Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, 1500 E. Medical Center Drive, 1903 Taubman Center SPC 5312, Ann Arbor, MI, 48109-5214, United States.
The Spokane Center for Facial Plastic Surgery, 217 W. Cataldo Avenue, Spokane, WA 99201, United States.
Am J Otolaryngol. 2021 Jan-Feb;42(1):102792. doi: 10.1016/j.amjoto.2020.102792. Epub 2020 Oct 24.
Complications in facial plastic surgery can lead to pain, suffering, and permanent harm. Yet, the etiology and outcomes of adverse events are understudied. This study aims to determine the etiology and outcomes of adverse events reported in aesthetic facial plastic surgery and identify quality improvement opportunities.
A cross-sectional survey analysis was conducted using an anonymous 22-item questionnaire distributed to members of the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) and American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS). Participants were queried on demographics, practice type, and adverse events related to aesthetic facial surgeries.
Two hundred fifty-three individuals participated; nearly half of respondents (49.0%) held membership in both AAO-HNS and AAFPRS. Of these, 40.8% of respondents reported at least one adverse event within the past 12 months of practice. A total of 194 adverse events were reported, most commonly related to facelift (n = 59/194, 30.4%), rhinoplasty (n = 55/194, 28.4%), and injection procedures (n = 38/194, 19.6%), with hematoma or seroma being the most commonly described. Most adverse events were self-limited, but approximately 68% resulted in further procedures. Surgeon error or poor judgement (n = 42) and patient non-adherence (n = 18) were the most commonly ascribed reasons for adverse events; 37.1% of participants reported a change in clinical practice after the incident.
Adverse events were not infrequent in facial plastic surgery. Understanding these adverse events can provide impetus for tracking outcomes, standardization, and engagement with lifelong learning, self-assessment, and evaluation of practice performance.
面部整形手术的并发症可导致疼痛、痛苦和永久性伤害。然而，不良事件的病因和结果仍研究不足。本研究旨在确定美容面部整形手术中报告的不良事件的病因和结果，并确定质量改进机会。
使用一项匿名的 22 项问卷调查分析，对美国耳鼻喉科学-头颈外科学会（AAO-HNS）和美国面部整形和重建外科学会（AAFPRS）的成员进行了横断面调查。参与者被询问了人口统计学、实践类型以及与美容面部手术相关的不良事件。
共有 253 人参与；近一半的受访者（49.0%）同时拥有 AAO-HNS 和 AAFPRS 的会员资格。其中，40.8%的受访者报告在过去 12 个月的实践中至少发生过一次不良事件。共报告了 194 起不良事件，最常见的是面部提升术（n=59/194，30.4%）、鼻整形术（n=55/194，28.4%）和注射手术（n=38/194，19.6%），最常见的描述是血肿或血清肿。大多数不良事件是自限性的，但约 68%的不良事件需要进一步手术。外科医生的错误或判断失误（n=42）和患者不遵医嘱（n=18）是最常归因于不良事件的原因；37.1%的参与者报告在事件发生后改变了临床实践。
面部整形手术中不良事件并不少见。了解这些不良事件可以为跟踪结果、标准化以及参与终身学习、自我评估和实践绩效评估提供动力。
