Summary
Background
The risk of social stigmatisation is an important determinant in the decision for
plastic and reconstructive surgery in children and adolescents. The purposes of this
cross-sectional study were threefold: (1) to assess self- and proxy-reported stigma
experiences of children and adolescents with congenital or acquired facial differences;
(2) to compare patients versus controls; and (3) to identify predictors of perceived
stigmatisation.
Methods
Data were obtained from a cohort of 87 children (ages 9 months to 16 years) with facial
burn scars, port-wine stains, infantile haemangioma or congenital melanocytic nevi,
using parent questionnaires (n = 85) and standardised interviews in children older than 7 years (n = 29). Perceived stigmatisation was assessed with the Perceived Stigmatization Questionnaire. Self-reported stigmatisation was compared versus a matched control group consisting
of 29 children and adolescents without a facial difference. Medical, demographic and
parental psychological variables were examined as predictors of proxy-perceived stigmatisation.
Results
Patients with a facial difference reported significantly higher levels of stigma experiences
than control subjects. A majority of the patients reported having experienced expressions
of pity, staring or startled reactions; and about one-quarter had been teased about
their facial difference. Multivariate analysis indicated that proxy-perceived stigmatisation
was predicted by larger size of the facial difference and greater age of the child.
Gender and type of facial difference (acquired vs. congenital) had no significant
impact.
Conclusions
These results demonstrate that children with a facial difference are at higher risk
of experiencing stigmatisation than children without a visible difference. Children
with a facial difference that covers more than 25% of their face are particularly
vulnerable to stigmatisation and therefore need special monitoring.
Keywords
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Article info
Publication history
Published online: July 09, 2012
Accepted:
June 10,
2012
Received:
December 23,
2011
Footnotes
☆Meetings at which parts of this research has previously been presented:
☆1. Appearance Matters 4 Conference, Bristol, 23–26 June, 2010.
☆2. International Expert Meeting for Large CMN and Neurocutaneous Melanocytosis, Tubingen, 6–8 May, 2011.
☆3. 19. Jahrestagung des Arbeitskreises “Das schwer-brandverletzte Kind”, Stuttgart, 20–21 May, 2011.
☆4. 6th Word Congress on Paediatric Burns, Zurich, 20–23 August, 2011.
Identification
Copyright
© 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
