Raised expectations

A female patient attended a private cosmetic surgery clinic to enquire about removal of fatty deposits on the lateral aspects of both thighs. She felt that she was physically out of proportion.

At the initial consultation the consultant surgeon, an MDU member, outlined the surgical options available. The patient was keen to undergo liposuction of the area and the risks of the procedure were discussed including scarring, bruises, infection, bleeding, numbness, loose skin, lumpiness, pain and expectations of the results that could reasonably be achieved. In addition to the warnings given by the surgeon, the private clinic issued a leaflet detailing the risks and complications of liposuction and the patient signed a consent form, also detailing the risks.

The liposuction procedure went ahead using a tumescent technique - 1.5 litres of fluid were injected and 1.5 litres aspirated. It was estimated that 500mls of fat was removed from each thigh. Post operative recovery was uneventful and the patient was discharged.

Three months later, the patient returned to clinic and expressed her unhappiness with the outcome of the surgery. The consultant advised waiting for the area to settle and documented in the patient's notes a plan to review in one year. After two further visits to the clinic, during which the patient complained about asymmetry of her thighs and a contour defect of the right outer thigh, the surgeon agreed to carry out further liposuction, again using the tumescent technique. On this occasion 50mls of fluid was injected and 40mls aspirated with approximately 20mls of fat. The procedure and post-operative recovery were once again uneventful.

The surgeon recommended a fat transfer using fat from the abdomen to try to correct the contour defect.
However, the patient remained unhappy with her appearance. The surgeon recommended a fat transfer using fat from the abdomen to try to correct the contour defect. He discussed the risks, including fat re-absorption, bruising, swelling, surface irregularity, bleeding and infection.

After the procedure, the fat re-absorbed and the contour defect remained. Two months later, a further fat transfer procedure was carried out, using fat from the abdomen and right buttock. 

The surgeon later received notification of a claim from the patient's solicitors. Her allegations included that the surgeon had removed too much fat from the area of the right thigh and had failed to appreciate that a large volume of fat would be required for transplant.

Following exchange of expert opinion it became evident that there had been an over-correction of the fatty deposits on the right thigh and that the appearance had been accentuated by the secondary liposuction and attempts at correction using fat transfer. This was considered a sub-optimal outcome about which the experts were critical.

In light of the expert opinion, the surgeon accepted that on balance the patient should be compensated. The MDU's legal team negotiated settlement of the claim without a formal admission of liability being made on behalf of the surgeon. Damages for pain, suffering and loss of amenity (PSLA) and associated losses were agreed at £22,000, while the claimant's costs amounted to £19,500.

Christopher Craig LLB PGDipLit PGDipLPC DipCII
Claims team manager

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