Outcomes Research in Facial Plastic Surgery: A Review and New Directions. An Update

Excerpt

As we celebrate the 50th anniversary of the ISAPS, and revisit selected contributions of its affiliated journal Aesthetic Plastic Surgery, it is interesting to see the range of most cited articles during this history, and with pleasure that I update why “Outcomes Research in Facial Plastic Surgery: A Review and New Directions” is as relevant today as it was twenty years ago when it was first published. One can see that the majority of these articles that are being revisited focus on specific surgical procedures, many of which remain to this day truly landmark improvements in plastic surgery technique. Just as other reviews of the last 50–70 years have shown, whether it is the evolution of deep plane, SMAS, or endoscopic face-lift techniques, a better understanding of facial anatomy and its implications for safer approaches to the eyelids, face, or neck, or improvements in perioperative and adjuvant therapies, such articles represent truly innovative technical improvements that make plastic surgery procedures more consistent, less risky, and more attractive to our patient population as a whole. The articles, like mine, which focus instead on the field of plastic surgery from without, the way in which results are compared and outcomes determined, in some ways simply compliment those technical advances which have driven our specialty over the last half century. How is one to know if technique A is truly better than technique B, if one cannot measure the outcomes of these two procedures in some quantitative and reproducible way? Twenty years ago, when this original article was first published, the answer to this question was difficult to find. Each of us, as surgeons, knows when our patients are completely happy and when they have misgivings; we know when a surgery has been a total, home-run success, and when it, unfortunately, falls short. The purpose of this original article was to suggest a replacement for these anecdotal and qualitative feelings of success or failure with the measurable and quantitative tools of quality-of-life outcomes research. …