SATISFACTION WITH FACIAL APPEARANCE AMONG SUBJECTS AFFECTED BY A CLEFT

Objective: This study examined the satisfaction of patients with cleft ing and their parents with facial appearance and how this alters with age. The relationship between satisfaction with appearance and psychos ocial functioning was also examined. Design: Prospective Setting: Subj ects were recruited for the study from nine hospital-based clinics. Pa tients, 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 par ents 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-sa tisfaction with appearance among the 10- and 15-year-old subjects corr elated with their psychosocial adjustment (p = .027), The 20-year-old subjects were, on average, significantly more satisfied with their app earance than the 10- and 15-year-olds (p = .009 and p = .012, respecti vely). However, some 20-year-old subjects remained greatly dissatisfie d with aspects of their facial appearance. Subjects with visible anoma lies were significantly more dissatisfied with their appearance than s ubjects with invisible anomalies (p = .035). The 15-year-old subjects were identified as being significantly more dissatisfied with appearan ce 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 clef t may be associated with their self-reported levels of psychosocial fu nctioning. Measuring self-satisfaction with appearance may help to ide ntify subjects at risk from adjustment problems.