Abstract
This study aims to identify factors influencing aesthetic outcomes following facial basal cell carcinoma (BCC) plastic surgery to enhance post-operative satisfaction and cosmetic results. A retrospective cohort study was conducted on 303 patients who underwent facial BCC plastic surgery between June 2021 and June 2023. Data on demographics, blood tests, SF-12, and Skindex-16 scores were analyzed. Patients were categorized into satisfactory and unsatisfactory outcome groups based on post-operative assessments. The training set of patients was sourced from the Third Affiliated Hospital of Soochow University, while the testing set of patients was sourced from the First Affiliated Hospital of Soochow University. Of 209 patients, 116 were in the satisfactory group, 93 in the unsatisfactory. Factors enhancing positive outcomes included reconstruction methods (P < 0.001) and smaller tumor diameters (P = 0.006). Higher pre-op 12-item Short Form Survey (SF-12) scores correlated with better outcomes (P = 0.005). Lower Skindex-16 scores were noted in the satisfactory group (P < 0.001). Logistic regression highlighted reconstruction method, aging signs, SF-12 scores, and Skindex-16 as key predictors. A random forest model achieved an area under the curve (AUC) of 0.984. External validation confirmed similar associations with satisfactory outcomes (AUC = 0.870). Aesthetic outcomes in facial BCC plastic surgery are influenced by reconstruction method and tumor diameter, patient health status (SF-12), and skin-related quality of life (Skindex-16). Personalized surgical planning and comprehensive care are essential for optimizing outcomes.