COSMIN database

Measuring quality of life and patient satisfaction after body contouring: a systematic review of patient-reported outcome measures

Reavey, P. L., Klassen, A. F., Cano, S. J., McCarthy, C., Scott, A., Rubin, J. P., Shermak, M., and Pusic, A. L.

BASED BACKGROUND: In both cosmetic and postbariatric body contouring populations, the primary determinants of success are patient satisfaction and quality of life (QOL). These patient-reported outcomes (PRO) are ideally measured with specially-designed, procedure- or condition-specific questionnaires.

OBJECTIVE: The authors identify and appraise all patient-reported outcome (PRO) measures (questionnaires) developed for patients undergoing body contouring surgery.

METHODS: MEDLINE, EMBASE, PsychINFO, Ebase, CINAHL, HAPI, Science Citation Index/Social Sciences Citation Index, Ovid Evidence Based Medicine databases were searched from the inception of each database through August 2010. Articles included in the study described the development and/or psychometric evaluation of a PRO measure developed for body contouring patients. Each measure was then appraised for adherence to internationally-recommended guidelines for item generation, item reduction, and psychometric evaluation.

RESULTS: The following five PRO questionnaires were identified by our search: one liposuction (the Freiburg Questionnaire on Aesthetic Dermatology and Cosmetic Surgery, FQAD), one general plastic surgery (Derriford Appearance Scale, DAS-59/24), and three breast reduction measures (the Breast Reduction Assessed Severity Scale Questionnaire, BRASSQ; Breast Related Symptoms questionnaire, BRS; and the BREAST-Q reduction module. Detailed examination of these measures revealed that the FQAD, DAS-59, and BRS are limited by both their content range and psychometric properties. The BRASSQ and BREAST-Q both have strong psychometric properties, and the BREAST-Q is unique in its inclusion of items covering specific postoperative issues such as scarring.

CONCLUSIONS: While instruments are available for measuring outcomes in breast reduction patients, reliable, valid, and responsive PRO measures are lacking for the majority of body contouring procedures. To demonstrate the unique outcomes of body contouring surgery, future research to rigorously develop and validate new PRO measures in this population is necessary.
Aesthet Surg J
1527-330X (Electronic)
Publication year:
Overall quality of life:
Overall quality of life
Adults (18-65)
Children (0-18)
Seniors (65+)
Certain conditions originating in the perinatal period and related symptoms
Codes for special purposes
Congenital malformations, deformations and chromosomal abnormalities and related symptoms
Diseases of and symptoms related to the circulatory system
Diseases of and symptoms related to the digestive system
Diseases of and symptoms related to the genitourinary system
Diseases of and symptoms related to the skin and subcutaneous tissue
Endocrine, nutritional and metabolic diseases and related symptoms
External causes of morbidity and mortality
Factors influencing health status and contact with health services
Mental and behavioural disorders and related symptoms
Neoplasms and related symptoms
Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
PRO / non-PRO:
Patient Reported Outcome
Type of measurement instrument:
1 - Questionnaires
BRASSQ - Breast Reduction Assessed Severity Scale Questionnaire
BREAST-Q-Reduction module
BRS - Breast Related Symptoms Questionnaire
DAS - Derriford Appearance Scale (versions: DAS-24 - DAS-24 items; DAS-59 - DAS-59 items)
FQAD - Freiburg Questionnaire on Aesthetic Dermatology and Cosmetic Surgery