, Newport Beach
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, Yale School of Medicine, New Haven, CT
| | - Hemali P Shah
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, Yale School of Medicine, New Haven, CT
- Department of Otolaryngology-Head and Neck Surgery, MedStar Georgetown University Hospital, Washington, DC
| | - Sina J Torabi
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine
| | - Alyssa Heiser
- Department of Otolaryngology-Head and Neck Surgery, Tufts Medical Center, Boston, MA
| | - Pauniz Salehi
- Department of Nutritional Sciences, College of Human Ecology, Cornell University, Ithaca, NY
| | | | | | - Yan H Lee
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, Yale School of Medicine, New Haven, CT
| | - Babak Azizzadeh
- Center for Advanced Facial Plastic Surgery, Beverly Hills, CA
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Warinner C, Loyo M, Gu J, Wamkpah NS, Chi JJ, Lindsay RW. Patient-Reported Outcomes Measures in Rhinoplasty: Need for Use and Implementation. Facial Plast Surg 2023; 39:517-526. [PMID: 37290455 DOI: 10.1055/s-0043-1769806] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023] Open
Abstract
Patient-reported outcome metrics (PROMs) are increasingly utilized to capture data about patients' quality of life. PROMs play an important role in the value-based health care movement by providing a patient-centered metric of quality. There are many barriers to the implementation of PROMs, and widespread adoption requires buy-in from numerous stakeholders including patients, clinicians, institutions, and payers. Several validated PROMs have been utilized by facial plastic surgeons to measure both functional and aesthetic outcomes among rhinoplasty patients. These PROMs can help clinicians and rhinoplasty patients participate in shared decision making (SDM), a process via which clinicians and patients arrive at treatment decisions together through a patient-centered approach. However, widespread adoption of PROMs and SDM has not yet been achieved. Further work should focus on overcoming barriers to implementation and engaging key stakeholders to increase the utilization of PROMs in rhinoplasty.
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Affiliation(s)
- Chloe Warinner
- Department of Otolaryngology - Head and Neck Surgery, Harvard Medical School, Massachusetts Eye and Ear, Boston, Massachusetts
| | - Myriam Loyo
- Department of Otolaryngology - Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon
| | - Jeffrey Gu
- Department of Otolaryngology - Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon
| | - Nneoma S Wamkpah
- Department of Otolaryngology - Head and Neck Surgery, Washington University in St. Louis, St Louis, Missouri
| | - John J Chi
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology - Head and Neck Surgery, Washington University in St Louis, St Louis, Missouri
| | - Robin W Lindsay
- Department of Otolaryngology - Head and Neck Surgery, Harvard Medical School, Massachusetts Eye and Ear, Boston, Massachusetts
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Citron I, Townley W. Assessing outcomes from rhinoplasty using clinical and patient reported measures (FACE-Q™). J Plast Reconstr Aesthet Surg 2023; 84:182-186. [PMID: 37336165 DOI: 10.1016/j.bjps.2023.04.091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 03/25/2023] [Accepted: 04/08/2023] [Indexed: 06/21/2023]
Abstract
AIM To assess the effect of cosmetic rhinoplasty on PROMS using the FACE-Q™ tool. METHODS Between July 2020 and February 2022 all patients undergoing rhinoplasty by a single surgeon were approached pre-operatively and 6 months post-operatively to complete the Face-Q™ "Satisfaction with Nose" module. Post-operative patients were asked to complete the FACE-Q™ "Satisfaction with Outcome" module. RESULTS One hundred and sixty-five patients underwent rhinoplasty (147 primary, 18 revisions). Eighty two percent (n = 135) completed a pre-operative "Satisfaction with Nose" module. Thirty three percent (n = 54) completed the full pre and post- operative dataset. The mean pre-operative "Satisfaction with Nose" score was 32.88 (± 8.40). The mean post-operative "Satisfaction with Nose" score was 77.45 (SD17.26) and "Satisfaction with Outcome" score was 75.27(SD 21.88). The mean change in score 133% (SD 63%). Seventy-seven percent of patients were "very satisfied" or "somewhat satisfied" across all 10 aspects of the nose. The tip had the lowest post-operative satisfaction with 19% of patients somewhat or very dissatisfied. CONCLUSION Rhinoplasty generates significant improvements in PROMS and satisfaction is high, an important positive finding for patients considering surgery. Routine collection of PROMS for rhinoplasty can inform practice and guide expectations as to its psychological impact.
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Affiliation(s)
- Isabelle Citron
- Weymouth Street Hospital, 42-46 Weymouth St, London W1G 6NP, United Kingdom.
| | - William Townley
- Weymouth Street Hospital, 42-46 Weymouth St, London W1G 6NP, United Kingdom
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Gallo L, Kim P, Yuan M, Gallo M, Thoma A, Voineskos SH, Cano SJ, Pusic AL, Klassen AF. Best Practices for FACE-Q Aesthetics Research: A Systematic Review of Study Methodology. Aesthet Surg J 2023; 43:NP674-NP686. [PMID: 37162009 DOI: 10.1093/asj/sjad141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/02/2023] [Accepted: 05/03/2023] [Indexed: 05/11/2023] Open
Abstract
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.
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Ottenhof MJ, Veldhuizen IJ, Hensbergen LJV, Blankensteijn LL, Bramer W, Lei BV, Hoogbergen MM, Hulst RRWJ, Sidey-Gibbons CJ. The Use of the FACE-Q Aesthetic: A Narrative Review. Aesthetic Plast Surg 2022; 46:2769-2780. [PMID: 35764813 PMCID: PMC9729314 DOI: 10.1007/s00266-022-02974-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 05/25/2022] [Indexed: 01/01/2023]
Abstract
INTRODUCTION In the past decade there has been an increasing interest in the field of patient-reported outcome measures (PROMs) which are now commonly used alongside traditional outcome measures, such as morbidity and mortality. Since the FACE-Q Aesthetic development in 2010, it has been widely used in clinical practice and research, measuring the quality of life and patient satisfaction. It quantifies the impact and change across different aspects of cosmetic facial surgery and minimally invasive treatments. We review how researchers have utilized the FACE-Q Aesthetic module to date, and aim to understand better whether and how it has enhanced our understanding and practice of aesthetic facial procedures. METHODS We performed a systematic search of the literature. Publications that used the FACE-Q Aesthetic module to evaluate patient outcomes were included. Publications about the development of PROMs or modifications of the FACE-Q Aesthetic, translation or validation studies of the FACE-Q Aesthetic scales, papers not published in English, reviews, comments/discussions, or letters to the editor were excluded. RESULTS Our search produced 1189 different articles; 70 remained after applying in- and exclusion criteria. Significant findings and associations were further explored. The need for evidence-based patient-reported outcome caused a growing uptake of the FACE-Q Aesthetic in cosmetic surgery and dermatology an increasing amount of evidence concerning facelift surgery, botulinum toxin, rhinoplasty, soft tissue fillers, scar treatments, and experimental areas. DISCUSSION The FACE-Q Aesthetic has been used to contribute substantial evidence about the outcome from the patient perspective in cosmetic facial surgery and minimally invasive treatments. The FACE-Q Aesthetic holds great potential to improve quality of care and may fundamentally change the way we measure success in plastic surgery and dermatology. LEVEL OF EVIDENCE III 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 www.springer.com/00266 .
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Affiliation(s)
- Maarten J Ottenhof
- Division of Plastic and Reconstructive Surgery, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA, 02115, USA.
- Department of Plastic and Reconstructive Surgery, Catharina Ziekenhuis, Eindhoven, The Netherlands.
- Department of Plastic and Reconstructive Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.
- Patient-Reported Outcomes, Value & Experience (PROVE) Center, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.
| | - Inge J Veldhuizen
- Department of Plastic and Reconstructive Surgery, Catharina Ziekenhuis, Eindhoven, The Netherlands
| | - Lusanne J V Hensbergen
- Department of Plastic and Reconstructive Surgery, Catharina Ziekenhuis, Eindhoven, The Netherlands
| | - Louise L Blankensteijn
- Department of Plastic and Reconstructive Surgery, Catharina Ziekenhuis, Eindhoven, The Netherlands
| | - Wichor Bramer
- Medical Library, Erasmus MC, Erasmus University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Berend Vd Lei
- Department of Plastic Surgery, University and University Medical School of Groningen and Bey Bergman Clinics, Groningen, The Netherlands
| | - Maarten M Hoogbergen
- Department of Plastic and Reconstructive Surgery, Catharina Ziekenhuis, Eindhoven, The Netherlands
| | - René R W J Hulst
- Department of Plastic and Reconstructive Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Chris J Sidey-Gibbons
- Patient-Reported Outcomes, Value & Experience (PROVE) Center, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA
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Autologous Biological Vitamin-C-added (ABC) Filler for Facial Volume Restoration. Aesthetic Plast Surg 2021; 45:2328-2337. [PMID: 33973050 DOI: 10.1007/s00266-021-02297-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 04/01/2021] [Indexed: 12/29/2022]
Abstract
PURPOSE Face rejuvenation procedures with injectable agents continue to gain popularity. Nowadays, a variety of commercial products are available as filler material. Ideal fillers should be inexpensive, easily obtainable, nontoxic, and biocompatible. The aim of this study is to report a clinical perspective for an appropriate, feasible, and inexpensive protocol of a stable, autologous biological filler for facial volume restoring without any commercial kits. METHODS Eight patients were investigated who underwent facial injection with ABC filler. Eleven ml of whole blood was placed in standard tubes containing anticoagulant and for each patient, 8 tubes were prepared. After the centrifugation at 1630 xg for 5 minutes, the upper plasma was taken, calcium was added and cooled. After the addition of vitamin C, the syringes were incubated at 85 °C for 10 minutes. The autologous biological material obtained was used as filling material. For comparison, FACE-Q satisfaction questionnaires were used before and after the procedure. RESULTS All patients were followed up for a minimum of 4 months. No major complications were recorded. The patient-reported FACE-Q satisfaction and FACE-Q quality of life pre- and post-procedure results showed statistically significant improvement (p < 0.05). Overall satisfaction with the outcome was 89.12 ± 16.73 (range 55-100). CONCLUSIONS ABC filler can be seen as a reliable, inexpensive, and easily obtainable material to restore facial volume with increased patient satisfaction and quality of life scores. We believe that our study will be encouraging to the application of autologous biological fillers for further clinical and scientific studies. LEVEL OF EVIDENCE IV 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 www.springer.com/00266 .
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Haddady Abianeh S, Moradi Bajestani S, Rahmati J, Shahrbaf MA, Fatehi Meybodi A. Evaluation of Aesthetic and Functional Outcomes After Open Rhinoplasty: A Quasi-experimental Study by the Aid of ROE and RHINO Questionnaires. Aesthetic Plast Surg 2021; 45:663-669. [PMID: 32747985 DOI: 10.1007/s00266-020-01905-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 07/26/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS Rhinoplasty is one of the common plastic surgery procedures which has a high rate in Iran. There are several tools for assessing the outcomes and quality of life after this surgical procedure which rhinoplasty outcome evaluation (ROE) questionnaire and rhinoplasty health inventory and nasal outcomes are two of them. The aim of this study was to investigate the aesthetic and functional outcomes of rhinoplasty by the aid of ROE and RHINO scales in patients who presented to a referral center in Iran. MATERIALS AND METHODS This prospective, quasi-experimental study was performed on patients who referred to the plastic surgery clinic of Imam Khomeini hospital complex during 2017 to 2019 and underwent open rhinoplasty. ROE and RHINO questionnaires were filled by patients before and 6 months after the surgery. Surgical outcomes and aesthetic satisfaction rate were evaluated in different age groups, genders and educational levels. The data were analyzed by version 21 of SPSS software. RESULTS ROE score increased from 51.27 ± 10.54 to 79.6 ± 9.67 (P < 0.001). In addition, RHINO score increased from 64.13 ± 11.43 to 83.36 ± 11.03 (P < 0.001). The most common satisfaction factors among patients in this study were "nose feels more natural" in 62% of patients and "tip rotation is good" in 32% of patients. Furthermore, the most common causes of dissatisfaction in patients were "nose too wide" in 25% of patients and "tip bulbous" in 25% of patients. CONCLUSION ROE and RHINO scales are effective for assessing rhinoplasty outcomes. The satisfaction rate of rhinoplasty is high in Iran and is related to the natural shape of the nose in addition to the tip rotation. LEVEL OF EVIDENCE IV 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 www.springer.com/00266 .
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Affiliation(s)
- Shahriar Haddady Abianeh
- Department of Plastic and Reconstructive Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
- Department of Plastic and Reconstructive Surgery, Razi Hospital, Tehran University of Medical Sciences, Wahdat-e-Islami St., District 12, Tehran, Tehran Province, 1199663911, Iran
| | - Sohrab Moradi Bajestani
- Department of Plastic and Reconstructive Surgery, Razi Hospital, Tehran University of Medical Sciences, Wahdat-e-Islami St., District 12, Tehran, Tehran Province, 1199663911, Iran.
- Department of Plastic and Reconstructive Surgery, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - Javad Rahmati
- Department of Plastic and Reconstructive Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
- Department of Plastic and Reconstructive Surgery, Razi Hospital, Tehran University of Medical Sciences, Wahdat-e-Islami St., District 12, Tehran, Tehran Province, 1199663911, Iran
| | | | - Abolfazl Fatehi Meybodi
- Department of Plastic and Reconstructive Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
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Ferreira MG, Santos M, e Carmo DO, Fertuzinhos A, e Sousa CA, Santos J, Dourado N, Amarante J. Spare Roof Technique Versus Component Dorsal Hump Reduction: A Randomized Prospective Study in 250 Primary Rhinoplasties, Aesthetic and Functional Outcomes. Aesthet Surg J 2021; 41:288-300. [PMID: 32722776 DOI: 10.1093/asj/sjaa221] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Most Caucasian aesthetic rhinoplasty patients complain about having a noticeable hump in profile view. Taking the integrity of the middle vault into consideration, there are 2 ways to dehump a nose: the structured technique and the preservation technique. OBJECTIVES The aim of this study was to compare the aesthetic and functional outcomes of 2 reduction rhinoplasty techniques. METHODS We performed a prospective, randomized, interventional, and longitudinal study on 250 patients randomly divided into 2 groups: the component dorsal hump reduction group (CDRg) (n = 125) and the spare roof technique group (SRTg) (n = 125). We utilized the Utrecht Questionnaire for Outcome Assessment in Aesthetic Rhinoplasty. Patients answered the questionnaire before the surgery, and at 3 and 12 months after surgery. In addition, we utilized a visual analog scale (VAS) to score nasal patency for each side. RESULTS Analyses of the preoperative and postoperative aesthetic VAS scores showed a significant improvement in both groups, from 3.66 to 7.00 (at 3 months) to 7.35 (at 12 months) in the CDRg, and from 3.81 to 8.14 (at 3 months) to 8.45 (at 12 months) in the SRTg. Analyses of postoperative means of aesthetic VAS scores showed a significant improvement in both groups over time. However, aesthetic improvement was higher in the SRTg than in the CDRg at both 3 (P < 0.001) and 12 months (P < 0.001) postsurgery. Analyses of the mean functional VAS scores showed a significant improvement with both techniques, with a better result for the SRTg. CONCLUSIONS The SRT is a reliable technique that can help deliver consistently better aesthetic and functional results than CDR for reduction rhinoplasty in Caucasian patients with a dorsal hump. LEVEL OF EVIDENCE: 2
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Affiliation(s)
- Miguel Gonçalves Ferreira
- Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar—Universidade do Porto, Portugal
| | - Mariline Santos
- Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar—Universidade do Porto, Portugal
| | | | | | - Cecília Almeida e Sousa
- Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar—Universidade do Porto, Portugal
| | - Jorge Santos
- Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar—Universidade do Porto, Portugal
| | - Nuno Dourado
- Universidade do Minho, Departamento de Engenharia Mecânica, Guimarães, Portugal
| | - José Amarante
- Faculdade de Medicina da Universidade do Porto, Portugal
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Lisiecki JL, Gilman RH. Invited Discussion on "Awareness of Facial Asymmetry and Its Impact on Postoperative Satisfaction of Rhinoplasty Patient". Aesthetic Plast Surg 2021; 45:221-223. [PMID: 33063160 DOI: 10.1007/s00266-020-02003-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 09/28/2020] [Indexed: 10/23/2022]
Abstract
In this invited discussion, we applaud the authors of "Awareness of Facial Asymmetry and Its Impact on Postoperative Satisfaction of Rhinoplasty Patient" for their efforts to reinforce the importance of recognizing facial asymmetry preoperatively in the rhinoplasty patient. They can be applauded for translating this known key factor into data in the form of validated patient-reported outcomes tools. The study could be improved by better defining the asymmetry that the study patients had and investigating the symmetry of the surgical result. Furthermore, we provide suggestions for how to better counsel patients on facial asymmetry and its effects on their rhinoplasty result. LEVEL OF EVIDENCE V: 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 www.springer.com/00266.
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Abstract
BACKGROUND Cosmetic procedures have demonstrated beneficial effects on physical appearance based on anatomic markers as well as patient-perceived self-image and quality of life. Recent studies of observer-reported outcomes (OROs) suggest an additional benefit from aesthetic interventions. OBJECTIVE The authors aimed to review the evidence of OROs from cosmetic procedures performed on the head and neck. PATIENTS, METHODS AND MATERIALS PubMed, Embase, and Cochrane Library databases were searched for relevant studies, yielding 24 included original investigations. RESULTS These studies captured 686 total patients, 8,257 observer evaluations, and a variety of interventions including face-lifts, blepharoplasty, rhinoplasty, and minimally invasive treatments including botulinum toxins and hyaluronic acid fillers. Forty-one distinct reported OROs were grouped into 12 descriptive domains. Domains were further grouped into 3 higher-order categories: aesthetics and wellness, social capacities, and skills and competencies. Improved perception after cosmetic intervention is most reproducibly demonstrated for the following ORO domains: age, attractiveness, sociability, relationship success, and occupational and financial competency. CONCLUSION The synthesized findings imply a tertiary layer of benefit for cosmetic intervention beyond anatomical and patient-centered outcomes through enhanced perceptions of others. These findings may inform the pre-procedure risk-benefit discussion with patients of cosmetic medicine and drive future research into longitudinal outcomes.
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Affiliation(s)
- Payal Shah
- Both authors are affiliated with The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York
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Kant SB, Mosterd K, Kelleners-Smeets NWJ, Van der Hulst RRWJ, Piatkowski A. Measuring aesthetic results after facial skin cancer surgery by means of the FACE-Q. EUROPEAN JOURNAL OF PLASTIC SURGERY 2020. [DOI: 10.1007/s00238-020-01625-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Abstract
Background
Skin cancer is the most commonly occurring type of cancer. However, the influence of facial skin cancer surgery on patients’ perceived aesthetic appearance is poorly understood. The objective of this study was to provide an insight into how patients perceive the aesthetic outcome of facial skin cancer surgery by means of a specialised patient-reported outcome measure designed for the aesthetic evaluation of the face: the FACE-Q.
Methods
A total of 47 patients with non-melanoma skin cancer who were scheduled for Mohs’s micrographic surgery (MMS) or standard surgical excision (SE) were included. These patients filled out three different FACE-Q questionnaires: satisfaction with facial appearance, social function, and satisfaction with outcome. Follow-up was conducted after baseline at 1 month and 3 months post-surgery.
Results
No significant differences were detected between baseline and follow-up regarding social function and satisfaction with facial appearance. However, after 3 months, patients were significantly more satisfied with the result of surgery when compared with the 1-month post-surgery follow-up.
Conclusions
The perceived aesthetic appreciation of patients does not seem to be significantly influenced by facial skin cancer SE or MMS surgery in this 3-month follow-up study.
Level of evidence: Not ratable.
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Levin M, Ziai H, Roskies M. Patient Satisfaction following Structural versus Preservation Rhinoplasty: A Systematic Review. Facial Plast Surg 2020; 36:670-678. [DOI: 10.1055/s-0040-1714268] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
AbstractRecently, dorsal preservation rhinoplasty has been gained acceptance among facial plastic surgeons. Despite this, there is limited literature on patient satisfaction following preservation rhinoplasty. This systematic review aims to evaluate all studies quantifying patient satisfaction and to compare results between structural and dorsal preservation rhinoplasty. OVID Medline, EMBASE, and PubMed databases were searched. All studies from the years 2010 to 2020 evaluating satisfaction in patients receiving either structural or dorsal preservation rhinoplasty were included. Data regarding study demographics as well as patient satisfaction results were extracted from included studies. Descriptive results and analysis were calculated. A total of 2,172 articles were initially identified, of which 29 articles were included in the final analysis. Of the 29 articles, 25 were focused on structural rhinoplasty and 4 were focused on preservation rhinoplasty. Of the 25 structural rhinoplasty articles, 17 used the Rhinoplasty Outcome Evaluation (ROE) questionnaire to evaluate patient satisfaction and 5 used the FACE-Q scale. Among the 25 structural rhinoplasty studies, 14 (56%) reported statistically significant improvements in patient satisfaction evaluation scores after rhinoplasty. Among the four preservation rhinoplasty studies, one (25%) study reported significant improvements in satisfaction scores after rhinoplasty. Despite this, most studies included a statement that satisfaction improved in patients following rhinoplasty. Literature in this review supports both structural and preservation rhinoplasty, resulting in high satisfactory results for patients following surgery. More research must be conducted to further quantify satisfaction following preservation rhinoplasty and prospectively compare satisfaction between the two rhinoplasty techniques.
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Affiliation(s)
- Marc Levin
- Department of Otolaryngology - Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Hedyeh Ziai
- Department of Otolaryngology - Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Michael Roskies
- Department of Otolaryngology - Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
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Gadkaree SK, Shaye DA, McCarty JC, Occhiogrosso J, Spagnuolo G, Derakhshan A, Lee LN. Prospective Qualitative Multidimensional Assessment of the Postoperative Rhinoplasty Experience. Facial Plast Surg Aesthet Med 2020; 22:213-218. [PMID: 32223570 DOI: 10.1089/fpsam.2020.0047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Understanding the multidimensional postoperative patient experience after rhinoplasty is critical for preoperative counseling and postoperative management. Methods: A prospective clinical study was conducted from June to December 2019 for 60 patients undergoing cosmetic and/or functional rhinoplasty by two facial plastic surgeons. All patients were administered the brief pain inventory, a clinically validated pain instrument, including multiple quality of life (QOL) domains, survey at postoperative days (PODs) 1, 2, 3, and 8. Nasal Obstruction Symptom Evaluation (NOSE) scores were used to predict patients having greatest QOL disturbance. Primary outcomes were postoperative QOL domains, pain scores, and oxycodone usage. Statistical analysis was performed using STATA 14.0 (STATA Corp., College Station, TX). Preoperative NOSE and postoperative Euro Quality of Life 5-Dimension scores were also recorded. Results: Patients showed greatest disruption to QOL in the first 3 PODs and essentially returned to normal levels by POD8, which mirrored trends in pain and opioid usage. All tested QOL domains (general activity, sleep, work, mood, enjoyment, and relationships) were strongly correlated with overall pain. NOSE scores were not significantly associated with pain or QOL impairment. Conclusions: This is the first study to prospectively evaluate the rhinoplasty patient's postoperative experience using a pain instrument, including multiple QOL domains. Utilizing a validated clinical instrument allows for standardized comparison of postrhinoplasty pain and QOL disruption with other surgical procedures and disease processes. These data may help guide preoperative counseling and set accurate patient expectations for the postoperative period.
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Affiliation(s)
- Shekhar K Gadkaree
- Department of Otolaryngology Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts, USA
| | - David A Shaye
- Department of Otolaryngology Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts, USA.,Department of Otolaryngology Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, Harvard Medical School, Massachusetts Eye and Ear, Boston, Massachusetts, USA
| | - Justin C McCarty
- Department of Otolaryngology Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts, USA.,Department of Otolaryngology Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, Harvard Medical School, Massachusetts Eye and Ear, Boston, Massachusetts, USA
| | - Jessica Occhiogrosso
- Department of Otolaryngology Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts, USA.,Department of Otolaryngology Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, Harvard Medical School, Massachusetts Eye and Ear, Boston, Massachusetts, USA
| | | | - Adeeb Derakhshan
- Department of Otolaryngology Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts, USA.,Department of Otolaryngology Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, Harvard Medical School, Massachusetts Eye and Ear, Boston, Massachusetts, USA
| | - Linda N Lee
- Department of Otolaryngology Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts, USA.,Department of Otolaryngology Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, Harvard Medical School, Massachusetts Eye and Ear, Boston, Massachusetts, USA
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14
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Zhukhovitskaya A, Cragun D, Su E, Barnes CH, Wong BJF. Categorization and Analysis of Nasal Base Shapes Using a Parametric Model. JAMA FACIAL PLAST SU 2020; 21:440-445. [PMID: 31343668 DOI: 10.1001/jamafacial.2019.0483] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Nasal base view is important for rhinoplasty analysis. Although some descriptors of nasal base shape exist, they are largely subjective and qualitative. Objective To evaluate a parametric model of nasal base shape and compare it with categorization by surgeons to create an objective classification system for clinical evaluation and communication. Design, Setting, and Participants Retrospective cohort review of deidentified photographs of 420 patients evaluated for possible facial plastic surgery at a tertiary care academic medical center between January 2013 and June 2017. The nasal bases were classified into 6 shape categories (equilateral, boxy, cloverleaf, flat, round, and narrow) via visual inspection. The contour of each nasal base was traced using MATLAB software (MathWorks Inc). The software then performed a curve fit to the parametric model with output of values for 5 parameters: projection-to-width ratio, the anterior-posterior positioning of the tip bulk, symmetry, degree of lateral recurvature of the nasal base, and size. The differences among shape categories for each parameter were analyzed using 1-way analysis of variance. Pairwise comparisons were then performed to ascertain how the various shapes differed. Finally, a multinomial logistic regression model was used to predict nasal base shape using parameter values. Data were analyzed between April 2017 and January 2018. Main Outcomes and Measures An algorithm that categorized nasal base shapes into 6 categories. Results The 420 nasal base photographs of patients evaluated for possible plastic surgery were categorized into 1 of 6 categories; 305 photographs were readily classified, and the remaining 115 were termed unclassified and were categorized. For both the classified and unclassified nasal base groups, there were statistically significant differences between projection-to-width ratio (classified, F5,299 = 21.51; unclassified, F4,100 = 10.59; P < .001), the anterior-posterior positioning of the tip bulk (classified, F5,299 = 3.76; P = .003; unclassified, F4,110 = 4.54; P = .002), and degree of lateral recurvature of the nasal base (classified, F5,299 = 24.14; unclassified, F4,100 = 7.21; P < .001). A multinomial logistic regression model categorization was concordant with surgeon categorization in 201 of 305 (65.9%) cases of classified nasal bases and 38 of 115 (33.0%) unclassified nasal bases. Conclusions and Relevance The parametric model may provide an objective and numerical approach to analyzing nasal base shape. Level of Evidence NA.
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Affiliation(s)
- Alisa Zhukhovitskaya
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, University of California, Irvine
| | - Dalan Cragun
- Washington University in St Louis, St Louis, Missouri
| | - Erica Su
- Department of Biostatistics, University of California, Los Angeles Fielding School of Public Health, Los Angeles
| | - Christian H Barnes
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, University of California, Irvine
| | - Brian J F Wong
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, University of California, Irvine.,Beckman Laser Institute & Medical Clinic, University of California, Irvine.,Department of Biomedical Engineering, University of California, Irvine
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15
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Gadkaree SK, Shaye DA, Occhiogrosso J, Lee LN. Association Between Pain and Patient Satisfaction After Rhinoplasty. JAMA FACIAL PLAST SU 2020; 21:475-479. [PMID: 31536105 DOI: 10.1001/jamafacial.2019.0808] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Importance In light of the current opioid crisis, there exists a demonstrated need to balance adequate postrhinoplasty pain control with measured use of narcotics. If pain is inadequately controlled, patients may be unsatisfied with their elective surgical experience. Objectives To characterize the association between patient-reported pain outcomes, objective opioid use, and perception of surgical success. Design, Setting, and Participants A case series survey study was conducted from July 2018 to January 2019. Consecutive patients who underwent cosmetic and/or functional rhinoplasty by 2 facial plastic surgeons (D.A.S. and L.N.L.) at an academic medical center were surveyed 1 month after surgery. Main Outcomes and Measures The number of oxycodone tablets taken, patient-reported pain outcomes, number of narcotic prescription refills, and patient-reported functional and cosmetic outcomes were recorded. Perception of pain, surgical outcome, and oxycodone intake were also evaluated by sex. Demographic information and perception of surgical results were recorded. Statistical analysis was performed using STATA statistical software (version 12.0, STATA Corp). Spearman rank order correlation was used for ordinal, monotonic variables with P < .05 being considered statistically significant. Results Overall, 104 patients were surveyed; 6 were lost to follow-up. Of the participants included, 50 were women with a mean (SD) age of 38 (16.0) years and 48 were men with a mean (SD) age of 38 (16.7) years. Although patients were prescribed a range of 10 to 40 tablets of oxycodone, patients took a mean (SD) of 5.2 tablets (range, 0-23). There were no significant sex differences in perception of pain, perception of outcome, or narcotic use. Among patients undergoing purely functional rhinoplasty, a statistically significant negative association between perception of pain and perception of functional outcome (breathing improvement) was evident. Patients who experienced less pain than they expected had a greater perception of functional improvement (rs = -0.62, P = .001). In contrast, among patients who underwent rhinoplasty with cosmetic improvement, no association was found between pain and perception of surgical outcome (rs = 0.05, P = .64). Conclusions and Relevance To our knowledge, this is the first study to prospectively evaluate the association between opioid use, patient-reported pain, and perceived surgical success. These data may help guide preoperative counseling because patients who are interested purely in breathing improvement (without cosmetic change) may warrant additional pain-specific counseling to optimize patient satisfaction. Level of Evidence 3.
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Affiliation(s)
- Shekhar K Gadkaree
- Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts
| | - David A Shaye
- Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts.,Harvard Medical School, Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Boston, Massachusetts
| | - Jessica Occhiogrosso
- Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts.,Harvard Medical School, Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Boston, Massachusetts
| | - Linda N Lee
- Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts.,Harvard Medical School, Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Boston, Massachusetts
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16
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Most SP. Invited Discussion on: Vertical Alar Folding (VAF) A Useful Technique for Correction of Long and Concave Lateral Crura in Rhinoplasty. Aesthetic Plast Surg 2019; 43:1279-1280. [PMID: 31342122 DOI: 10.1007/s00266-019-01462-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 07/15/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Sam P Most
- Division of Facial Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA, 94305, USA.
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17
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Patient-reported Aesthetic Satisfaction following Facial Skin Cancer Surgery Using the FACE-Q Skin Cancer Module. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2019; 7:e2423. [PMID: 31942391 PMCID: PMC6908379 DOI: 10.1097/gox.0000000000002423] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 07/02/2019] [Indexed: 11/25/2022]
Abstract
Over 5 million basal and squamous cell skin cancers are diagnosed each year. Seventy to 80% of these cancers occur in the head and neck region, for which surgical excision is the standard treatment. As patient satisfaction and quality of life are among the most important outcomes in plastic and reconstructive surgery, understanding patient perception of aesthetic postoperative outcome is critical. The objective of this study was to assess aesthetic satisfaction following facial skin cancer surgery using the FACE-Q Skin Cancer Module in the context of sociodemographic and clinical factors. Methods This is a single-center, cross-sectional study in a tertiary care cancer setting of patients who underwent facial skin cancer surgery from March 1, 2016, to March 31, 2018. Patients completed the FACE-Q Skin Cancer Satisfaction with Facial Appearance and Appraisal of Scar scales postoperatively, between May 21, 2018, and October 1, 2018. Results Patients completed the Satisfaction with Facial Appearance (n = 405) and Appraisal of Scar scales (n = 408) postoperatively (response rate 39%). Lower postoperative facial appearance and scar satisfaction scores were associated with female gender, younger age (<65 years), surgery location on the lip or nose, repair by flap or graft, and greater defect size. Linear regression models established that younger age, female gender, nose location, and flap repair were independently predictive of lower aesthetic satisfaction. Conclusions Sociodemographic factors, central facial location, and repair type strongly contribute to aesthetic satisfaction following facial skin cancer surgery. This patient-reported data may guide counseling regarding postoperative aesthetic outcome and inform patient expectations.
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18
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Assessment of Rhinoplasty Outcomes with FACE-Q Rhinoplasty Module: Norwegian Linguistic Validation and Clinical Application in 243 Patients. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2019; 7:e2448. [PMID: 31942405 PMCID: PMC6908397 DOI: 10.1097/gox.0000000000002448] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Accepted: 07/17/2019] [Indexed: 11/26/2022]
Abstract
Patient satisfaction after rhinoplasty is a growing area of research. The FACE-Q Rhinoplasty Module, used to assess these values, requires translation to national languages.
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19
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Xiao H, Zhao Y, Liu L, Xiao M, Qiu W, Liu Y. Functional/Aesthetic Measures of Patient Satisfaction After Rhinoplasty: A Review. Aesthet Surg J 2019; 39:1057-1062. [PMID: 30722008 DOI: 10.1093/asj/sjz029] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Multiple patient-reported outcome measures (PROMs) are available to assess patient satisfaction after rhinoplasty. These self-assessment measures can be divided into 3 categories: measures for functional outcomes, aesthetic outcomes, and both. Although Barone et al have discussed this classification, a recently developed scale was not featured. We performed a PubMed search for publications in English that described patient satisfaction post-rhinoplasty, utilizing PROMs that facilitate both functional and aesthetic self-assessment. PROMs, including the Rhinoplasty Outcomes Evaluation, the Functional Rhinoplasty Outcome Inventory 17, the Rhinoplasty Health Inventory and Nasal Outcomes scale, the FACE-Q Rhinoplasty module, and the Standardized Cosmesis and Health Nasal Outcomes Survey, were reviewed and critically appraised in terms of their content, ease of use, and analysis parameters. This review highlights the benefit of using multi-functional PROMs after rhinoplasty instead of single-purpose PROMs and enables surgeons and researchers to choose the most appropriate measure for their purpose.
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Affiliation(s)
- Hong Xiao
- Department of Plastic Surgery, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Yanan Zhao
- Department of Plastic Surgery, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Liu Liu
- Department of Plastic Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Minqin Xiao
- Department of Plastic Surgery, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Wei Qiu
- Department of Plastic Surgery, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Yin Liu
- Department of Plastic Surgery, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
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20
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Bustillo AMB, Lobato RC, Luitgards BF, Camargo CP, Gemperli R, Ishida LC. Translation, Cross-Cultural Adaptation and Linguistic Validation of the FACE-Q Questionnaire for Brazilian Portuguese. Aesthetic Plast Surg 2019; 43:930-937. [PMID: 31089752 DOI: 10.1007/s00266-019-01399-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 05/06/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Patient-reported outcomes measurement instruments (PRO) are a good way to measure results after aesthetic procedures. FACE-Q is a systematized and standardized PRO tool and was not available in Portuguese. METHODS This cross-sectional study included four stages: translation of FACE-Q, backtranslation, testing in patients who underwent facial aesthetic procedures and review of the questionnaires between September and December, 2018. Guidelines merging WHO and ISPOR's rules were followed. RESULTS Translation was conducted by two translators, resulting in two versions, translation A and translation B, which were reconciled to generate the first Portuguese version. Reconciliation showed inconsistencies between TA and TB in 63% (n = 222) of the 353 questions, which were solved by maintaining TA in 25% of cases (n = 87), TB in 27% and a new version in 11% (n = 40) of the questions. Backtranslation showed written differences with the original FACE-Q in 64 (22.7%) of the 353 question, but only one case of semantic difference, which was corrected resulting in production of the second Portuguese version. Seven patients with a mean age of 35.8 years were interviewed to assess the difficulty in understanding the questionnaires. Four patients had no or minor difficulties understanding the questionnaire, and the other three had difficulties and suggested changes that led to a third Portuguese version. The third version was reviewed for grammar and spelling resulting in the final Portuguese version. CONCLUSION A Brazilian Portuguese version of the FACE-Q questionnaire was obtained maintaining equivalency with the source instrument. This will allow cross-cultural research and comparison of results between different studies. LEVEL OF EVIDENCE V 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 www.springer.com/00266 .
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Affiliation(s)
| | - Rodolfo Costa Lobato
- Plastic Surgery Division, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
- , São Paulo, Brazil.
| | - Bruno Ferreira Luitgards
- Plastic Surgery Division, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Cristina Pires Camargo
- Plastic Surgery Division, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Rolf Gemperli
- Plastic Surgery Division, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Luiz Carlos Ishida
- Plastic Surgery Division, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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21
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Micro-Autologous Fat Transplantation Combined With Platelet-Rich Plasma for Facial Filling and Regeneration: A Clinical Perspective in the Shadow of Evidence-Based Medicine. J Craniofac Surg 2019; 30:672-677. [PMID: 30688814 DOI: 10.1097/scs.0000000000005122] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Despite the popularity of lipofilling procedures in recent years, the presence of older habits still in fat graft harvesting and processing seems to be the biggest obstacle to the final better outcome of fat grafting. Our study is aimed to highlight some strategies what should be done in fat grafting in the shadow of evidence-based medicine and patient-reported outcomes which might be of interest to the clinicians. Between 2015 and 2017, 14 patients were included who underwent facial micro-autologous fat transplantation with platelet-rich plasma injection. The outcome was determined by the difference in presurgery and postsurgery FACE-Q modules, which were designed as patient-reported outcome instrument to evaluate the unique outcomes of patients undergoing facial cosmetic procedures. Surveys conducted were modules of satisfaction with facial appearance, satisfaction with cheeks, satisfaction with skin, psychological function, social function, aging appearance appraisal, and satisfaction with the outcome. All patients were followed up minimum 9 months. No major complications were recorded. The patient-reported FACE-Q satisfaction and FACE-Q quality-of-life presurgery and postsurgery results showed statistically significant improvement (<0.001). Overall satisfaction with the outcome was 87.6 ± 16.8 (range 55-100). A combination of platelet-rich plasma and micro-fat grafting with soft harvesting and processing could be seen a good surgical technique to restore volume and enhance skin quality in facial soft tissue augmentation. The authors believe that with minimum detrimental effect on fat grafting while harvesting, processing, and with the addition of platelet-rich plasma while applying may increase the surgeon's and patient's satisfaction with the outcome.
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22
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Santos M, Rego ÂR, Coutinho M, Sousa CAE, Ferreira MG. Spare roof technique in reduction rhinoplasty: Prospective study of the first one hundred patients. Laryngoscope 2019; 129:2702-2706. [PMID: 30628092 DOI: 10.1002/lary.27804] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 11/18/2018] [Accepted: 12/21/2018] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Assess the aesthetic and functional outcomes of the first 100 patients who underwent reduction rhinoplasty with the spare roof technique (SRT). METHODS Prospective, interventional, and longitudinal study performed on consecutive patients undergoing primary rhinoplasty by SRT. All the surgical procedures were performed by the surgeon who first described this technique. The validated Portuguese version of the Utrecht Questionnaire for Outcome Assessment in Aesthetic Rhinoplasty was used. Patients completed the questionnaire presurgery and again 3 and 12 months postsurgery. In addition, a visual analogue scale (VAS) was used to score nasal patency for both sides. RESULTS The study population included 100 Caucasian Mediterranean patients (33 males; 67 females). Mean age at surgery was 32.8 years. Analysis of the preoperative and postoperative mean aesthetic VAS scores showed a significant improvement from 3.67 to 8.1 (P < 0.001) and 8.44 (P < 0.001), respectively, 3 and 12 months postsurgery. Analysis of the five aesthetic Likert scale questions all showed a highly significant improvement after rhinoplasty. The mean preoperative aesthetic sum score was 13.9, which improved to 8.26 and 7.08, respectively, 3 and 12 months postsurgery (P < 0.001), indicating a significant improvement of subjective body image in relation to nasal appearance. Analysis of the preoperative and postoperative mean functional VAS score showed a significant improvement on both sides. CONCLUSION This prospective statistical study confirms that SRT significantly improved patient quality of life regarding nose function and appearance. It is a reliable technique that can help deliver consistently good results in reduction rhinoplasty in Caucasian patients with dorsal hump seeking rhinoplasty. LEVEL OF EVIDENCE 2 Laryngoscope, 129:2702-2706, 2019.
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Affiliation(s)
- Mariline Santos
- Department of Otolaryngology, Head and Neck Surgery, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Ângela Reis Rego
- Department of Otolaryngology, Head and Neck Surgery, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Miguel Coutinho
- Department of Otolaryngology, Head and Neck Surgery, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Cecília Almeida E Sousa
- Department of Otolaryngology, Head and Neck Surgery, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Miguel Gonçalves Ferreira
- Department of Otolaryngology, Head and Neck Surgery, Centro Hospitalar Universitário do Porto and Hospital Luz Arrábida, Vila Nova de Gaia, Portugal
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Zhao JY, Guo XS, Song GD, Zong XL, Yang XN, Du L, Lai CZ, Qi ZL, Jin XL. Surgical outcome and patient satisfaction after Z-epicanthoplasty and blepharoplasty. Int J Ophthalmol 2018; 11:1922-1925. [PMID: 30588423 DOI: 10.18240/ijo.2018.12.07] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 06/25/2018] [Indexed: 11/23/2022] Open
Abstract
AIM To evaluate surgical outcomes of modified Z-epicanthoplasty with blepharoplasty that we previously reported from the patient's perspective using patient-reported outcome measures (PROMs) and patient satisfaction scores. METHODS A total of patients (n=180) who underwent the surgery between January 2013 and June 2016 were randomly selected. Standardized patient satisfaction forms (total score, 40) and validated PROMs questionnaires (total score, 12) were sent to patients for completion. PROMs assesses the severity of scarring, pain and asymmetry, as well as functional and appearance issues. RESULTS All patients were female, ranging from 18 to 35 years old (mean=24). The response rate was 73.3% (n=132). The majority of patients reported good or excellent outcomes based on PROM analysis. Patients reported minimum or non-visible scarring at both the double eyelid surgical scar (85.6%) and the inner canthus (80.3%). Issues concerning function and appearance were minimal as 80.3% reported satisfaction with both domains. Notably, the majority of patients reported either a high or very high satisfaction rate to yield a mean score of 104 out of 120 (P<0.05). CONCLUSION Integration of our modified Z-epicanthoplasty with blepharoplasty produces good outcomes based on PROM results, which shows a positive linear relationship with patient satisfaction scores.
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Affiliation(s)
- Jing-Yi Zhao
- Department No.16, Plastic Surgery Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100144, China
| | - Xiao-Shuang Guo
- Department No.16, Plastic Surgery Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100144, China
| | - Guo-Dong Song
- Department No.16, Plastic Surgery Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100144, China
| | - Xian-Lei Zong
- Department No.16, Plastic Surgery Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100144, China
| | - Xiao-Nan Yang
- Department No.16, Plastic Surgery Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100144, China
| | - Le Du
- Department No.16, Plastic Surgery Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100144, China
| | - Chen-Zhi Lai
- Department No.16, Plastic Surgery Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100144, China
| | - Zuo-Liang Qi
- Department No.16, Plastic Surgery Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100144, China
| | - Xiao-Lei Jin
- Department No.16, Plastic Surgery Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100144, China
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24
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Patient-reported Outcomes in Facial Reconstruction: Assessment of FACE-Q Scales and Predictors of Satisfaction. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2018; 6:e2004. [PMID: 30656106 PMCID: PMC6326617 DOI: 10.1097/gox.0000000000002004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 09/14/2018] [Indexed: 01/01/2023]
Abstract
Background There is a paucity of patient-reported outcome measures for facial trauma reconstruction. To measure satisfaction and health-related quality of life (HRQOL), following repair of traumatic facial fractures, we used the FACE-Q, a set of patient-reported outcome instruments designed for aesthetic facial surgery. As a step toward validating the scales for facial trauma, we evaluated their reliability. Methods This is a prospective study of patients following primary repair of traumatic facial fractures at a level 1 trauma center from 2016 to 2018. Six FACE-Q scales with relevance to the facial trauma population were completed by patients at their 1-month postoperative visits. Predictors of satisfaction were examined using multiple linear regression models. Reliability of the scales in this population was evaluated using psychometric methods. Results One hundred eighty-five participants fulfilled inclusion criteria. Mean scores for the 6 scales ranged from 59 (SD = 15) for Recovery-Early Life Impact to 94 (SD = 13) for Satisfaction with Medical Team. Predictors of lower satisfaction and/or HRQOL include current tobacco smoking status, mandibulomaxillary fixation, and Le Fort pattern fractures. All scales were found to have good to excellent reliability (Cronbach's alpha = 0.824-0.969). Conclusions Following repair of facial fractures, patient-reported outcomes can be reliably measured using FACE-Q scales. On average, patients report poor health-related quality of life in the early postoperative period. Predictors of low satisfaction and/or poor HRQOL include current smoking habit, mandibulomaxillary fixation, and Le Fort fractures.
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