Development and Psychometric Evaluation of the FACE-Q Satisfaction with Appearance Scale: A New Patient-Reported Outcome Instrument for Facial Aesthetics Patients

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Key points

  • Accurate and reliable measurement of patient-centered outcomes is critical to ongoing practice improvement and clinical research in facial aesthetics.

  • Modern psychometric methods overcome the limitations of traditional psychometric methods by providing clinically meaningful interval-level data.

  • The FACE-Q Satisfaction with Facial Appearance scale is a new-generation condition-specific patient-reported outcome instrument, capable of providing clinically meaningful and scientifically sound data

Background

Facial aesthetics procedures are an important area of continued growth in plastic surgery; 13.8 million cosmetic procedures were performed in the United States in 2011, an increase of 5% from 2010.1 Rhinoplasty (n = 244,000) and blepharoplasty (n = 196,000) were second and third to breast augmentation (n = 307,000) in popularity. Botulinum toxin type A (n = 5.7 million), soft tissue fillers (n = 1.9 million) and chemical peels (n = 1.1 million) were the top three cosmetic minimally invasive

Qualitative and quantitative methods

We obtained local institutional ethics review board approval before commencing our study. The content for the Satisfaction with Facial Appearance scale was developed as part of a larger suite of scales that cover a range of concepts important to facial aesthetics patients.10 These scales were constructed with strict adherence to recommended guidelines for PRO instrument development.11, 12, 13, 14, 15 The guidelines outline three phases required to develop a scientifically credible and

Phase 1: Qualitative Phase

As described earlier and in our previous publication,10 the qualitative work resulted in the development of a conceptual framework (see Fig. 1) and a series of independent scales that capture the important concerns described by facial aesthetics patients (see Table 2). The Satisfaction with Facial Appearance scale was specifically developed to be relevant to all aesthetic facial patients regardless of the number or type of procedures undergone. This scale is composed of 10 items that ask about

Discussion

Satisfaction with appearance and improved quality of life are arguably the most important outcomes for patients undergoing facial aesthetic procedures.4, 44 Despite this, research in facial aesthetics has been hindered by a lack of reliable and valid condition-specific PRO instruments. The FACE-Q is developed to address this void. In this study, the FACE-Q Satisfaction with Facial Appearance scale is a short, easy to complete, reliable, valid and responsive measurement tool. Our study provides

Acknowledgments

The authors acknowledge and thank the following clinicians for their invaluable assistance with the recruitment of patients and countless hours spent as expert reviewers: Vancouver, BC, Canada: Drs Nick Carr, Francis Jang, Nancy VanLaeken, Alistair Carruthers, Jean Carruthers, Richard Warren. Washington DC: Dr Stephen Baker; Dallas, TX: Drs Jeffery Kenkel, Rod Rohrich; Atlanta GA: Dr Foad Nahai; St Louis, MO: Dr Leroy Young; New York, NY: Drs David Hidalgo, David Rosenberg, Philip Miller,

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    Disclosure: The FACE-Q © is owned by Memorial Sloan-Kettering Cancer Center (MSKCC). Drs Cano, Klassen, and Pusic are codevelopers of the FACE-Q © and, as such, receive a share of any license revenues based on MSKCC’s inventor sharing policy.

    This study was funded by grants from the Plastic Surgery Education Foundation.

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