{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T16:50:45Z","timestamp":1783097445508,"version":"3.54.6"},"reference-count":45,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2022,4,11]],"date-time":"2022-04-11T00:00:00Z","timestamp":1649635200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Facial Plastic Surgery &amp; Aesthetic Medicine"],"published-print":{"date-parts":[[2022,12,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The relationship between the value of reconstructive surgery and the visual attention drawn by facial deformity has not been studied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>We hypothesized that willingness to pay (WTP) for reconstructive surgery would increase as visual attention to deformity increased in a Mohs defect eye-tracking model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We conducted a randomized observational study. Eighty casual observers participated in timed eye-tracking trials utilizing preoperative and postoperative photographs from 32 patients with facial Mohs defects. Fixation on each defect was quantified in milliseconds. For each photograph, casual observers reported how much they would be willing to pay for a perfect reconstruction and rated defect severity and patient attractiveness. The associations between defect fixation time and WTP, attractiveness, and severity were modeled using a multivariate mixed-effects model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Increased defect fixation time was associated with increased WTP (regression coefficient\u2009=\u20090.332651,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001), decreased attractiveness (regression coefficient\u2009=\u2009\u22120.221779,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and increased severity (regression coefficient\u2009=\u20090.363111,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001). As defect fixation time increased, WTP increased exponentially.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Observer WTP for facial reconstruction increases exponentially as defects become more distracting. These findings justify the dedication of health care resources to reconstructive procedures that decrease attentional distraction to the greatest extent possible.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/fpsam.2021.0361","type":"journal-article","created":{"date-parts":[[2022,4,11]],"date-time":"2022-04-11T11:23:57Z","timestamp":1649676237000},"page":"436-442","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Visual Attention to Facial Defects Predicts Willingness to Pay for Reconstructive Surgery"],"prefix":"10.1177","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2373-8388","authenticated-orcid":false,"given":"John F.","family":"Ryan","sequence":"first","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5287-2597","authenticated-orcid":false,"given":"Lisa E.","family":"Ishii","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA."},{"name":"Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob K.","family":"Dey","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA."},{"name":"Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4924-7560","authenticated-orcid":false,"given":"Kofi D.O.","family":"Boahene","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA."},{"name":"Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick J.","family":"Byrne","sequence":"additional","affiliation":[{"name":"Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaru","family":"Ishii","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,4,11]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1211374"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-017-5954-8"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/0194599815587509"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1089\/fpsam.2020.0036"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamafacial.2018.1639"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamafacial.2016.1429"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/lary.29548"},{"key":"e_1_3_5_9_2","author":"Bruins TE","year":"2021","unstructured":"Bruins TE, , van Veen MM, , Werker PMN, , Dijkstra PU, , Broekstra DC. 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