title: Psychosocial impact of craniofacial deformities before and after reconstructive surgery.
abstract: Pre- and post-operative body image, self-confidence and individual and family adjustment were compared in 250 patients (aged 6 weeks to 39 years) with severe craniofacial deformities. Major congenital deformities of genetic or idiopathic etiology were present in 178 patients and 72 had tumours or other late-onset deformities. The patients and/or parents were interviewed by a child psychiatrist and a social worker as part of the routine pre-operative assessment. In addition to a semistructured interview protocol, the patients and parents were asked to rate the deformity according to Hay's Scale and, when appropriate, to complete the Piers-Harris Self-esteem Inventory. One and two year post-operative reevaluations followed the same protocol. The results indicated that the age of the patient, pre-operative expectations and origin of the decision for surgery (particularly in adolescents) are the most significant predictive factors of post-operative psychosocial improvement.
mesh_terms: D000293:Adolescent; D000328:Adult; D001828:Body Image; D002648:Child; D002675:Child, Preschool; D002971:Cleft Lip / Q000601:surgery; D002972:Cleft Palate / Q000601:surgery; D003394:Craniofacial Dysostosis / Q000523:psychology / Q000601:surgery*; D005145:Face / Q000601:surgery*; D005146:Facial Asymmetry / Q000601:surgery; D005153:Facial Neoplasms / Q000601:surgery; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008310:Malocclusion / Q000601:surgery; D011788:Quality of Life; D012649:Self Concept; D012917:Social Adjustment; D013518:Surgery, Plastic / Q000523:psychology*