Yanjun Xie1, Michael J Brenner2, Jordan P Sand3, Shaun C Desai4, Caitlin Murray Drumheller5, David W Roberson6, Brian Nussenbaum7, Matthew A Kienstra8. 1. Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, 1500 E. Medical Center Drive, 1903 Taubman Center SPC 5312, Ann Arbor, MI, 48109-5214, United States. Electronic address: xieya@med.umich.edu. 2. Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, 1500 E. Medical Center Drive, 1903 Taubman Center SPC 5312, Ann Arbor, MI, 48109-5214, United States. Electronic address: mbren@med.umich.edu. 3. The Spokane Center for Facial Plastic Surgery, 217 W. Cataldo Avenue, Spokane, WA 99201, United States. Electronic address: jsand@spokaneent.com. 4. Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, 601 N. Caroline Street, Baltimore, MD 21287, United States. Electronic address: sdesai27@jhmi.edu. 5. Measure Development, American Society of Clinical Oncology (ASCO), 2318 Mills Road, Suite #800, Alexandria, VA 22314, United States. 6. Global Tracheostomy Collaborative, Raleigh, NC, United States; Bayhealth Medical Group, 806 Seabury Avenue, Milford, DE 19963, United States. Electronic address: droberson@globaltrach.org. 7. American Board of Otolaryngology-Head and Neck Surgery, 5615 Kirby Drive, Suite# 600, Houston, TX 77005, United States. Electronic address: briannussenbaum@abohns.org. 8. Mercy Facial Plastic Surgery, Mercy Health Care, 1965 S. Fremont Avenue, Suite #120, Springfield, MO 65804, United States. Electronic address: Matthew.Kienstra@mercy.net.
Abstract
PURPOSE: Complications in facial plastic surgery can lead to pain, suffering, and permanent harm. Yet, the etiology and outcomes of adverse events are understudied. This study aims to determine the etiology and outcomes of adverse events reported in aesthetic facial plastic surgery and identify quality improvement opportunities. MATERIAL AND METHODS: A cross-sectional survey analysis was conducted using an anonymous 22-item questionnaire distributed to members of the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) and American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS). Participants were queried on demographics, practice type, and adverse events related to aesthetic facial surgeries. RESULTS: Two hundred fifty-three individuals participated; nearly half of respondents (49.0%) held membership in both AAO-HNS and AAFPRS. Of these, 40.8% of respondents reported at least one adverse event within the past 12 months of practice. A total of 194 adverse events were reported, most commonly related to facelift (n = 59/194, 30.4%), rhinoplasty (n = 55/194, 28.4%), and injection procedures (n = 38/194, 19.6%), with hematoma or seroma being the most commonly described. Most adverse events were self-limited, but approximately 68% resulted in further procedures. Surgeon error or poor judgement (n = 42) and patient non-adherence (n = 18) were the most commonly ascribed reasons for adverse events; 37.1% of participants reported a change in clinical practice after the incident. CONCLUSIONS: Adverse events were not infrequent in facial plastic surgery. Understanding these adverse events can provide impetus for tracking outcomes, standardization, and engagement with lifelong learning, self-assessment, and evaluation of practice performance.
PURPOSE: Complications in facial plastic surgery can lead to pain, suffering, and permanent harm. Yet, the etiology and outcomes of adverse events are understudied. This study aims to determine the etiology and outcomes of adverse events reported in aesthetic facial plastic surgery and identify quality improvement opportunities. MATERIAL AND METHODS: A cross-sectional survey analysis was conducted using an anonymous 22-item questionnaire distributed to members of the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) and American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS). Participants were queried on demographics, practice type, and adverse events related to aesthetic facial surgeries. RESULTS: Two hundred fifty-three individuals participated; nearly half of respondents (49.0%) held membership in both AAO-HNS and AAFPRS. Of these, 40.8% of respondents reported at least one adverse event within the past 12 months of practice. A total of 194 adverse events were reported, most commonly related to facelift (n = 59/194, 30.4%), rhinoplasty (n = 55/194, 28.4%), and injection procedures (n = 38/194, 19.6%), with hematoma or seroma being the most commonly described. Most adverse events were self-limited, but approximately 68% resulted in further procedures. Surgeon error or poor judgement (n = 42) and patient non-adherence (n = 18) were the most commonly ascribed reasons for adverse events; 37.1% of participants reported a change in clinical practice after the incident. CONCLUSIONS: Adverse events were not infrequent in facial plastic surgery. Understanding these adverse events can provide impetus for tracking outcomes, standardization, and engagement with lifelong learning, self-assessment, and evaluation of practice performance.