Assessing Patient-Reported Satisfaction with Appearance and Quality of Life following Rhinoplasty Using the FACE-Q Appraisal Scales

Overview

Rhinoplasty outcomes have traditionally been judged by surgeons looking at photographs. FACE-Q is a questionnaire developed and validated to capture what patients themselves report about appearance and quality of life. This study applied four of its scales to rhinoplasty patients at consultation and at follow-up visits after surgery.

Sections of note

• 56 patients completed FACE-Q at preoperative consultation, at postoperative follow-up, or both.
• Scales used were satisfaction with facial appearance overall, satisfaction with nose, psychological wellbeing and social function.
• Scale scores run from 0 to 100. Facial appearance rose 26.5 points (p less than 0.01), psychological wellbeing 15.7 points (p less than 0.01), social function 13.7 points (p = 0.03).
• Individual nose items are scored 1 to 4 and all rose significantly: appearance in the mirror 1.4, size 1.1, shape 1.5, profile 1.6, appearance in photographs 1.6.
• Similar results were found in the subgroup who completed the questionnaire both before and after surgery.
• Level of evidence 4, therapeutic.

What it means for a patient

• Patients reported not only liking their nose more but feeling better psychologically and functioning better socially.
• Every specific aspect of the nose asked about improved, including how it looks in photographs.
• Gains in wellbeing and social function were about half the size of the gain in appearance satisfaction.
• No comparison group, no stated follow-up interval, and part of the sample answered only once, before or after, rather than both times.

Why this paper matters

It is one of the early applications of a validated patient-reported instrument to rhinoplasty, moving the field away from surgeon-graded photographs. The FACE-Q has since become a common outcome measure. What this study cannot show is how long the gains last or which patients do not benefit.

Terms

• Patient-reported outcome: a result measured by asking the patient rather than by examination.
• FACE-Q: a validated questionnaire measuring appearance satisfaction and quality of life after facial procedures.
• Validated instrument: a questionnaire formally tested to show it measures what it claims to measure.
• Psychological wellbeing: a scored measure of confidence and emotional state.
• Social function: a scored measure of comfort and participation in social situations.
• Level of evidence 4: a case series without a control group.