Living with a facial prosthesis
Research on daily life with a facial prosthesis is mixed and mostly quantitative. It shows real strain for many people, large differences between them, and routines that become habit.
Most writing about facial prostheses is written by the people who make them. Far less comes from the people who wear them, and what does is often a questionnaire score rather than a description of a Tuesday. That is a limit of the evidence, and this page says so as it goes. It brings together what peer-reviewed studies and hospital information report about daily routines and wellbeing, without inventing anyone's story. If you wear a prosthesis, your own experience is the authority; this is only background.
A daily routine
Hospital leaflets give the plainest picture of the routine. Cambridge University Hospitals tells patients with an adhesive-retained prosthesis to remove it daily, clean the outer surface under cold or lukewarm water with a little soap lather, dry it gently and store it in a clean, dry container front side down on tissues. Edges are thin and can tear. Skin should be clean, dry and free of old adhesive before a prosthesis goes back on. For an implant-retained prosthesis the leaflet describes cleaning the underside and the magnets daily with a soft toothbrush, lukewarm water and mild liquid soap.
The same leaflets advise not wearing the prosthesis in bed, and, in the implant-retained case, removing it for part of the day, usually the evening, so the skin can breathe. They advise against wearing a nasal prosthesis for contact sports such as rugby. Routines like these are covered in more detail on care and cleaning. Patients are reviewed every six months by the maxillofacial prosthetist, who arranges a new prosthesis when one is needed, and the leaflets say to contact the laboratory rather than try to adjust or repair it at home.
Weather, sport and practical friction
Practical difficulties are mentioned throughout the literature. In the discussion of a 2013 quality-of-life study, the authors report, citing earlier work, that patients with nasal prostheses described more problems with going out in hot and cold weather, playing sports and allergies. They also note that people with impaired vision in one eye may find it harder to clean a prosthesis well. These are findings from specific groups, not guarantees about any person.
What studies report about wellbeing
The 2013 study, published in Health and Quality of Life Outcomes, compared 72 patients wearing orbital, auricular (ear) and nasal prostheses with 24 people with no facial or body deformity, using a standard World Health Organization quality of life questionnaire. Patients had lower scores than the controls for overall quality of life and for the physical and environmental domains. Patients with nasal prostheses scored lower than the controls in every domain, and also lower than the ear group on overall quality of life and psychological health. Age, income and the age of the prosthesis were linked to some scores. The authors write that further studies are needed to confirm the results.
The same authors explain the nose finding as speculation: the nose is a prominent structure in the middle of the face, and a change there can lead to social isolation, psychological distress and low self-esteem. They also cite earlier studies saying that loss of part of the face and its prosthetic restoration require social and psychological adjustment, while noting that results in the literature are inconsistent. One cited study found a person's own body image significantly altered without any restriction in how others accepted their body. Another reported people avoiding showing a partner their face without the prosthesis. Adjustment, the authors write, depends on cognitive self-schemas and on the social and cultural setting, and they call for qualitative and quantitative studies of these factors.
The International Journal of Dentistry review takes a more positive framing, saying prostheses can immediately correct defects after surgery and allow people to reintegrate into their social and family environments. That is a statement from a review of materials and techniques, and it sits alongside the studies above rather than replacing them.
The gap in the evidence
A 2021 systematic review in the Journal of Prosthetic Dentistry looked at how facial prosthesis research measures success. It found that patient-reported outcomes were used in 74 percent of studies, assessing satisfaction, quality of life and psychological health, but that many studies used self-designed, unvalidated questionnaires and that consensus is lacking on the most meaningful measures. In plain terms, we know less than the volume of papers suggests about how it feels to live with a prosthesis, and different studies are hard to compare.
Support and the clinical team
A Frontiers in Oral Health review says facial rehabilitation today is handled by a multiprofessional team, and the UK national guidelines on head and neck reconstruction say the decision involves the patient and family along with the surgical and prosthetic teams. A paper in Current Oncology on psychological care in head and neck cancer argues for psychological support alongside medical treatment, noting that visible disfigurement can bring embarrassment, withdrawal from others and, in some people, depression or anxiety. If you recognize that in yourself or someone you know, say so to your clinical team or your doctor; they can point to support where you live.
A prosthesis that fits poorly, skin that is sore or red, or any change in the face under or around it should be reported to the team promptly. The information on this site is general and does not replace their advice. How color and light affect how a prosthesis reads in different rooms is on colour matching, and the underlying choices are on prosthesis or reconstruction and what a facial prosthesis is.
Questions people ask
Can I wear it all day and night?
Cambridge University Hospitals advises against wearing its prostheses in bed and suggests, for the implant-retained type, removing it for part of the day so the skin can breathe. Your own team's instructions come first, because they depend on the type of prosthesis and the skin beneath it.
Do people with facial prostheses have lower quality of life?
On average, in one study of 72 patients, yes for overall quality of life and the physical and environmental domains, compared with healthy controls. The authors stress the results need confirming, and individuals differ widely. Other studies, they note, found different patterns.
Is the evidence on this reliable?
It is limited. A systematic review found most studies rely on patient-reported measures and that many use unvalidated questionnaires, which makes comparisons difficult.
In brief
Living with a facial prosthesis involves a daily routine of removal, cleaning and careful handling, plus periodic remaking. Studies suggest wellbeing can be affected, especially with nasal prostheses, but results vary and the measures are not standardized. Support from the clinical team, and from psychological services where available, is part of care.