Plastic Surgery Research Council
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PSRC 60th Annual Meeting
Program and Abstracts

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Patient Perceived Benefit in Facial Aesthetic Procedures: the FACE-Q as a Tool to Study Botulinum Toxin Injection Outcomes
Anthony J. Taglienti, MD1, Anthony Wilson, MD1, Brian Chang, BA2, Nancy Folsom, RN1, Catherine Chang, MD1, Bianca Chin, MD1, Ivona Percec, MD, PhD1.
1Hospital of the University of Pennsylvania, Philadelphia, PA, USA, 2Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.

An understanding of patient perceived benefit allows for improved counseling and quality of aesthetic procedures. The FACE-Q is a novel, validated measure of patient perceptions following facial procedures. This prospective study evaluates FACE-Q outcomes pre and post botulinum toxin (BoNTA) injection in the glabella.
After obtaining IRB approval, 73 BoNTA naïve, female patients between the ages of 18-75 were recruited from 5/2014-9/2014. Patients electronically completed the FACE-Q survey prior to, and 2 weeks following, injection with a standardized dose of FDA-approved botulinum toxin in the glabella. The PI performed Fitzpatrick Skin Type and Glogau Wrinkle Assessments on all subjects at their initial visit. Descriptive and comparative statistics using matched pair t-tests were conducted.


Of 73 patients enrolled, 57 subjects completed the FACE-Q at both time-points, with a mean age of 45.6 years (+/- 11 years). Approximately half (28) were classified as Fitzpatrick skin type III, and a majority (41) was rated as a 2 or 3 on the Glogau Wrinkle Assessment Scale.
Patients reported that their overall face appeared significantly more symmetric (p<0.05), balanced (p<0.05), well-proportioned (p<0.05), fresh (p<0.05), and rested post treatment (p<0.05). Additionally, patients reported that their face looked better upon waking (p<0.05), at the end of the day (p<0.05), in photographs (p<0.05), and under bright lights (p<0.05) post treatment. Interestingly, patients also reported a significant improvement in their profile view (p<0.05), cheek smoothness (p<0.05), and cheek fullness (p<0.05) after injection.
Subjects also reported being less bothered by how old they appeared (p<.05), and following injection felt they looked, on average, 5.8 years younger (p<.05).
There was no correlation between age, Glogau or Fitzpatrick scales and perceived benefits.

The FACE-Q reveals strong patient perceived benefits on facial aesthetics following botulinum toxin injection to the glabella. This is the first prospective clinical study to use an objective measure to quantify the perceived effects of botox, and to demonstrate that subjects may perceive other areas of facial improvement outside the injection zone. It is critical to understand patient perceived benefits of aesthetic procedures for optimization of cosmetic treatment regimens.

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