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Quality of Life and Facial Trauma: Psychological and Body Image Effects

Levine, Elie MD; Degutis, Linda PhD; Pruzinsky, Thomas PhD; Shin, Joseph MD; Persing, John A. MD

doi: 10.1097/
Original Article

This study evaluated the social and psychologic impact of facial trauma on previously healthy individuals. Inclusion criteria for the study included 18- to 45-year-old individuals who had a facial laceration of 3 cm or greater and/or a fractured facial bone requiring operative intervention within 6 months to 2 years prior to participation in the study. Retrospective analysis of patients at Yale New Haven Hospital Emergency Department was done between May 1997 and December 1998. When compared with a control population, the study group showed a statistically significant lower satisfaction with life, more negative perception of body image, higher incidence of posttraumatic stress disorder, higher incidence of alcoholism, and an increase in depression. Also, among the study group there was a significantly higher incidence of posttrauma unemployment, marital problems, binge drinking, jail, and lower attractiveness scores. In conclusion, in this preliminary study, it appears that the result of facial scarring/trauma includes a significantly decreased satisfaction with life, an altered perception of body image, a higher incidence of posttraumatic stress disorder, a higher incidence of alcoholism, and increased posttrauma jail, unemployment, binge drinking, and marital problems. Thus, it appears that there is significant negative social and functional impact related to facial trauma and scarring.

Interviews and psychological testing of 108 patients with recent significant facial injuries demonstrated decreased satisfaction with life scores, more negative body image perception, more PTSD, and an increase in depression.

From the Section of Plastic Surgery, Department of Surgery, Yale University School of Medicine, New Haven, CT.

Received July 14, 2003 and accepted for publication, after revision, December 2, 2004.

This work has been supported in part by an Alpha Omega Alpha Student Research Fellowship.

Reprints: John A. Persing, MD, Professor and Chief, Section of Plastic Surgery, Yale University School of Medicine, 333 Cedar Street, P.O. Box 208041, New Haven, CT 06520-8041. E-mail:

© 2005 Lippincott Williams & Wilkins, Inc.