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Patient-reported Outcomes in Facial Reconstruction

Assessment of FACE-Q Scales and Predictors of Satisfaction

Elegbede, Adekunle, MD, PhD*,†; Mermulla, Sara, MD; Diaconu, Silviu C., MD; McNichols, Colton, MD*,†; Liang, Yuanyuan, PhD, MS; Liang, Fan, MD§; Rasko, Yvonne M., MD; Grant, Michael P., MD, PhD§; Nam, Arthur J., MD, MS§

Plastic and Reconstructive Surgery – Global Open: December 5, 2018 - Volume Latest Articles - Issue - p
doi: 10.1097/GOX.0000000000002004
Latest Articles: PDF Only

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.

This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

From the *Department of Plastic and Reconstructive Surgery, The Johns Hopkins Hospital, Baltimore, Md

Department of Surgery, University of Maryland School of Medicine Baltimore, Md

Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Md

§Department of Surgery, Division of Plastic, Reconstructive, and Maxillofacial Surgery, R Adams Cowley Shock Trauma Center, Baltimore, Md

Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Maryland School of Medicine, Baltimore, Md.

Published online 5 December 2018.

Received for publication September 6, 2018; accepted September 14, 2018.

Disclosure: The authors have no financial interest to declare in relation to the content of this article. The Article Processing Charge was paid for by the authors.

Arthur J. Nam, MD, MS, Division of Plastic Surgery, R Adams Cowley Shock Trauma Center, 110 South Paca Street, Suite 4S-125, Baltimore, MD 21201, E-mail:

Copyright © 2018 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Society of Plastic Surgeons. All rights reserved.