The "First Look": Individuals' Initial Experiences of Viewing Their Appearance Following Craniofacial Surgery.

Elective surgeries to improve facial appearance are frequently offered to adolescents and adults with craniofacial conditions. While some studies point to the psychosocial benefits of surgery, others have described patient distress and disappointment. The aim of this study was to explore individuals' experiences of viewing their appearance for the first time following craniofacial surgery. An existing questionnaire was adapted for the craniofacial population and disseminated online. Retrospective, mixed methods data from 31 adults with a range of craniofacial conditions were analysed using descriptive statistics, Pearson correlations and conventional content analysis. Seventy-one percent of participants were worried about looking in the mirror for the first time. Participants reported a moderate level of distress and satisfaction with the surgical results on average, yet ratings varied considerably between participants. Almost half felt more distressed than expected and perceived their immediate postsurgical appearance to be worse than they had imagined. A range of emotions were described in response to the "first look," many of which were negatively valenced. Greater preparedness was significantly associated with feelings of relief and greater initial satisfaction with the surgical outcome, yet most participants felt that support at the time of the first look could have been improved. The findings represent a self-selected group of adults, some of whom underwent surgery several years ago. Nonetheless, patients' psychosocial experiences of the immediate postsurgical phase appear to be important. Preparing individuals for what they will look like and how they may feel after seeing themselves in the mirror for the first time is, therefore, an important consideration for craniofacial teams.