Abstract
Introduction With increasing incidence of facial skin cancer, more patients undergo facial reconstruction
following Mohs micrographic surgery (MMS). Aesthetically unpleasing, thickened facial
flaps, and disturbing scars can be treated with a pressure mask with inner silicone
lining to help improve functional and aesthetic outcomes. However, data on long-term
patient satisfaction and quality of life (QoL) following this treatment are lacking.
Methods We aimed to assess long-term satisfaction and QoL of patients who underwent local
flap reconstruction following MMS. Patients treated between January 2012 and October
2020 were invited to answer FACE-Q and SCAR-Q questionnaires. Demographic data, skin
cancer type and location, type of reconstruction, postoperative complications, duration
of pressure mask therapy, daily compliance, and additional scar treatment were collected
to explore possible predictors.
Results Of 92 eligible patients, 50 responded. Eighteen respondents were male (36%) and 32
were female (64%). Mean duration of pressure mask therapy was 10.20 ± 4.61 months.
Patients were 61.14 ± 32.91 months after completion of pressure mask therapy upon
participation. Patients whose reconstruction consisted of multiple flaps had significantly
worse outcomes in social function (p = 0.012), scar appearance (p = 0.045), and scar symptoms (p = 0.008). A trend of increasing time since therapy completion predicting better outcomes
was observed for all scales, and it was a significant predictor for better scar appearance
(p = 0.001) and less scar symptoms (p = 0.001).
Conclusion Pressure mask treatment for facial flaps and scars following MMS results in good
long-term patient satisfaction and QoL. Multiple local flaps, reflecting a larger
skin defect postexcision, is a predictor for worse outcomes in social function, scar
appearance, and symptoms. Increasing time is associated with increasing satisfaction,
which reflects satisfactory and stable long-term effects of treatment, possibly combined
with more acceptance of the result over time.
Keywords
scars - facial pressure mask - pressure therapy - quality of life - patient-reported
outcome
