Measuring Outcomes of Facial Skin Cancer Surgery Using the FACE-Q Skin Cancer Module

Background: Facial skin cancer and surgical removal can alter appearance, contributing to patient morbidity through effects on self-perception and psychosocial well-being. This study aimed to assess the impact of surgical intervention on appearance and health-related quality of life before and after surgery. Methods: A single-center, prospective cohort study of 108 participants undergoing facial skin cancer surgery was conducted between November 2021 and December 2023. Participants completed the FACE-Q Skin Cancer questionnaire preoperatively up to 12 months postoperatively. Statistical significance was defined as P < 0.05. Results: A total of 105 participants completed the preoperative questionnaires, with 101, 96, 93, and 76 completing questionnaires at 1, 3, 6, and 12 months postoperatively. Postoperatively, participants were more satisfied with their facial appearance and reported improvements in appearance-related distress. Significant improvements ( P < 0.001) were shown in cancer worry, appraisal of scars, sun protection behaviors, and adverse effects. Younger age (<65 y) was a significant predictor of worse outcomes across all domains. Participants with melanoma and those managed with reconstructive repair were associated with lower satisfaction and greater appearance-related distress. Women were more satisfied with their facial appearance, although they rated their scars less favorably. Nonmelanoma skin cancers were predictive of increased cancer worry. Conclusions: Facial skin cancer surgery improves health-related quality of life, appearance factors, and sun protection behaviors. Younger participants, and those with melanoma or managed with a component of reconstructive repair, may benefit from targeted perioperative support alongside interdisciplinary care. Further clinical integration of the FACE-Q Skin Cancer module will assist in providing individualized patient care.