Salient body image concerns of patients with cancer undergoing head and neck reconstruction
Abstract
BACKGROUND: Patients with cancer undergoing head and neck reconstruction can experience significant distress from alterations in appearance and bodily functioning. We sought to delineate salient dimensions of body image concerns in this patient population preparing for reconstructive surgery. METHODS: Participants completed self-report questionnaires evaluating numerous aspects of body image. We used Bayesian factor analysis modeling methods to identify latent factors emerging from the data. RESULTS: We identified 2 latent factors: appearance distress and functional difficulties. The highest level of preoperative body image concerns were related to distress about appearance changes and its perceived social consequences. Appearance distress items displayed greater variability compared with functional difficulties. CONCLUSION: Appearance and functional changes to body image are important areas of concern for patients with head and neck cancer as they prepare for reconstructive surgery. Knowledge regarding specific body image issues can be used to guide psychosocial assessments and intervention to enhance patient care. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1035-1042, 2016.
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The BICSI-AF demonstrated good reliability and validity in college students and strong reliability in visibly different populations.
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Cites
Bayesian Analysis of Binary and Polychotomous Response Data
Albert, J. H., & Chib, S. (1993) · Journal of the American Statistical Association · doi:10.1080/01621459.1993.10476321 · Cited by 3,160 · see citing works
A body image scale for use with cancer patients
Hopwood, P., Fletcher, I., Lee, A., & Al Ghazal, S. (2001) · European Journal of Cancer · doi:10.1016/s0959-8049(00)00353-1 · Cited by 984 · see citing works
The assessment of body image investment: An extensive revision of the appearance schemas inventory
Cash, T. F., Melnyk, S. E., & Hrabosky, J. I. (2004) · International Journal of Eating Disorders · doi:10.1002/eat.10264 · Cited by 577 · see citing works
Clinical Predictors of Quality of Life in Patients With Head and Neck Cancer
Terrell, J. E., Ronis, D. L., Fowler, K. E., Bradford, C. R., Chepeha, D. B., Prince, M. E. P., Teknos, T. N., Wolf, G. T., & Duffy, S. A. (2004) · Archives of Otolaryngology - Head and Neck Surgery · doi:10.1001/archotol.130.4.401 · Cited by 454 · see citing works
Cash, T. F., Phillips, K. A., Santos, M. T., & Hrabosky, J. I. (2004) · Body Image · doi:10.1016/j.bodyim.2004.10.001 · Cited by 420 · see citing works
Tamburrino, M. (2003) · JAMA · doi:10.1001/jama.289.14.1861 · Cited by 377 · see citing works
Cash, T. F., Santos, M. T., & Williams, E. F. (2005) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2004.07.008 · Cited by 348 · see citing works
Managing body image difficulties of adult cancer patients: Lessons from available research
Fingeret, M. C., Teo, I., & Epner, D. E. (2013) · Cancer · doi:10.1002/cncr.28469 · Cited by 316 · see citing works
Self-citationAltered body image: appearance‐related concerns of people with visible disfigurement
Rumsey, N., Clarke, A., White, P., Wyn‐Williams, M., & Garlick, W. (2004) · Journal of Advanced Nursing · doi:10.1111/j.1365-2648.2004.03227.x · Cited by 286 · see citing works
Katz, M. R., Irish, J. C., Devins, G. M., Rodin, G. M., & Gullane, P. J. (2003) · Head & Neck · doi:10.1002/hed.10174 · Cited by 270 · see citing works
Concern About Aspects of Body Image and Adjustment to Early Stage Breast Cancer
Carver, C. S., Pozo-Kaderman, C., Price, A. A., Noriega, V., Harris, S. D., Derhagopian, R. P., Robinson, D. S., & Moffat, F. L. (1998) · Psychosomatic Medicine · doi:10.1097/00006842-199803000-00010 · Cited by 215 · see citing works
Fingeret, M. C., Yuan, Y., Urbauer, D., Weston, J., Nipomnick, S., & Weber, R. (2012) · Psycho-Oncology · doi:10.1002/pon.1990 · Cited by 190 · see citing works
Self-citationLang, H., France, E. F., Williams, B., Humphris, G. M., & Wells, M. (2013) · Psycho-Oncology · doi:10.1002/pon.3343 · Cited by 170 · see citing works
Body Image and Quality of Life After Head and Neck Cancer Surgery
Dropkin, M. J. (1999) · Cancer Practice · doi:10.1046/j.1523-5394.1999.76006.x · Cited by 161 · see citing works
Body image in patients with head and neck cancer: A review of the literature
Rhoten, B. A., Murphy, B., & Ridner, S. H. (2013) · Oral Oncology · doi:10.1016/j.oraloncology.2013.04.005 · Cited by 156 · see citing works
Psychosocial adjustment of patients surgically treated for head and neck cancer
Gamba, A., Romano, M., Grosso, L. M., Tamburini, M., Cantú, G., Molinari, R., & Ventafridda, V. (1992) · Head & Neck · doi:10.1002/hed.2880140309 · Cited by 151 · see citing works
Oxford Handbook of the Psychology of Appearance
Frith, H. (2012) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780199580521.001.0001 · Cited by 138 · see citing works
Nonparametric Bayesian sparse factor models with application to gene expression modeling
Knowles, D. A., & Ghahramani, Z. (2011) · The Annals of Applied Statistics · doi:10.1214/10-aoas435 · Cited by 132 · see citing works
Lundgren, J. D., Anderson, D. A., & Thompson, J. K. (2004) · Eating Behaviors · doi:10.1016/s1471-0153(03)00055-2 · Cited by 127 · see citing works
Are head and neck specific quality of life measures necessary?
Gliklich, R. E., Goldsmith, T. A., & Funk, G. F. (1997) · Head & Neck · doi:10.1002/(sici)1097-0347(199709)19:6 · Cited by 104 · see citing works
Fingeret, M. C., Vidrine, D. J., Reece, G. P., Gillenwater, A. M., & Gritz, E. R. (2010) · Head & Neck · doi:10.1002/hed.21181 · Cited by 101 · see citing works
Self-citationIssues of intimacy and sexual dysfunction following major head and neck cancer treatment
Low, C., Fullarton, M., Parkinson, E. K., O’Brien, K., Jackson, S., Lowe, D., & Rogers, S. N. (2009) · Oral Oncology · doi:10.1016/j.oraloncology.2009.03.014 · Cited by 99 · see citing works
Fingeret, M. C., Hutcheson, K. A., Jensen, K., Yuan, Y., Urbauer, D. L., & Lewin, J. S. (2012) · Head & Neck · doi:10.1002/hed.22980 · Cited by 89 · see citing works
Self-citationBody Image: a Critical Psychosocial Issue for Patients With Head and Neck Cancer
Fingeret, M. C., Teo, I., & Goettsch, K. (2015) · Current Oncology Reports · doi:10.1007/s11912-014-0422-0 · Cited by 79 · see citing works
Self-citationDjan, R., & Penington, A. (2013) · Journal of Plastic Reconstructive & Aesthetic Surgery · doi:10.1016/j.bjps.2013.01.007 · Cited by 67 · see citing works
Radiation therapy tolerance limits: For one or for all?-Janeway lecture
Peters, L. J. (1996) · Cancer · doi:10.1002/(sici)1097-0142(19960601)77:11 · Cited by 66 · see citing works
Heinberg, L. J., Kudel, I., White, B., Kwan, A., Medley, K., Wigley, F. M., & Haythornthwaite, J. A. (2007) · Body Image · doi:10.1016/j.bodyim.2006.11.002 · Cited by 65 · see citing works
Assessing the body image: relevance, application and instruments for oncological settings
Annunziata, M. A., Giovannini, L., & Muzzatti, B. (2011) · Supportive Care in Cancer · doi:10.1007/s00520-011-1339-x · Cited by 65 · see citing works
Multivariate Bayesian Statistics
Rowe, D. B. (2002) · Chapman & Hall/CRC eBooks · doi:10.1201/9781420035261 · Cited by 58 · see citing works
Body image in cancer survivors: a systematic review of case-control studies
Lehmann, V., Hagedoorn, M., & Tuinman, M. A. (2015) · Journal of Cancer Survivorship · doi:10.1007/s11764-014-0414-y · Cited by 55 · see citing works
Newell, R. (2000) · British Journal of Plastic Surgery · doi:10.1054/bjps.1999.3273 · Cited by 47 · see citing works
Looking beyond Disfigurement: The experience of Patients with Head and Neck Cancer
Henry, M., Ho, A., Lambert, S., Carnevale, F. A., Greenfield, B. J., MacDonald, C., Mlynarek, A., Zeitouni, A. G., Rosberger, Z., Hier, M., et al. (2014) · Journal of Palliative Care · doi:10.1177/082585971403000102 · Cited by 43 · see citing works
Selby, C. L. B. (2011) · Eating Disorders · doi:10.1080/10640266.2011.584816 · Cited by 39 · see citing works
MD Anderson Manual of Psychosocial Oncology
Duffy, J., & Valentine, A. D. (2010) · Medical Entomology and Zoology · Cited by 32 · see citing works
The association between body image and smoking cessation among individuals living with HIV/AIDS
Fingeret, M. C., Vidrine, D. J., Arduino, R. C., & Gritz, E. R. (2007) · Body Image · doi:10.1016/j.bodyim.2007.01.005 · Cited by 24 · see citing works
Self-citationDropkin, M. J. (1997) · PubMed · Cited by 21 · see citing works
A Bayesian nonparametric approach for the analysis of multiple categorical item responses
Waters, A. E., Fronczyk, K. M., Guindani, M., Baraniuk, R. G., & Vannucci, M. (2014) · Journal of Statistical Planning and Inference · doi:10.1016/j.jspi.2014.07.004 · Cited by 4 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Zebolsky, A. L., Patel, N. N., Heaton, C. M., Park, A. M., Seth, R., & Knott, P. D. (2021) · JAMA Otolaryngology–Head & Neck Surgery · doi:10.1001/jamaoto.2021.1563 · Cited by 60 · see citing works
Ellis, M. A., Sterba, K. R., Brennan, E. A., Maurer, S., Hill, E. G., Day, T. A., & Graboyes, E. M. (2019) · Otolaryngology–Head and Neck Surgery · doi:10.1177/0194599819829018 · Cited by 56 · see citing works
Ellis, M. A., Sterba, K. R., Day, T. A., Marsh, C. H., Maurer, S., Hill, E. G., & Graboyes, E. M. (2019) · Otolaryngology · doi:10.1177/0194599819837621 · Cited by 53 · see citing works
Chen, S., Huang, B., Lin, C., Fan, K., Chang, J. T.-C., Wu, S., & Lai, Y. (2016) · Psycho-Oncology · doi:10.1002/pon.4308 · Cited by 44 · see citing works
Zucchelli, F., White, P., & Williamson, H. (2020) · Body Image · doi:10.1016/j.bodyim.2019.12.002 · Cited by 41 · see citing works
Manier, K. K., Rowe, L. S., Welsh, J. A., & Armstrong, T. S. (2018) · Neuro-Oncology Practice · doi:10.1093/nop/npy018 · Cited by 38 · see citing works
Graboyes, E. M., Hill, E. G., Marsh, C. H., Maurer, S. N., Day, T. A., & Sterba, K. R. (2019) · Otolaryngology · doi:10.1177/0194599819835534 · Cited by 38 · see citing works
Graboyes, E. M., Maurer, S. N., Park, Y., Marsh, C. H., McElligott, J. T., Day, T. A., Hornig, J. D., & Sterba, K. R. (2020) · Psycho-Oncology · doi:10.1002/pon.5399 · Cited by 33 · see citing works
Outcomes following Autologous Fat Grafting for Oncologic Head and Neck Reconstruction
Karmali, R. J., Hanson, S. E., Nguyen, A. T., Skoracki, R. J., & Hanasono, M. M. (2018) · Plastic & Reconstructive Surgery · doi:10.1097/prs.0000000000004686 · Cited by 30 · see citing works
Self-citationMacias, D., Hand, B. N., Pipkorn, P. J., Williams, A. M., Chang, S. S., Zenga, J., Nilsen, M. L., Rhoten, B. A., Huang, A. T., Osazuwa‐Peters, N., et al. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.794038 · Cited by 27 · see citing works
Factors influencing body image in posttreatment oral cavity cancer patients
Chang, Y., Huang, B., Hung, T., Lin, C., & Chen, S. (2019) · Psycho-Oncology · doi:10.1002/pon.5067 · Cited by 26 · see citing works
Graboyes, E. M., Hill, E. G., Marsh, C. H., Maurer, S. N., Day, T. A., Hornig, J. D., Lentsch, E. J., Neskey, D. M., Skoner, J. M., & Sterba, K. R. (2020) · Otolaryngology · doi:10.1177/0194599819898861 · Cited by 25 · see citing works
Zucchelli, F., Donnelly, O., Rush, E., White, P., Gwyther, H., Williamson, H., & The VTCT Foundation Research Team at the Centre for Appearance Research (2022) · JMIR Formative Research · doi:10.2196/33449 · Cited by 21 · see citing works
Kimberly, L. L., Alfonso, A. R., Ramly, E. P., Kantar, R. S., Caplan, A. L., & Rodriguez, E. D. (2019) · The AMA Journal of Ethic · doi:10.1001/amajethics.2019.980 · Cited by 17 · see citing works
Ivanova, A. E., Rodríguez‐Cano, R., Kvalem, I. L., Harcourt, D. M., Kiserud, C. E., & Amdal, C. D. (2022) · Journal of Cancer Survivorship · doi:10.1007/s11764-022-01311-y · Cited by 15 · see citing works
From brains to branch points: cognitive constraints in navigational design
Jul, S., & Furnas, G. W. (2004) · Cited by 13 · see citing works
Optimizing Function and Appearance After Head and Neck Reconstruction
Graboyes, E. M., & Barbon, C. E. A. (2023) · Otolaryngologic Clinics of North America · doi:10.1016/j.otc.2023.04.017 · Cited by 9 · see citing works
Assessment of Variability in Free Flap Color Match to Facial Skin by Donor Site and Race
Plonowska‐Hirschfeld, K. A., Eltawil, Y., Soroudi, D., Patel, N. N., Park, A. M., & Knott, P. D. (2024) · The Laryngoscope · doi:10.1002/lary.31436 · Cited by 8 · see citing works
Xu, W., Xiang, L., Wang, S., Zhu, Y., Zheng, M., & Wan, H. (2024) · BMJ Open · doi:10.1136/bmjopen-2024-085551 · Cited by 6 · see citing works
Mukherjee, A., Bhowmick, C., Chattopadhyay, S., Kathar, M. A., Bhattacharya, M., Nasreen, S., Jain, P., Arun, P., & Datta, S. S. (2022) · ecancermedicalscience · doi:10.3332/ecancer.2022.1401 · Cited by 5 · see citing works
Body image among people living with HIV: A systematic review
Drabarek, K., Rzeszutek, M., Poncyliusz, C., Michałowska, M., & Guest, E. (2025) · Body Image · doi:10.1016/j.bodyim.2025.101880 · Cited by 4 · see citing works
Chen, S., Huang, Y.-C., Su, Z., Yang, F., Lubamba, G. P., Gupta, A., Alkebsi, K., Zhang, Z., Zhang, Z., Xia, H., et al. (2025) · Clinical Oral Investigations · doi:10.1007/s00784-024-06118-y · Cited by 3 · see citing works
Keeling, M., Harcourt, D. M., White, P., Evans, S., V., V. S. W., Kiff, J. D., & Williamson, H. (2025) · PLoS ONE · doi:10.1371/journal.pone.0305022 · Cited by 3 · see citing works
Body Image and Facial Transplantation
Coffman, K. L., Dean, E. A., & Zwiebel, S. J. (2022) · Springer eBooks · doi:10.1007/978-3-031-15052-4_11 · Cited by 3 · see citing works
Head and Neck Cancer and Body Image Distress
Duckett, K. A., Sterba, K. R., Maurer, S. N., Balliet, W. E., Ruggiero, K. J., Starr, E., Rush, A., Johnson, B., McLeod, T., Slavin-Spenny, O., et al. (2024) · Springer eBooks · doi:10.1007/978-3-031-32046-0_68-1 · Cited by 1 · see citing works
Head and Neck Cancer and Body Image Distress
Duckett, K. A., Sterba, K. R., Maurer, S. N., Balliet, W. E., Ruggiero, K. J., Starr, E., Rush, A., Johnson, B., McLeod, T., Slavin-Spenny, O., et al. (2025) · Springer eBooks · doi:10.1007/978-3-031-73363-5_68 · Cited by 1 · see citing works
Objective Measurement of Skin Color Matching in Flap Reconstructive Surgery: A Systematic Review
Wong, Z. Y., Ou, K. Q., Wong, Z. N., Danpanichkul, P., Faderani, R., Nikkhah, D., Kanapathy, M., & Mosahebi, A. (2025) · Plastic & Reconstructive Surgery Global Open · doi:10.1097/gox.0000000000007264 · Cited by 1 · see citing works
Gupta, A., Tripathi, A., & Rai, P. (2022) · Prosthodontics · doi:10.5114/ps/147493 · Cited by 1 · see citing works
Prise en charge sociale et psychologique
Heutte, N., & Babin, E. (2019) · Elsevier eBooks · doi:10.1016/b978-2-294-76676-3.00016-1
Preoperative and Postoperative Speech Therapy
Crevier‐Buchman, L., Julien‐Laferriere, A., & de Pemille, G. V. (2022) · Springer eBooks · doi:10.1007/978-3-031-09621-1_35
Bidakhavidi, Y. M., Jandaghi, B., & Akbarinejhad, H. S. (2024) · Journal of Health and Care · doi:10.61186/jhc.26.4.328
Sadegi, M., Heris, M. G., & Akbarinejhad, H. S. (2025) · فصلنامه علوم پزشکی دانشگاه آزاد اسلامی واحد پزشکی تهران · doi:10.61882/iau.35.3.323
Luo, Y., An, X., Yang, T., Hong, Z., Huang, C., Xiong, X., & Zhou, X. (2026) · Cancer Nursing · doi:10.1097/ncc.0000000000001551
Psychosocial Effect of Appearance Changes Associated With Cancer: A Scoping Review
Wakabayashi, M., Tanaka, K., & Nagata, K. (2026) · Cureus · doi:10.7759/cureus.113254
- Authors
- Teo, I., Fronczyk, K. M., Guindani, M., Vannucci, M., Ulfers, S. S., Hanasono, M. M., & Fingeret, M. C.
- Affiliations
- The University of Texas MD Anderson Cancer Center (US)
- Rice University (US)
- Washington University in St. Louis (US)
- Corresponding author
- Fingeret, Michelle Cororve
- ORCID
- Venue
- Head & Neck
- Publisher
- Wiley
- Published
- 2016-03-11
- Volume
- 38
- Issue
- 7
- Pages
- 1035-1042
- ISSN
- 1043-3074 (ISSN-L)
- OpenAlex
- W2295707681
- Cited by
- 34
- References
- 38
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 4 · 2023: 1 · 2022: 5 · 2021: 3 · 2020: 2 · 2019: 7 · 2018: 2 · 2016: 1
- FWCI
- 1.80
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Head & Neck (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Cancer Institute (P30CA016672)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Surgery › Reconstructive Facial Surgery Techniques
- Social Sciences › Psychology › Clinical Psychology › Body Image and Dysmorphia Studies
- Keywords
- body image concern, head and neck cancer, head and neck reconstruction, functional difficulties, psychosocial assessment, Bayesian factor analysis
- MeSH terms
- Adaptation, Physiological, Adaptation, Psychological, Aged, Aged, 80 and over, Bayes Theorem, Body Image, Female, Head and Neck Neoplasms, Humans, Male, Middle Aged, Quality of Life, Surveys and Questionnaires, Texas, Cohort Studies, Treatment Outcome, Survivors, Plastic Surgery Procedures, Neck Dissection, Self Report
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