The available records indicate that the patient underwent an elective face and neck lift on or about July 29, 2025, performed by the treating cosmetic surgeon. In a subsequent second opinion consultation, the patient reported experiencing skin compromise on the left side of her neck following surgery and stated that the surgeon released the posterior/occipital suture lines for approximately one week.
Since the procedure, the patient has consistently expressed that the outcome was “botched” or “shoddy,” citing unacceptable visible scarring along the hairline, around the ear, and down the neck, as well as dissatisfaction with facial contour in the cheek, jawline, and nasolabial regions. She also reports a “pulled” or “tight” appearance and believes that certain areas, particularly the area under the chin, were not adequately addressed. In addition, she alleges that her buccal fat pads were removed, although this has not been confirmed, and she also believes that her temples now appear more sunken with associated eye drooping.
Around September 4, 2025, the patient sought a plastic surgery second opinion regarding her concerns. The evaluating provider documented that she was still in the healing phase and that it was too early to form definitive conclusions or consider revision surgery. Observation and follow up were recommended.
On September 14, 2025, approximately seven weeks after surgery, the patient presented to an emergency department with complaints of facial pain, left sided neck pain, and left upper extremity pain accompanied by paresthesia and perceived weakness. She attributed these symptoms to the cosmetic surgery. Imaging did not reveal any acute facial or neck soft tissue abnormality or intracranial pathology. However, providers allegedly told her that a plastic surgeon would have to read the imaging. Degenerative cervical spine changes and an incidental thyroid finding were noted, and she was discharged without identification of an acute postoperative complication.
Two days later, on September 16, 2025, which was approximately two months after surgery, the patient sought another second opinion from a facial plastics specialist. She was described as very upset and tearful, reiterating that the scarring was unacceptable and that her facial and neck contour did not meet her expectations. On examination, the provider noted that her incisions were healing well with no evidence of hypertrophic or otherwise unfavorable scar formation. Facial nerve branches were intact bilaterally. Some diminished sensation was present, but this was described as expected for her stage of recovery. The provider did not identify a specific complication and advised against early revision. Conservative scar management was recommended, including the use of silicone gel and sun protection, with reevaluation between six months and one year if her dissatisfaction persisted.
During her most recent evaluation with our team, much of the scarring that had been visible in earlier photographs had faded significantly. Despite this, the patient maintains that she is now “deformed,” and she repeats her allegations regarding an altered hairline, unconfirmed buccal fat pad removal, and increased temple hollowing. She continues to assert that she was compliant with wearing her postoperative facial compression garment.
However, the treating surgeon’s documentation reflects an alleged statement from the patient’s husband indicating that she had left the garment on the bathroom counter. It is also relevant that the patient has a prior history of elective cosmetic procedures, including a previous rhinoplasty and potentially other post-incident elective procedures, although the full extent of those procedures remains unclear.
Looking for opinion concerning deviations for initial procedure's effectiveness, hairline scarring and if her complications were abnormal for typical healing process.
MAT#18377186
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Do you believe there might have been medical error?
The scenario does not describe any medical error. The complications experienced can occur with no medical error. The complications experienced are included in the informed consent.
Do you believe there might have been causation (i.e. the medical error resulted in an injury)?
There is no evidence of medical error and therefore no causation either.
What makes you a good expert for this case?
Before certified plastic surgeon for 25 years having performed this procedure regularly.
How often do you encounter cases similar to this one in your practice?
I don't experience cases similar to this anymore.
Do you believe there might have been medical error?
Delayed wound healing or post op wound dehiscence is a known risk of facelift, including scarring more visible than desired. I can glean nothing from the history as presented or post procedure photos to indicate any deviation from acceptable care.
Do you believe there might have been causation (i.e. the medical error resulted in an injury)?
See answer above. Even a “perfect” operation with “perfect” post op care can lead to imperfect result. Neither the result nor the patient’s dissatisfaction indicates a deviation from standard of care.
What makes you a good expert for this case?
I have done hundreds facelifts throughout my career and have seen hundreds of postop facelifts from other community surgeons for complications. My own complication rate is rare but not zero so I can also relate to the patient’s dissatisfaction but that has to be tempered with reality and science.
How often do you encounter cases similar to this one in your practice?
Rare but not zero. One. Just balance the treatment of a complication either the appropriate time frame for resolution or intervention.
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