A plastic surgeon made a woman he had performed a $31,000 facelift on feel inadequate, humiliated and insignificant, the patient says. Health and Disability Commissioner Anthony Hill has censured the doctor for his treatment of the 49-year-old woman, Mrs A, who had the surgery in September 2008 because she was concerned about her “prematurely aged facial appearance”.

Mrs A and her husband travelled five hours for a 45-minute consultation, during which Dr B examined her and advised on what he believed would be the best surgery. He made no clinical record of the consultation but wrote to her summarizing the consultation and their discussions, and quoting $31,000 for the procedure.

She accepted, and about two months later Dr B performed an endoscopic brow lift, limited incision facelift, necklift, pinch lower blepharoplasty and upper eyelid blepharoplasty at a private hospital. Mrs A was initially happy with the results, emailing after a week to say she was “fascinated observing the changes”.

However, by January she was concerned about the skin on her cheekbones sagging and asking whether it was likely to tighten with time. Mrs A attended her follow-up appointment a year after the surgery and said she found Dr B “intimidating” when she said she was not happy with the results.

“… the consultation, which was conducted in a treatment room, made her feel inadequate, humiliated and insignificant,” Mr Hill said in his report, released today.

“He was vague about the causes of the poor outcome and told her it was not a ‘biggie’, that he would ‘sort it out’ and would ‘see her right’.” However, he then sent her a quote for $19,000 to carry out another surgery, when she had expected he would do it for little or no cost. She asked for a full refund of the initial $31,000.

Mrs A said in her complaint to the Health and Disability Commission she felt like a “financial commodity”.

“The unexpected results of this surgery have had a huge impact on my confidence and well being. [Dr B] has failed to realize this and continues to respond without genuine consideration of what impact this has had on me.

“I cannot adequately express the distress that this experience has had on myself, or my family. It has been a devastating time. I have felt devalued, disregarded and disrespected by [Dr B].”

Mrs A had further surgery performed by a different surgeon.

Dr B told the commission he did not believe a technical error was made, or that his technique or patient care was inappropriate.

Mr Hill found Dr B did not give Mrs A an adequate explanation of the options available regarding facial rejuvenation surgery, including an assessment of the expected risks, side effects, benefits and costs of each option.

She was therefore not in a position to make an informed choice and give informed consent, meaning Dr B breached her rights.

Mr Hill recommended Dr B apologize to Mrs A.

Source: nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=10793161

It is interesting for me to see reports of plastic surgery from other countries. Here a woman had a pretty significant facelift which in her eyes did very little despite the high price tag.

It sounds like her doctor (who was not named) was less than adequate (by US terms anyway) in maintaining a proper medical record. He saw a patient who came from many hours away and recommended a large amount of surgery for her. When she was not pleased a year later and requested more surgery, she became angry when he wanted to charge her even more money for it. The report says the surgeon humiliated the patient, but did not provide details of this so it is hard to characterize.

The local authorities investigated and censured him, but did not return her money or accuse him of poor quality care. They recommended he apologize to her. They noted the doctor’s lack of informed consent. Medical records issues are often the easiest upon which to find fault in medical cases such as these.

You have to wonder what really happened here. In the US, the doctor’s name would have been printed whether nor not he was at fault. It seems probable that this surgeon was at the very least not the kindest man. Other than that this is a case with few facts to review. It is the lack of facts that makes it so interesting relative to a domestic case.

Best Regards,

John Di Saia MD