Affiliation:
1. Department of Dermatology Leiden University Medical Center Leiden The Netherlands
2. Department of Dermatology Ziekenhuisgroep Twente Hengelo The Netherlands
3. Department of Health, Medical, and Neuropsychology, Institute of Psychology Leiden University Leiden The Netherlands
4. Department of Biomedical Data Sciences Leiden University Medical Center Leiden The Netherlands
5. Department of Dermatology Roosevelt Kliniek Leiden The Netherlands
Abstract
AbstractBackgroundKnowledge of the psychosocial impact of facial skin surgery on patients can help improve counselling strategies.ObjectivesThe objective was to measure the psychological impact of facial skin cancer surgery on patients over a 1‐year period. Secondary objective was to measure the difference between Mohs micrographic surgery (MMS) and conventional excision (CE) on these parameters.MethodsThis observational survey study was conducted between March 2019 and July 2020. Patients who had facial skin surgery using MMS or CE were selected. Five surveys were conducted on four timepoints (preoperative, 1 week, 3 months and 1 year post‐operative) measuring the quality of life, perceived stigmatization, body image, satisfaction with facial appearance and psychosocial distress.ResultsA total of 228 patients (MMS 154 patients, CE 74 patients) were included for the analysis. Scores for quality of life did not significantly change, in the year after surgery (PCS‐12 mean 50.5, SD 9.3 and MCS‐12 50.6, SD 9.4); however, stigmatization (F (3, 235,39) 7,26, p < 0.01, d = −0.07), body image concerns (F (3, 198,28) = 3.75, p < 0.01, d = −0.14), satisfaction with facial appearance (F (3, 205,18) = 10.74, p < 0.01, d = 0.43) and psychosocial distress (F (3, 208,69) = 9.26, p < 0.01, d = −0.15) did change over time. The use of MMS or CE did not significantly affect outcome scores after 1 year.ConclusionPatients receiving facial skin cancer surgery exhibited low scores for perceived stigmatization and body image concerns. Their quality of life was not statistically influenced by facial surgery, and their satisfaction with their facial appearance and psychosocial distress even improved after 1 year. The results suggest that the surgical treatment type (MMS or CE) does not influence the outcome. The overall results can help in counselling strategies to improve expectations for patients receiving facial surgery.