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Surgical reconstruction of facial defects viewed as high-value intervention

Casual observers perceived that facial defects were related to a significant decrease in quality of life, and data show that surgical reconstruction of the defects is perceived as a high-value intervention, according to study results published in JAMA Facial Plastic Surgery.

Researchers conducted a randomized observational study of data from surveys of 200 socioeconomically diverse observers (79% female; mean age, 32.3 years), who viewed images of faces with defects before and after surgical reconstruction. The observers were asked to rate their health state utility if they had the defects, and how much they would pay to have the defect surgically repaired.

Perceived health state utility was significantly decreased by facial defects, with large and centrally located defects being attributed to the greatest penalty by the observers.

“Surgical reconstruction of the facial defects increased health state utility to near-normal ranges for all groups except large central defects,” the researchers wrote.

Prices observers were willing to pay for surgical repairs included an average of $1,170 (95% CI, 767-1,572) to repair de novo small peripheral defects; $4,274 more than the average (95% CI, 3,296-5,251) to repair a large defect and $2,372 more than average (95% CI, 1,379-3,366) for a central-defect repair.

Willingness to pay per quality-adjusted life-year (QALY) was calculated using the valuations and health utility data. There was a range of mean willingness to pay per QALY ratios from $639 per QALY for small peripheral defect repairs to $2,383 per QALY for large-central defect repairs.

“To our knowledge, this is the first study to measure the impact of facial defects on quality of life and willingness to pay, as perceived by society,” the researchers wrote. “This study illustrates the significant quality-of-life penalty associated with facial defects, and the value society places on their surgical reconstruction.”

“These finding have important implications for patients, surgeons and health policymakers,” the researchers concluded. “They also set the framework for using [willingness to pay] to better understand facial perception.” – by Bruce Thiel

Disclosure: The researchers report no relevant financial disclosures.