Those with facial scars rate their own appearance more critically than surgeons and strangers
Date:
March 16, 2022
Source:
University of Pennsylvania School of Medicine
Summary:
Patients who undergo facial surgery think their surgical scars
look worse than surgeons and independent observers do, according
to a new study.
FULL STORY ========================================================================== Patients who undergo facial surgery think their surgical scars look
worse than surgeons and independent observers do, according to a
new study from the Perelman School of Medicine at the University of Pennsylvania. Surgeons and those not tied personally to the particular
scarring felt similarly about how significant a scar appeared, but
those who looked at their own faces had more negative feelings about
the condition and appearance of the scar. Researchers say that surgeons
should explain to their patients in detail how their scar will likely look post-surgery and explicitly say to their patients that they themselves
will likely perceive their scars to be more significant than others
will. The study is published in the journal Facial Plastic Surgery &
Aesthetic Medicine.
========================================================================== Eighty-one patients who had facial skin cancer and then received Mohs micrographic surgery (a type of precise skin surgery where layers of
skin are removed a little at a time) rated their scars a week after
surgery and then three months after. While their feelings about their
scar improved by roughly 40% from week one to the three-month mark,
they still judged their scars more critically than Mohs surgeons and independent observers after three months.
"Our research seems to support the saying 'we are our own worst critics,'"
said senior author Joseph F. Sobanko, MD, director of Dermatologic Surgery Education and an associate professor of Dermatology at Penn. "Patients
are probably going to view scarring on their faces as more severe than
their own surgeon will and even someone they walk by on the street."
Armed with that knowledge, surgeons should speak to their patients not
just about the process of surgery but also what to expect during the
healing process and what their face will look like after the incision
is completely healed, Sobanko said.
"Our goal as surgeons should be to remove cancer effectively while
minimizing scarring," Sobanko added. "Nevertheless, skin cancer surgery
will produce highly visible changes early in the healing process and our
job as surgeons is to prepare patients for how their skin will look during
the healing process. We should also be direct with our patients and tell
them that they are going to be the most critical of their appearance."
The Penn researchers made very specific choices when designing the
study. The team decided to use facial scarring because of the obviously personal relationship people have with their faces. Previous research
from Sobanko and colleagues showed that people are the most sensitive
about scars on their faces compared to scars on other parts of their
body. The researchers also chose to have participants assess scars at
the one-week mark and at three months.
"At one week, incisions from surgery are quite visible, and that can
be very jarring for patients," Sobanko said. "As weeks progress the
incisions heal predictably and our prior research has shown that most
patients return to their baseline quality of life approximately 3 months
after surgery." While the advice for providers is to be honest and clear
with their patients about scarring, Sobanko and his team are planning
to study specific ways that surgeons can help patients feel better about
their surgical mark.
"One method we have used in our practice is to connect people about
to go through Mohs facial surgery with willing individuals who already
have been through the surgery," said Sobanko. "Anecdotally, our patients
have appreciated the opportunity to ask questions to someone who has experienced what they are about to go through and also see first-hand
how someone else's face healed.
We're excited to study whether that and other interventions can ease
patients' minds and help them feel better about the entire surgery
experience." This research supported by funding from the Dermatology Foundation Career Development Award.
========================================================================== Story Source: Materials provided by University_of_Pennsylvania_School_of_Medicine. Note: Content may be
edited for style and length.
========================================================================== Journal Reference:
1. Kimberly Shao, Shannon W. Zullo, William Fix, Lynne Taylor, Junqian
Zhang, Christopher J. Miller, Jeremy R. Etzkorn, Thuzar
M. Shin, Cerrene N. Giordano, William H. Higgins, Joseph
F. Sobanko. Measuring Stakeholder Assessments of Postsurgical
Facial Scars. Dermatologic Surgery, 2022; Publish Ahead of Print
DOI: 10.1097/DSS.0000000000003405 ==========================================================================
Link to news story:
https://www.sciencedaily.com/releases/2022/03/220316114953.htm
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