Satisfaction With Anaplastology and Willingness for Face Transplantation in Patients With Facial Epitheses: A Pretest Study

INTRODUCTION: Extensive facial defects can significantly affect self-confidence, psychological well-being, and social interaction. While facial epitheses offer aesthetic coverage, they oftentimes do not restore function. Facial Vascularized Composite Allotransplantation (FVCA) has emerged as a promising solution that addresses both appearance and function. However, little is known about how patients with epitheses perceive these 2 treatment options. METHODS: We conducted a 2-round, patient-centered survey pretest to evaluate the feasibility, comprehensibility, and preliminary face validity of a questionnaire evaluating patients' views on living with epitheses, concerns about facial transplantation, and expectations for aesthetic and functional outcomes. Quantitative measures included ratings of exemplary surgical results and optimism toward transplantation; qualitative data captured psychological and social experiences. RESULTS: Ten patients (100%) participated with no dropouts. All emphasized the value of epitheses despite limitations and maintenance demands. Immunologic rejection was cited as the main barrier to FVCA (60%), while prolonged hospitalization and temporary functional loss were less concerning. Aesthetic results were rated highly, with a mean score of 89.9/100. CONCLUSION: This pilot study supports the questionnaire's potential to assess patient perspectives on epitheses and FVCA. Epitheses were considered important for psychological well-being and social functioning, yet functional deficits persisted. Patients showed openness to learning about FVCA, despite concerns about immune rejection. Further studies with larger samples are needed to confirm and expand the findings of this pretest.