University of Sheffield interdisciplinary PhD studentship

Project description

Elective facial surgery (orthognathics) is the correction of a range of different malformations of the upper and lower jawbones. It is carried out after puberty, typically around 16 years upwards. Orthognathic treatment is a lengthy process (2-3 years), which has significant consequences for both patient and their families; multiple clinic appointments, time off work and school, financial costs, hospital in-patient stay, in addition to functional impacts (speech, eating, breathing, pain), and the psychosocial consequences of treatment and an altered facial appearance.

There has been little attention paid to (often elective) treatment for visible conditions. This is surprising given that surgery to ‘normalise appearance’ can produce sudden and often dramatic changes, changing the individual’s life in many ways and placing demands on the person’s coping and body image adaptation. This is particularly the case during formative years, such as young adulthood. The aim of this project is to investigate the impact of orthognathic surgery on quality of life and how this changes over time.

The study also seeks to explore the clinical and psychosocial factors that may predict improvements in young people’s quality of life in the longer-term. Young people will complete pre-existing and validated questionnaires to obtain baseline (up to 1 month pre-surgery) psychosocial data on generic and facial specific quality of life, perceived intensity of the condition and inconvenience or “bothersomeness”, levels of social support and resilience, and attitudes towards surgery. At 8 days, 3 weeks and 6 weeks (immediate follow-up) and then at 6 months and 1 year (longer-term follow-up), post-surgery measures will be collected on generic and facial specific quality of life, perceived intensity and inconvenience, together with attitudes towards surgery. Changes in quality of life, perceived intensity and inconvenience and attitudes towards surgery will be assessed over the short- and longer-term. Relationships between resilience and social support and each of the key outcomes will be examined, and a model of the factors predicting improvements in quality of life in the longer-term will be developed.

The knowledge which is gained from this project will hopefully contribute to a better understanding of the effects of such appearance-altering surgery on life quality and also help inform and develop orthognathic services so that they can better meet the needs of young people and their families.