Facial Plast Surg 2002; 18(2): 077-086
DOI: 10.1055/s-2002-32197
Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Outcomes Instruments in Facial Plastic Surgery

Ramsey Alsarraf
  • The Newbury Center, Cosmetic Facial Plastic Surgery, Boston, MA
Further Information

Publication History

Publication Date:
13 June 2002 (online)


The accurate measurement of patient-related outcomes of facial plastic surgery procedures relies upon the development, standardization, and use of validated, procedure-specific quality of life instruments. Although other fields of medicine and surgery have embraced the use of such instruments for the quantification and measurement of otherwise subjective or qualitative aspects of patient satisfaction, in the fields of both general and facial plastic surgery, little has been done in this realm. The study of outcomes research and the application of outcomes research to facial plastic surgery have already been discussed in this issue. Outcomes research is founded upon the ability to measure in some fashion those aspects of patient satisfaction that have hitherto been ignored or at best poorly quantified in the assessment of the results of a medical or surgical intervention. In facial plastic surgery, particularly cosmetic facial plastic surgery, the overwhelming majority of results are subjective in nature, be they patient related or based upon the surgeon's own personal assessment of outcome. For this reason, the use of validated instruments to quantify and measure these results is of particular importance in facial plastic surgery compared with other fields of medicine where many outcomes are objectively determined, such as mortality. This article outlines the background of the use of quality of life instruments in the field of outcomes research to provide a basic understanding for the application of such tools to the work of facial plastic surgery. Specific instruments that have already been developed and validated are described as well. Finally, future directions are highlighted that may allow the improved measurement of patient satisfaction as the field of outcomes research in facial plastic surgery continues to evolve.


  • 1 Alsarraf R, Larrabee W F. Outcomes research and facial plastic surgery.  Arch Facial Plast Surg . 2001;  3 7
  • 2 Alsarraf R. Outcomes research in facial plastic surgery: a review and new directions.  Aesth Plast Surg . 2000;  24 192-197
  • 3 Alsarraf R, Larrabee W F, Johnson C M. Cost outcomes of facial plastic surgery: regional and temporal trends.  Arch Facial Plast Surg . 2001;  3 41-47
  • 4 Alsarraf R, Larrabee W F, Murakami C S, Johnson C M. Cosmetic surgery procedures as luxury goods: measuring price and demand in facial plastic surgery (in press).  Arch Fac Plast Surg.
  • 5 Krieger L M, Shaw W W. The effect of increased plastic surgeon supply on fees for aesthetic surgery: an economic analysis.  Plast Reconstr Surg . 1999;  104 559-563
  • 6 Alsarraf R, Larrabee W F, Anderson S, Murakami C S, Johnson C M. Measuring cosmetic facial plastic surgery outcomes: a pilot study.  Arch Facial Plast Surg . 2001;  3 198-201
  • 7 Wilkins E G, Lowery J C, Smith D J. Outcomes research: a primer for plastic surgeons.  Ann Plast Surg . 1996;  37 1-11
  • 8 Piccirillo J F, Stewart M G, Gliklich R E, Yueh B. Outcomes research primer.  Otolaryngol Head Neck Surg . 1997;  117 380
  • 9 Patrick D L, Erickson P. Health status and health policy: quality of life in health care evaluation and resource. 
  • 10 Alsarraf R, Jung C J, Perkins J, Crowley C, Gates G A. Otitis media health status evaluation: a pilot study for the investigation of cost-effective outcomes of recurrent acute otitis media treatment.  Ann Otol Rhin Laryngol . 1998;  107 120-128
  • 11 Alsarraf R, Kriet J D, Weymuller E A. Quality of life outcomes following osteoplastic frontal sinus obliteration.  Otolaryngol Head Neck Surg . 1999;  121 435-440
  • 12 Weymuller E A, Yueh B, Alsarraf R, Deleyiannis F WB, Kuntz A L, Coltrera M D. Quality of life in patients with head and neck cancer-lessons learned from 549 prospectively evaluated patients.  Arch Otolaryngol Head Neck Surg . 2000;  126 329-336
  • 13 Isenberg S F, Rosenfeld R M. Problems and pitfalls in community-based outcomes research.  Otolaryngol Head Neck Surg . 1997;  116 662
  • 14 Shakespeare V, Cole R P. Measuring patient-based outcomes in a plastic surgery service: breast reduction surgical patients.  Br J Plast Surg . 1997;  50 242-248
  • 15 Chung K C, Hamill J B, Walters M R, Hayward R A. The Michigan hand outcomes questionnaire (mhq): assessment of responsiveness to clinical change.  Ann Plast Surg . 1999;  42 619-622
  • 16 Cooper H M, Meyer D R. Outpatient ophthalmic plastic surgery: outcomes and patient satisfaction using initial postoperative telephone call follow-up.  Ophthal Plast Reconstr Surg . 2000;  16 231-236
  • 17 Rankin M, Borah G L, Perry A W, Wey P D. Quality of life outcomes after cosmetic surgery.  Plast Reconstr Surg . 1998;  102 2139-2145
  • 18 Stewart E J, Robinson K, Wilson J A. Assessment of patient's benefit from rhinoplasty.  Rhinology . 1996;  34 57-59
  • 19 McKiernan D C, Banfield G, Kumar R, Hinton A E. Patient benefit from functional and cosmetic rhinoplasty.  Clin Otolaryngol . 2001;  65 50-52
  • 20 Siegel N S, Gliklich R E, Taghizadeh F, Chang Y. Outcomes of septoplasty.  Otolaryngol Head Neck Surg . 2000;  122 228-232
  • 21 Alsarraf R. In search of a hammer.  Otolaryngol Head Neck Surg . 2000;  123 525-526
  • 22 Luce E A. Outcome studies and practice guidelines in plastic surgery.  Plast Reconstr Surg . 1999;  104 1187-1190
  • 23 Larrabee J, Wayne F. Personal communication. 2001