Botched Facial Surgery: Rare Disfiguring Result Brings Record $10 Million Award

UK judge finds physical, psychological damages from botched facelift.

ByJANE E. ALLEN, ABC News Medical Unit
May 24, 2011, 1:15 PM

May 25, 2011— -- A self-made British businesswoman who testified that nerve damage from a facelift ruined her consulting business and family life has won a record $10 million judgment from a British judge.

Penny Johnson, 49, said she consulted Dr. Le Roux Fourie, a cosmetic surgeon in Leeds, UK, about eliminating dark circles under her eyes and reshaping her nose, but the doctor talked her into more extensive procedures. After undergoing a facelift and replacement of her breast implants, she developed palsy on the right side of her face. Despite some improvement following surgical revisions, Johnson developed uncontrollable right-side twitching, a grimace, and couldn't close her right eye. In 2007, she sued Fourie.

"I don't sleep and I have a permanent buzzing around my eye which can be so intense that I can't think about anything," she testified in the High Court in London. "My husband has a separate life with my son which I'm not included in. I can't be a wife anymore."

Unable to work, she initially sued Fourie for the value of her 50 percent share in Bishop Cavanagh Ltd., a consulting firm she and her husband ran. Fourie admitted negligence in her case, but his attorneys claimed Johnson was seeking excessive compensation -- $87 million.

"The negligent surgery has had serious consequences both physical and psychological," Justice Owen wrote in the judgment he issued on Monday. "The physical injuries have resulted in a prolonged adjustment disorder with features of anxiety and depression."

He described Johnson, of Godstone in Surrey, as "a confident, happy and outstandingly successful woman with a full and rewarding family and social life" before her ordeal. In rejecting her accounting of lost future earnings, he reduced her economic losses to slightly more than $10 million.

Dr. Fazel Fatah, president of the British Association of Aesthetic Plastic Surgeons, called the award "disproportionate, especially considering the compensation people – including those in the armed forces – receive after losing limbs or requiring care the rest of their lives," according to an Associated Press report. "Understanding the procedure, its likely outcome and possible risks is the key to making an informed choice about whether to have an operation."

Johnson's story is among cautionary tales of what can happen when surgery goes awry.

"It's a well-known risk that nerves can be damaged during facelifts. It's extremely rare, less than a 1 percent chance," said Dr. Phil Haeck, a Seattle plastic surgeon and president of the American Society of Plastic Surgeons. "It's not unheard of."

Lawsuits involving facelifts are "not as common as you might think," he said, and are less common than lawsuits associated with breast reconstruction after cancer, rhinoplasty, breast enhancement and breast reduction.

A patient who sustains significant nerve damage that cannot be reversed "can ultimately become depressed over this and have some reactionary feelings toward the surgeon," Haeck said Tuesday in an interview from Vancouver, where he was attending the International Confederation for Plastic Reconstructive and Aesthetic Surgery 2011 meeting. "What I tell my patients is that 95 percent of the time things will go exactly as you and I wanted it to occur, but in 5 percent of the time, there may be a longer healing period, there may need to be a second surgery or even a third surgery to correct something."

Case Is A Reminder That All Surgery Carries Risk of Complications

An American psychologist who specializes in body image issues said Johnson's case was a reminder that "plastic surgery is a surgery and it has the possibility of complications like any other surgery."

"There's kind of this myth of transformation, that if I can get rid of these dark circles and if I can get a facelift and get these boobs replaced, I'm going to feel great. I'll be a new woman," said Ann Kearney-Cooke, director of the Cincinnati Psychotherapy Institute. "They may be forgetting what's at stake here, too."

According to the court documents, Johnson grew up in a mining village, did well in school and left at 16 for a hair-dressing course. "But she had greater ambition than a career in hairdressing," the judge wrote. Johnson soon was on a fast-track in the civil service, interrupted by pregnancy and the birth of a special-needs child in 1985. She worked part-time for several years before building a lucrative consulting business with top corporate clients.

Kearney-Cooke, co-author with Bob Greene of "The Life You Want: Get Motivated, Lose Weight, and Be Happy," said that although she doesn't know Johnson, patients who have risen from similarly modest beginnings sometimes "don't feel they really have made it – and they feel that to make it, you have to look perfect." A less-vulnerable woman might have told the plastic surgeon, "No, I just want my nose and the bags under my eyes done. Enough."

In the United States, Heidi Montag underwent a marathon 10-procedure makeover in November 2009, and a year later, expressed in an interview with Life & Style magazine buyer's remorse about scars and disfigurements in her breasts, chin, and body: "Surgery ruined my career and my personal life and just brought a lot of negativity into my world. I wish I could jump into a time machine and take it all back."

Haeck said that in many cases where patients sue over breast scarring, "either the communication broke down, because the patient wasn't listening to the word 'scar,' or the patient had it inherent in their own genetic makeup to form coarse scars." He said 80 percent of U.S. patients' plastic surgery claims never make it to court, and of the 20 percent that go to court, "the plastic surgeon wins in 80 percent of those cases."

He called the British award in Johnson's case "astounding," and noted that when U.S. juries are determining economic damages in plastic surgery cases, they tend to take into consideration that plastic surgeons' liability insurance on average covers $1 million per incident. In rare cases, juries will exceed that "to send a very strong message to the surgeon." In California and Texas, economic awards are capped at $250,000, although medical damages can be "as high as needed."

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