Assessing aesthetic outcomes after trigonocephaly correction

Purpose This study analysed the aesthetic outcome assessments after trigonocephaly correction using different assessor groups. Methods Twenty-four patients (9 males, 15 females) with a surgical age between 8 and 10 months were included. Standardised photographs showing different facial views of the patients between ages 3 and 6 years were evaluated in terms of aesthetics by three study groups: surgeons, medical students, and lay persons. Each photograph was scored as follows: 1 (normal), 2 (acceptable, no need for revision), or 3 (unacceptable, needs revision). Results The mean surgical age was 9.1 +/- 0.4months. Based on the en-face images, the mean scores assigned by the surgeon, student, and lay groups were 1.4 +/- 0.49, 1.25 +/- 0.44, and 1.13 +/- 0.34, respectively. Based on the patients' profiles, the mean scores assigned by the surgeon, student, and lay groups were 1.37 +/- 0.49, 1.16 +/- 0.37, and 1.09 +/- 0.29, respectively. The scores of the hemi-profile evaluation were 1.14 +/- 0.35, 1.07 +/- 0.26, and 1.09 +/- 0.31, respectively. The scores of the frontal region were 1.47 +/- 0.54, 1.33 +/- 0.49, and 1.39 +/- 0.49, respectively. Within the orbital area, the surgeon, student, and lay groups assigned mean scores of 1.53 +/- 0.56, 1.29 +/- 0.46, and 1.15 +/- 0.36, respectively. The midface analysis showed mean scores of 1.8 +/- 0.66, 1.63 +/- 0.52, and 1.46 +/- 0.5, respectively. In all areas, there were significant differences (P<0.05) among the assessor groups. Conclusion The expectations regarding aesthetic outcome differ considerably between experts and non-experts. The need for correction did not concern the reshaped bone but rather the soft tissue epicanthal area.