Validation of the Finnish FACE-Q for use in patients undergoing surgery for functional problems or malignancy

Figures & data

Table 1. Characteristics of the included patients.

Gender, n (%)
Male	47 (35)
Female	89 (65)
Age, years (median, range)	65 (18–84)
Time from surgery, years (median, range)	6 (0–10)
Reason for surgery, n (%)
Facial nerve paralysis	51 (38)
Brow ptosis	29 (21)
Meretoja amyloidosis syndrome	21 (15)
Skin cancer	19 (14)
Mucosal or salivary gland tumor	8 (6)
Trauma	3 (2)
Other^a	5 (4)
Type of surgery, n (%)
Forehead lift, open or endoscopic	56 (41)
Facelift	42 (31)
Direct brow lift	14 (10)
Removal of a skin lesion^b	13 (10)
Microvascular reconstruction	7 (5)
Superficial parotidectomy	3 (2)
Other^c	1 (1)

^aOther diagnoses: two patients with lower lid ectropion, one patient with neurofibromatosis, one with acromegaly, one with a facial arteriovenous malformation. ^bRemoval of a skin lesion accompanied by either direct closure (n = 6), a local flap (n = 3) or a skin graft (n = 4). ^cEmbolization and resection of an arteriovenous malformation.

Table 2. Assessment of the internal consistency of the FACE-Q subscales.

	Min (%)	Max (%)	Median (IQR)	Cronbach’s alpha (95% CI)
Satisfaction with Facial Appearance	3	7	58 (40–66)	0.97 (0.96–0.98)
Appearance-related Psychosocial Distress	19	2	31 (3–47)	0.95 (0.94–0.97)
Satisfaction with Outcome	6	6	52 (35–66)	0.95 (0.93–0.96)
Satisfaction with Forehead and Eyebrows	2	10	72 (64–87)	0.91 (0.87–0.94)
Adverse effects: Forehead, Eyebrows and Scalp	0	0	17 (14–22)	0.80 (0.72–0.85)
Adverse effects: Cheeks, Lower face and Neck	0	0	19 (16–23)	0.90 (0.78–0.94)

IQR: interquartile range; CI: confidence interval.

Table 3. Exploratory factor analysis for the FACE-Q subscales.

	Factors provided by parallel analysis	Eigenvalue	Loading value range	Communality range
Satisfaction with Facial Appearance	1	7.81	0.83–0.91	0.69–0.82
Appearance-related Psychosocial Stress	1	6.06	0.62–0.94	0.39–0.88
Satisfaction with Outcome	1	4.79	0.79–0.93	0.63–0.86
Satisfaction with Forehead and Eyebrows	1	4.22	0.67–0.90	0.45–0.81
Adverse effects: Forehead, Eyebrows and Scalp	4	4.02	−0.18–0.81	0.21–1.00
		2.08	−0.23–0.98
		1.36	−0.08–0.74
		1.07	−0.14–0.87
Adverse effects: Cheeks, Lower face and Neck	1	6.88	0.21–0.95	0.04–0.90

Figure 1. Reliability of the FACE-Q subscales on repeat administration. ICC: Intraclass correlation coefficient; SEM: standard error of measurement; R: repeatability coefficient.

Table 4. Correlation between the FACE-Q subscale scores and the 15 D domains and the self-perceived normality of the forehead or cheeks.

15D domains	Satisfaction with facial Appearance	Appearance-related Psychosocial Distress	Satisfaction with Outcome	Satisfaction with Forehead and Eyebrows	Adverse effects: Forehead, Eyebrows and Scalp	Adverse effects: Cheeks, Lower face and Neck
Mobility	*	*	*	*	*	*
Vision	−0.33 (<0.001)	0.33 (<0.001)	*	*	0.45 (<0.001)	*
Hearing	−0.32 (<0.001)	0.38 (<0.001)	*	*	*	*
Breathing	*	*	*	*	*	*
Sleeping	−0.32 (<0.001)	0.31 (<0.001)	*	*	*	*
Eating	*	*	*	*	0.30 (0.002)	0.41 (0.033)
Speech	−0.30 (<0.001)	0.33 (<0.001)	*	*	*	0.40 (0.039)
Excretion	*	*	*	*	*	*
Usual activities	*	*	*	*	0.35 (<0.001)	*
Mental function	*	*	*	*	*	*
Discomfort and symptoms	−0.30 (<0.001)	*	*	*	0.40 (<0.001)	*
Depression	−0.41 (<0.001)	0.47 (<0.001)	−0.36 (<0.001)	−0.39 (<0.001)	0.38 (<0.001)	0.43 (0.024)
Distress	−0.31 (<0.001)	0.40 (<0.001)	*	−0.35 (<0.001)	0.34 (<0.001)	0.43 (0.027)
Vitality	−0.41 (<0.001)	0.43 (<0.001)	−0.37 (<0.001)	*	0.44 (<0.001)	0.53 (0.004)
Sexual activity	−0.41 (<0.001)	0.38 (<0.001)	*	*	0.30 (0.002)	0.48 (0.013)
How normal do you think your forehead is/cheeks are?	0.53 (<0.001)	−0.47 (<0.001)	0.36 (<0.001)	0.48 (<0.001)	−0.56 (<0.001)	−0.78 (<0.001)

The numbers are Spearman correlation coefficient (p-value). * = Spearman correlation coefficient <0.30 or p > 0.05.