Honigman Roberta J, Jackson Alun C, Dowling Nicki A
St. Vincent's Hospital Mental Health Service, The University of Melbourne, Parkville, Victoria, Australia.
Ann Plast Surg. 2011 Jan;66(1):16-23. doi: 10.1097/SAP.0b013e3181d50e54.
Currently no brief and objective screening protocol exists to assist surgeons and dentists in the identification of patients who are likely to report unsatisfactory outcomes after cosmetic surgery interventions. The aims of this study were to (1) investigate the relationship between postoperative dissatisfaction and preoperative characteristics (psychiatric disturbance, anxiety, depression, self-esteem, dysmorphic concern, and body image), and (2) empirically derive a preoperative psychosocial screening instrument to identify patients who may require preoperative assessment or counseling.
The sample composed of 84 patients (69 women and 15 men) undergoing elective cosmetic facial surgery or cosmetic dentistry. Before surgery, a self-report questionnaire was administered to the patients, which comprised questions designed to evaluate many of the psychosocial characteristics thought to be associated with unsatisfactory outcomes. Six months after surgery, a questionnaire was administered to the patients, which included items evaluating postoperative satisfaction.
The findings revealed that preoperative psychiatric disturbance, anxiety, depression, low appearance evaluation, and body areas dissatisfaction are psychosocial risk factors that indicate an increased likelihood of patient dissatisfaction with surgical outcomes. The PreFACE (Preoperative FAcial Cosmetic surgery Evaluation), a brief objective preoperative screening questionnaire that can be easily and efficiently administered to elective facial cosmetic surgery and cosmetic dentistry patients, was empirically derived. It is able to identify most patients who are likely to express dissatisfaction and minimizes the selection of those who will express satisfaction. The PreFACE is recommended for validation using other cosmetic surgery populations.
The routine use of PreFACE is recommended for identification of patients who may benefit from preoperative counseling.
目前尚无简短且客观的筛查方案可协助外科医生和牙医识别那些在接受整容手术干预后可能报告不满意结果的患者。本研究的目的是：（1）调查术后不满与术前特征（精神障碍、焦虑、抑郁、自尊、畸形担忧和身体意象）之间的关系；（2）通过实证推导一种术前心理社会筛查工具，以识别可能需要术前评估或咨询的患者。
样本由84例接受择期面部整容手术或美容牙科治疗的患者组成（69名女性和15名男性）。手术前，向患者发放一份自我报告问卷，其中包含旨在评估许多被认为与不满意结果相关的心理社会特征的问题。手术后六个月，向患者发放一份问卷，其中包括评估术后满意度的项目。
研究结果显示，术前精神障碍、焦虑、抑郁、外貌评价低和身体部位不满是心理社会风险因素，表明患者对手术结果不满意的可能性增加。通过实证推导得出了PreFACE（术前面部整容手术评估），这是一种简短客观的术前筛查问卷，可轻松、高效地用于择期面部整容手术和美容牙科患者。它能够识别出大多数可能表示不满的患者，并尽量减少对那些会表示满意的患者的选择。建议使用其他整容手术人群对PreFACE进行验证。
建议常规使用PreFACE来识别可能从术前咨询中获益的患者。
