The impact of cosmetic interventions on quality of life.

In the last decade, the number of cosmetic procedures performed in the United States has rapidly increased. While physicians historically have focused on minimizing side effects and optimizing the physical outcome, a broad spectrum of patient needs also factors in treatment success. Unfortunately, few data are available regarding the effects of cosmetic procedures on patient's self-esteem, confidence, relationships, and acceptance by others. Quality of life represents a relevant and important long-term measurement of outcomes in these patients. Studies have shown that cosmetic surgery can have a positive impact on patient quality of life. In contrast, fewer data are available regarding the effects of nonsurgical cosmetic procedures on quality of life. Much of the quality-of-life data regarding nonsurgical cosmetic procedures focuses on patients with human immunodeficiency virus-associated facial lipoatrophy, a condition associated with depression, problems with self-esteem and interpersonal relationships, in addition to nonadherence to the treatment. Recent data indicate that cosmetic treatment of human immunodeficiency virus-related facial lipoatrophy with injectable facial rejuvenators can improve quality of life in these patients. However, there is a dearth of quality-of-life data on patients who undergo facial rejuvenation procedures using the newer injectable devices, such as hyaluronic acid, calcium hydroxylapatite, and poly-L-lactic acid. Future studies should focus on developing standardized tests to assess quality of life in patients undergoing facial rejuvenation interventions. More data obtained from validated assessment tools are needed to systematically evaluate the effects specific treatments have on satisfying the needs of the cosmetic patient.