Facial Appearance as Core Expression Scale: Benchmarks and Properties

Patients presenting for corrective facial surgery may have ideals that are not congruent with their surgeon's expectations for surgical outcomes. To identify and reduce disparities in expectations, the Facial Appearance as Core Expression Scale (FACES) was developed to assess the extent to which individuals identify their own faces as representing their ideal self.

In Study 1, 504 healthy young adult participants answered online questions about their own faces. In Study 2, 165 participants rated their own faces, digitally manipulated images of four patients before and after surgery, and two digitally averaged benchmark images.

In Study 1, the final FACES instrument had seven items and was highly reliable across genders and races. Study 2 replicated reliability findings. The before surgery and after surgery pictures yielded significant improvements in ratings, suggesting scale validity.

The FACES consists of 14 items including a benchmark image to detect unusual responding. Results indicate the measure is reliable and sensitive to perceptions of surgical changes to faces. While the scale needs to be validated in a clinical sample, the measure may help identify patients with atypical ideal expectations for their face and may be used to quantify surgical outcomes.