Patient expectations in facial transplantation

Meeting patients' expectations is essential for successful outcomes in reconstructive surgery. In the case of new procedures like facial transplantation that carry with them many unknowns and real, or potential, risk of toxic side effects this becomes especially important. In this study we assessed patient expectations in facial transplantation by surveying individuals with facial disfigurement (n = 34), reconstructive surgeons (n = 45), and controls from the general population (n = 148). Questions focused on quality of life improvement, esthetic and functional outcomes. Student t test was used to compare means of the 3 study groups. All groups projected low quality of life for nontreated disfigured persons, controls responding the most negatively (M = 1.91), followed by disfigured persons (M = 2.91; t = 2.14, P <= 0.03) and plastic surgeons (M = 2.71; t = 2.10, P <= 0.04). Regarding face transplantations' ability to improve a disfigured persons' quality of life, the disfigured group reported the highest score (M = 8.12) followed by controls (M = 6.99; t = 2.744, P < 0.007) and plastic surgeons (M = 6.57; t = 3,72, P <= 0.0001). Regarding the importance of esthetic outcomes, controls (M = 6.63) and disfigured persons (M = 6.15) responded similarly whereas plastic surgeons expected the least (M = 4.84; t = 4.13, P < 0.0001, and 2.74, P <= 0.008). Regarding functional outcomes, disfigured individuals (M = 7.55) and controls (M = 7.36; NS) placed significantly more importance on expressive functionality than plastic surgeons (M = 6.11; t = 2.66, P <= 0.009, t = 2.79, P < 0.007). We observed a significant difference between disfigured persons and reconstructive surgeons regarding their expectations for face transplantation. When consulting potential face transplantation patients, surgeons should maintain open communication to assure that their expectations are closely aligned with the realities of the procedure.