Differential judgements about disfigurement: the role of location, age and gender in decisions made by observers

Psychological distress associated with disfiguring facial lesions is common. However, whilst the intrusive behaviour of observers is commonly reported, for example, staring, comments and questions, these factors which may influence the judgements of observers have not been well described. This is important as it may influence a subject's perception of how their appearance is viewed by the external world. This study is the first to investigate age and gender differences when measuring the importance of location in judgements about facial disfigurement. Observers were asked to rank the impact of simulated lesions in different positions on the face of Caucasian subjects. Age and gender varied in both groups. Our results show that lesions on the young and female subjects are ranked as having a greater impact than those on the old and male subjects. Lesions on central facial features have a higher impact than those located more peripherally. Both of these findings were not significantly influenced by observer age or gender. These results are discussed in terms of culturally derived attributions about appearance. It is also suggested that there is a scope to use feedback on how disfigurement is viewed by others as a therapeutic tool in clinical settings. (C) 2009 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.