Satisfaction with facial appearance among subjects affected by a cleft

Objective: This study examined the satisfaction of patients with clefting and their parents with facial appearance and how this alters with age. The relationship between satisfaction with appearance and psychosocial functioning was also examined. Design: Prospective Setting: Subjects were recruited for the study from nine hospital-based clinics. Patients, Participants: All subjects had some type of cleft and were 10, 15, or 20 years of age. In all, 111 subjects with clefting and 62 parents were included. Main Outcome Measures: Facial appearance was rated on a subjective ordinal scale of 1 to 7; psychosocial adjustment was measured with the Childhood Experience Questionnaire. Results: Self-satisfaction with appearance among the 10- and 15-year-old subjects correlated with their psychosocial adjustment (p = .027), The 20-year-old subjects were, on average, significantly more satisfied with their appearance than the 10- and 15-year-olds (p = .009 and p = .012, respectively). However, some 20-year-old subjects remained greatly dissatisfied with aspects of their facial appearance. Subjects with visible anomalies were significantly more dissatisfied with their appearance than subjects with invisible anomalies (p = .035). The 15-year-old subjects were identified as being significantly more dissatisfied with appearance than their parents (p = .005). Conclusions: Subjects affected by a cleft with visible impairments are more dissatisfied with their facial appearance than are subjects with invisible impairments. Satisfaction with facial appearance among 10- and 15-year-old subjects with a cleft may be associated with their self-reported levels of psychosocial functioning. Measuring self-satisfaction with appearance may help to identify subjects at risk from adjustment problems.