(0523) Physician and Lay Persons Perception of Aesthetic Outcomes After Mohs Reconstruction

Introduction: Mohs surgery is the gold standard for treatment of non melanoma skin cancers. Patients often perceive Mohs surgery and reconstructive as procedures that will cause significant asymmetry and deformity. Their fear of perception by others is a source of anxiety. In addition, physician satisfaction can vary greatly based on specialty and training. We sought to identify differences in aesthetic outcome as perceived by physicians and lay persons.

Methods: A 52 question survey based on 13 postoperative Mohs reconstruction patients was distributed to two facial plastic surgeons, two plastic surgeons, two dermatologists, two non-surgeons, and 10 lay persons. Unpaired t-tests were used for statistical analysis.

Results: The average rating for aesthetic outcome in the physician group was 90.115 (Standard deviation 10.499). The average rating for aesthetic outcome in the lay persons group was 92.659 (Standard deviation 8.906). The facial plastic surgeon and plastic surgeons average rating for aesthetic outcome was 88.077 (standard deviation 10.564), and for all other physicians was 92.346 (standard deviation 9.936). An unpaired t-test comparing average rating of all facial plastic surgeons and plastic surgeons (88.077) and lay persons (92.6599) revealed a statistically significant difference with p = 0.0034.

Conclusions: Our study highlights the differences in training by specialty of physicians, and how this can influence perception of aesthetic outcomes. We also found that lay persons often rated aesthetic outcomes higher than facial plastic surgeons and plastic surgeons. Non-surgeons also rated aesthetic outcomes higher than facial plastic surgeons and plastic surgeons. This suggests that lay persons often are less critical and apt at identifying asymmetries and scars, whereas facial plastic surgeons and plastic surgeons are. This should help decrease patient anxiety when considering reconstructive surgery and their fear of perception of others.