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How Patient Decision-Making Characteristics Affect Satisfaction in Facial Plastic Surgery: A Prospective Pilot Study

Oliver, Jeremie D. B.S., B.A.; Menapace, Deanna C. M.D.; Staab, Jeffrey P. M.D., M.S.; Friedman, Oren M.D.; Recker, Chelsey P.A.-C.; Hamilton, Grant S. M.D.

Plastic and Reconstructive Surgery: December 2019 - Volume 144 - Issue 6 - p 1487-1497
doi: 10.1097/PRS.0000000000006269
Plastic Surgery Focus: Special Topics
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Background: The main objective of this study was to prospectively analyze which personality traits, clinical psychiatric states, and patient decision-making characteristics predict who will be less satisfied after facial plastic surgery.

Methods: This prospective study enrolled 60 adult subjects into one of three groups: aesthetic, functional, and reconstructive facial plastic surgery procedures (n = 20 in each group) from November of 2011 to February of 2016. Self-report surveys of personality traits (i.e., NEO Personality Inventory-Revised), psychiatric state (i.e., Patient Health Questionnaire, Generalized Anxiety Disorder, Health Anxiety Inventory–Short Form), and decision-making characteristics (maximizer/satisficer survey) were given during the preoperative clinic visits. In postoperative follow-up, satisfaction questionnaires at 3, 6, and 12 months were administered. Data analysis examined associations between patient satisfaction, decision-making characteristics, and psychiatric variables.

Results: Bivariate analyses showed that maximizer/satisficer decision-making style was significantly related to patient satisfaction scores in the year following surgery. This difference reached statistical significance at 6 months and remained a strong trend at 12 months. Patients who were less than extremely satisfied at both postoperative time points were more likely to portray the maximizer decision-making style. No other variables were associated with patient satisfaction at any time point. Maximizer/satisficer survey scores were not associated with self-reports of depression, anxiety, or illness anxiety. Mean scores on the maximizer/satisficer survey did not differ among the aesthetic, functional, and reconstructive groups.

Conclusions: The maximizer/satisficer survey captures an aspect of patient care not traditionally measured by standard clinical psychometric screening tools to help predict satisfaction. A short questionnaire targeting consumer decision-making may be a helpful tool for preoperative counseling.

Rochester, Minn.; and Philadelphia, Pa.

From the Mayo Clinic School of Medicine; the Division of Facial Plastic and Reconstructive Surgery, Department of Otorhinolaryngology, and the Department of Psychiatry and Psychology, Mayo Clinic; and the Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology, University of Pennsylvania.

Received for publication September 9, 2018; accepted February 25, 2019.

A “Hot Topic Video” by Editor-in-Chief Rod J. Rohrich, M.D., accompanies this article. Go to and click on “Plastic Surgery Hot Topics” in the “Digital Media” tab to watch.

Disclosure:None of the authors has a financial interest to declare in relation to the content of this article.

Grant S. Hamilton, M.D., Division of Facial Plastic and Reconstructive Surgery, Department of Otorhinolaryngology, 200 First Street SW, Rochester, Minn. 55905,, Instagram: jeremie_oliver, Twitter: jeremie_oliver, Facebook: Jeremie Oliver

Copyright © 2019 by the American Society of Plastic Surgeons