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Patient-reported Outcomes after Extended Superficial Musculo-aponeurotic System (SMAS) Facelift
Eliana F. R. Duraes, Isis Scomacao; Stephanie Kortyka, Ahmed Hashem, Julia M. Maxey, Graham S. Schwarz, Bahar Bassiri-Gharb, James Zins
Cleveland Clinic
2018-02-15
Presenter: Eliana Duraes
Affidavit:
I certify the project represents original work of the residents and authors on this project
Director Name: Steven Bernard
Author Category: Fellow Plastic Surgery
Presentation Category: Clinical
Abstract Category: Aesthetics
Background: Little objective data exist tracking patient-reported outcomes (PRO) after facelift. This study aimed to: evaluate our extended SMAS facelift outcomes comparing our results with available literature1; and investigate the impact of late sequelae and length of follow up on PRO.
Methods: FaceQ questionnaires2-4 were e-mailed to patients from 2010 and 2014. No/mild discomfort due to late sequelae patients (Group 1) were compared to moderate/severe discomfort (Group 2). P<0.05 considered significant.
Results: Survey response rate was 24.17% (n=58). Patients reported looking younger by 7.7±3.4 years. Group 1 had 36(62%) patients. The most reported discomfort reasons were: face areas not seeming smooth, blotchy or uneven skin tones, and redness. Group 1 had significantly higher satisfaction in: facial appearance overall (74.9vs.63.4, p=0.014); skin (76.5vs.57.4, p=0.002); cheek bones (91.6vs.70.5, p=0.002); nasolabial folds (79.7vs.63.4, p=0.012); lower face & jawline (86.4vs.71.2, p=0.022); marionette lines (85.3vs.67.8, p=0.01); psychological well-being (89.3vs.74, p=0.005); outcome (78.8vs.55.9, p=0.001); and decision to undergo facelift (88.4vs.76.4, p=0.043). The time between surgery and questionnaire was 3.4±1.5 years and did not influence satisfaction with overall appearance (r=0.18; p=0.16) or aging appraisal (r=-0.21; p=0.11).
Conclusion: High patient-reported satisfaction was achieved in most patients and was negatively affected by late sequelae. Compared to the literature, similar results were found in satisfaction with outcomes, decision to undergo facelift, neck, lower face and jawline; ours fared better in satisfaction with the area under the chin; while satisfaction with facial appearance, cheeks, nasolabial folds, social, and psychological functions were higher in Sinno's1. Differences may reflect our longer follow up.
