Study examines factors that may predict if patients will be satisfied with facial plastic surgery

A study of patients undergoing elective facial plastic surgery suggests that older patients and those currently being treated for depression may be more likely to be satisfied with the results of their procedures, whereas overall optimism and pessimism do not appear related to satisfaction with surgical outcomes, according to a report in the May/June issue of Archives of Facial Plastic Surgery.

Almost 12 million cosmetic procedures were performed in 2007, a more than four-fold increase over the previous 10 years, according to background information in the article. "Because more patients choose to undergo cosmetic surgery, improvement of surgical outcomes becomes increasingly important," the authors write. "Currently, there is an emphasis in the plastic and facial plastic surgery literature on surgical techniques to improve surgical results. A relative improvement in surgical outcomes, however, tends to be subjective and patient and/or surgeon satisfaction can be highly unpredictable."

Jill L. Hessler, M.D., of Premier Plastic Surgery, Palo Alto, Calif., and colleagues surveyed 51 patients at one facial cosmetic surgery center between 2007 and 2008. Participants completed a demographic questionnaire, a test to evaluate optimism and pessimism and a surgical outcomes survey specific to their type of procedure (for instance, facelift or nasal surgery). Four to six months later, they again completed the optimism/pessimism and surgical outcomes assessments. The four surgeons at the center were also asked to participate.

Patients who were older than the average age of 53 were more satisfied with their surgical results than patients younger than the average age. This may reflect more realistic expectations among older patients, the authors note.

In addition, those currently being treated for depression were more satisfied than those who were not being treated for depression. No correlation was identified between a patient's optimism or pessimism at the beginning of the study and later satisfaction, nor did any other demographic factor assessed predict later satisfaction.

Patients and physicians generally agreed with regard to satisfaction, although surgeons tended to be less positive in their assessment of outcomes than were patients.

"The ability to preoperatively identify patient characteristics (psychological, social or demographic) that might impact the subjective perception of surgical outcome and predict dissatisfaction with facial plastic surgery could be highly useful to surgeons," the authors conclude. "Although preliminary, our observations provide insight into these relationships and identify potential associations, which establish a basis upon which future studies can be built. In particular, it will be interesting to design larger scale studies to examine the potential associations between perceived surgical outcomes and sex, education, marital status, depression and/or inclination toward optimism/pessimism."