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Study measures social impact of facial lesions

Researchers at Johns Hopkins School of Medicine have released the results of a study that measures the social impact of facial lesions before and after surgical reconstruction — a topic not investigated heretofore.

In a prospective, randomized setting, 120 people were asked to view images of faces with lesions of varying sizes and locations before and after reconstruction. For comparison, they also viewed lesion-less faces. The observers were instructed to rate faces using a battery of metrics, including how comfortable they would be having a conversation with the participant in each facial image. The conversation questions were answered on a scale of zero to 100, with higher numbers indicating a higher level of comfort the observer would feel talking with the face viewed.

Researchers found:

  • The mean conversation score for subjects with lesion-less faces was 85.02
  • Facial lesions had a negative effect, or penalty, on conversation (61.63)
  • Penalties varied with lesion size and location, with large and central lesions generating the greatest penalty
  • Reconstructive surgery increased observers’ comfort and willingness to converse with individuals with facial lesion by an average of 19.83 points, an improvement that also varied with preoperative lesion size and location
  • Reconstructive surgery seemed to normalize observer comfort in communicating with people with small peripheral, small central and large peripheral lesions
  • Even after surgery, substantial discomfort communicating with patients with large central lesions remained

Facial lesions induce a significant social penalty as rated by the casual observer,” the authors write. “Specifically, observers are less comfortable communicating with people who have facial lesions. Surgical reconstruction of facial lesions increased observers’ comfort in conversing with people with facial lesions, an impact that varied with lesion size and location.”

The study was published in JAMA Facial Plastic Surgery.

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