Patients have worse perception of own surgical scars than observers do

April 1, 2022
Patients have worse perception of own surgical scars than observers do

Recent research from the University of Pennsylvania (Penn) Perelman School of Medicine showed that patients who have facial surgical scars have a more negative perception of their appearance than those not personally tied to the experience, including surgeons and independent observers.

While other research alludes to the fact that people are more sensitive about scars on their faces compared to scars on other parts of their body, researchers from the Perelman study nevertheless advise surgeons to alleviate their patient’s potential perception by explaining the surgery process and how scar will look post-surgery. Surgeons are also advised to remind their patients that they themselves will likely perceive their scars to be more significant than others will.

“Our research supports the saying ‘we are our own worst critics,'” said Dr. Joseph F. Sobanko, the Director of Dermatologic Surgery Education and Associate professor of Dermatology at Penn. “Patients are probably going to view scarring on their faces as more severe than their own surgeon will and even someone they walk by on the street.”

In the Perelman study, some 81 patients who had facial surgery were seen to judge their scars more harshly than necessary. These patients had facial skin cancer and received Mohs micrographic surgery (a type of precise skin surgery where layers of skin are removed a little at a time). While their feelings about their respective scars improved by roughly 40% from week one post-surgery to the three-month mark, they still judged their appearance more critically than Mohs surgeons and independent observers after three months.

Dr. Sobanko explained: “Skin cancer surgery will produce highly visible changes early in the healing process – but at one week, incisions from surgery are [still] quite visible, and that can be very jarring for patients. Our job as surgeons is to prepare patients for how their skin will look during the healing process. We should also be direct with our patients and tell them that they are going to be the most critical of their appearance.”

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