The Experience of Acquiring a Significant Change to Facial Appearance

This thesis was concerned with the psychosocial experience of living with a significant change to facial appearance acquired through trauma or disease. The thesis comprises a literature review and a report of an original research study. The review used a meta-ethnography approach to synthesise qualitative literature on the experience of altered facial appearance following cancer. The findings demonstrate the varying experience of changed facial appearance depending on the stage of the disease or treatment, with appearance being more salient at less acute stages of cancer treatment. Changes to appearance lead to experiences of stigma and threatened self-image and self-identity, necessitating a range of coping strategies. Clinical implications and future research needs are outlined. The research study aimed to understand the experience of living with a facial prosthesis using Interpretative Phenomenological Analysis. Findings indicate that a prosthesis could restore normalcy and enable social participation, however the impact of having altered facial appearance continued to pervade the experience and practicalities continued to be problematic. Social support and humour were notable factors contributing to positive adjustment. This research implicates a role for peer support interventions in this population, and further research is needed to explore different stages and levels of adjustment.