Scarring: In the Eyes of the Beholder

Patients [and Clients] and Doctors [as well as CPs] often disagree about the final evaluation of scars. Agreement on the definition of a good final surgical scar outcome is needed so that patients can be advised on what to expect. In the past surgical scarring outcomes have been based on ratings by physicians and “blinded” experts. Patient-reported outcomes was incorporated only recently in research studies.

In a new systematic review, published online (1 February 2018) in JAMA Facial Plastic Surgery, Dr. Joseph F. Sobanko of the University of Pennsylvania in Philadelphia and colleagues found 29 studies that incorporated at least one physician- and patient-reported scar measure, a total of 4,485 patients. Only 10% of studies focused on facial procedures. Eight of the 29 studies (1.2 in 4 cases) showed disagreement between the patient and physician ratings and they also had different views on which aspects of a scar (depth, relief, pigmentation) were important.


By showing Clients “after procedure” pictures of proposed procedures (in different stages of healing / response), CPs can help to preempt expectations and concerns. Results and possible Adverse Effects should always be discussed in the informed consent process.

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