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To see or not to see: Impact of viewing facial skin cancer defects prior to reconstruction

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Abstract

Patient expectations of the scar after Mohs micrographic surgery (MMS) are often not realistic, leading to subsequent psychosocial sequelae such as anxiety, depression, and avoidance of social situations. When patient expectations are not met, this may also contribute to a decrease in patient satisfaction after surgery. Therefore, altering expectation levels may change patient satisfaction and psychosocial distress levels after surgery. To assess whether patient satisfaction improves in patients after MMS when patients view the surgical defect prior to reconstruction. Patients undergoing facial MMS between December 2017 and September 2019 were included. Patients received or did not receive a mirror after MMS to view the surgical defect before closing the defect. Patients were asked to complete the Dutch FACE-Q Skin Cancer before, one-week, three-months, and one-year after MMS. A total of 113 patients where included. One-hundred-eight (95.6%), 113 (100%), and 93 (82.3%) questionnaires were completed, one-week, three-months, and one-year follow-up, respectively. Satisfaction with facial appearance and appraisal of scars significantly improved over time for all patients, no such improvement was seen for appearance-related distress. Female patients who looked in the mirror had higher satisfaction with facial appearance than female patients who did not look in the mirror. Also, lower appearance-related distress scores were seen in patients who looked in the mirror prior to a flap reconstruction. Showing the defect in the mirror prior to the reconstruction may result in higher patient satisfaction in female patients and patients before undergoing a flap reconstruction.

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Author information

Authors and Affiliations

  1. Department of Plastic and Reconstructive Surgery, Catharina Hospital, Michelangelolaan 2, 5623EJ, Eindhoven, The Netherlands

    Inge J. Veldhuizen, Lucy J. van Hensbergen, Marleen C. Hölscher, Maarten J. Ottenhof & Maarten M. Hoogbergen

  2. Dermatology Division, Memorial Sloan Kettering Cancer Center, New York, USA

    Inge J. Veldhuizen, Erica H. Lee, Nicholas R. Kurtansky & Stephen W. Dusza

  3. Department of Plastic and Reconstructive Surgery, Nutrim, Maastricht University Medical Center, Maastricht, the Netherlands

    Inge J. Veldhuizen & René R. W. J. van der Hulst

  4. Plastic and Reconstructive Surgery Division, Brigham and Women’s Hospital, Boston, MA, USA

    Andrea L. Pusic

Authors
  1. Inge J. Veldhuizen
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  2. Erica H. Lee
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  4. Lucy J. van Hensbergen
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Contributions

IJV, EHL, NRK, LJH, SWD, MCH, RRWJH, MJO, ALP, MMH: Made substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data; or the creation of new software used in the work; IJV, EHL, NRK, LJH, SWD, MCH, RRWJH, MJO, ALP, MMH: Revised drafted work of Inge J Veldhuizen critically for important intellectual content; IJV, EHL, NRK, LJH, SWD, MCH, RRWJH, MJO, ALP, MMH: Approved the version to be published; and IJV, EHL, NRK, LJH, SWD, MCH, RRWJH, MJO, ALP, MMH: Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. The accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Maarten M. Hoogbergen.

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Conflicts of interest

Andrea Pusic is co-developer of the FACE-Q Skin Cancer which is owned by Memorial Sloan Kettering Cancer Center.

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Institutional review board approval was obtained at Catharina Hospital.

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Veldhuizen, I.J., Lee, E.H., Kurtansky, N.R. et al. To see or not to see: Impact of viewing facial skin cancer defects prior to reconstruction. Arch Dermatol Res 313, 847–853 (2021). https://doi.org/10.1007/s00403-021-02187-1

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  • DOI: https://doi.org/10.1007/s00403-021-02187-1

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