FACE-Q scales for health-related quality of life, early life impact, satisfaction with outcomes, and decision to have treatment: development and validation

Plast Reconstr Surg. 2015 Feb;135(2):375-386. doi: 10.1097/PRS.0000000000000895.


Background: An ever-growing range of facial cosmetic products and treatments are available, but little clinical research is being performed to determine treatment outcomes from the patient's perspective. The FACE-Q is a patient-reported outcome instrument composed of more than 40 independently functioning scales and checklists. The aim of this article is to describe the development and psychometric evaluation of five new FACE-Q scales.

Methods: FACE-Q scales were developed according to international guidelines for patient-reported outcome instrument development. The following FACE-Q scales and a single symptom checklist (Recovery Early Symptoms) were evaluated in this study: Psychological Wellbeing, Social Function, Satisfaction with Decision to Have Treatment, Satisfaction with Outcome of Treatment, and Early Life Impact of Treatment. Modern and traditional psychometric methods were used to examine reliability, validity, and responsiveness.

Results: The sample included 702 participants from three studies. The FACE-Q scales were found to be reliable, valid, and responsive to clinical change. These findings were supported by Rasch measurement theory (e.g., overall chi-square values, p ≥ 0.06; Person Separation Index ≥0.81), traditional psychometric (e.g., Cronbach alpha values ≥0.90) and responsiveness (i.e., significant improvement following face lift and lip treatment) analysis.

Conclusions: The FACE-Q measures concepts and symptoms important to facial aesthetic patients. The five scales and single symptom checklist described here can be used to measure what patients think about cosmetic treatments in a scientifically sound manner. As the cosmetics industry continues to expand, the patient perspective of treatment outcomes should be measured and reported.

Clinical question/level of evidence: Diagnostic, III.

Publication types

  • Evaluation Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Checklist
  • Clinical Trials as Topic / psychology
  • Cosmetic Techniques / psychology*
  • Emotions
  • Esthetics*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Satisfaction*
  • Patient Selection
  • Plastic Surgery Procedures / psychology*
  • Psychometrics
  • Quality of Life / psychology*
  • Selection Bias
  • Self Report
  • Surveys and Questionnaires*
  • Symptom Assessment / methods*
  • Treatment Outcome
  • Young Adult