To the Editor We commend Jacono and colleagues1 for using a patient-reported outcome measure (PROM) in their study, adding to the body of evidence-based outcomes data for facial aesthetics treatments. We have concerns, though, about their choice of PROM. The Rosenberg Self-Esteem scale (RSES) is a legacy scale, published in 1965 after testing in more than 5000 US high school students. Jacono and colleagues1 found no change in self-esteem in 50 patients 6 months after a face-lift. This was not a surprise; self-esteem is a relatively stable construct.2 What was a surprise was the authors’ choice to use a generic rather than cosmetic-surgery specific PROM.
Klassen AF, Cano SJ, Pusic AL. Use of FACE-Q to Measure Quality of Life Following Aesthetic Facial Treatments. JAMA Facial Plast Surg. 2016;18(2):148-149. doi:10.1001/jamafacial.2016.0001