This case involves a 54-year-old male actor with sleep apnea who had a dermal filler injected into his nasolabial fold. Several months after the procedure, the patient believed he was having an adverse reaction to the dermal filler and visited a plastic surgeon to inquire about removing it. The plastic surgeon informed the patient that the dermal filler could be removed. The surgeon also suggested that the patient’s sleep apnea would be improved with an additional procedure on his nose. The patient underwent a removal of the dermal filler and elected to take the surgeon’s advice and undergo the procedure on his nose. At no point was the patient informed by his surgeon that the procedure would cosmetically alter his nose. After the nasal procedure, the patient discovered that a large part of the dorsum of his nose had been removed and the tip and shape of the nose looked markedly different. In the months following the procedure, the patient’s sleep apnea worsened and he suffered from chronic thick drainage which made swallowing difficult.
Question(s) For Expert Witness
- 1. Please describe your background as it relates to the type of procedure performed here?
- 2. Can you speak to the process of informed consent when performing cosmetic or reconstructive surgery?
Expert Witness Response E-008607
I am in active plastic surgery practice at an elite university on the west coast where I am also a clinical associate professor and chief of the cosmetic surgery section for our division. I give a lecture on rhinoplasty yearly to plastic surgeons preparing for their American Board of Plastic Surgery examination and I have published on rhinoplasty. I am familiar with the type of procedure that was performed in this case. I can speak to the process of informed consent when performing cosmetic or reconstructive surgery. The communication is through the discussion of the procedure and the consent process as well as digital imaging if indicated. I have reviewed cosmetic surgery cases of the face including rhinoplasty.