March, 31, 2011 -- After cosmetic eyelid surgery left her incapable of fully closing her eyes, Marilyn Leisz said her life has been thrown into shambles.
After suing her New Jersey plastic surgeon, a jury on Wednesday awarded Leisz $115,000 -- an amount Leisz called "a joke."
"The award given to me can't anywhere touch what has happened with my eyes," said Leisz of her medical malpractice lawsuit against Dr. Paul Parker, a cosmetic surgeon in Paramus, N.J..
"I'm not happy with the decision," she said. "They didn't take into consideration what I go through every day. I expected around $500,000.
"But even with that, nothing can really make up for it," she said. "You can't put a price on your eyes."
In a statement, Parker said: "As a board certified plastic surgeon, over the past 25 years I have performed more than 10,000 surgical procedures. Our practice is centered on compassion, attention-to-detail and superior patient care."
"We have thousands of happy patients who voice their satisfaction through the personal letters they send us and countless, unprompted positive reviews and testimonials they post online."
Leisz has had two other eye procedures in the past. The first was meant to fix a congenital condition known as ptosis, where the muscles are not strong enough to hold up the lid, thus creating a droopy eyelid. The second was cosmetic.
Blepharoplasty Gone Bad
In 2005, Leisz went to Parker to fix the second cosmetic eye surgery. She had small bumps along her eyelid creases from the procedure. Leisz said Parker initially gave her Scarguard, a cream that would help smooth the skin.
"I was satisfied with the results," she said. "But he told me that I could not see what he could see, and I'd be very unhappy with the way I looked in a few years. He told me I needed surgery."
He performed a blepharoplasty, an eyelid surgery meant to give a rejuvenated appearance to the surrounding area of the eye and make a person look rested and more alert.
When asked if she thought she should have questioned Parker, Leisz said: "He's the doctor. I trusted him. You're supposed to count on your doctor that they're being honest and truthful and not worrying about their own pocketbook."
But Parker had a different view.
"We are a reputable practice with a solid track record," Parker said in his statement. "This is based on our commitment not only to patient care but to pre-surgical counseling."
Since surgery, Leisz cannot fully close her eyes. She uses steroid drops and creams to lubricate her eyes and wears a mask over her face at night to prevent scratching her corneas.
Leisz said she is at high risk of getting glaucoma and potentially going blind because of the overexposure of her eyes.
She has visited a Pennsylvania eye specialist 45 times and has had 30 surgeries in five years in attempts to reverse the cosmetic surgery results.
Leisz said she has not been able to have a full life and participate in her favorite hobbies, such as swimming, gardening and tennis, because of her condition.
"From the minute I wake up, I have to worry about my eyes," said Leisz. "They're bloodshot and dry and feel like someone is always pinching them."
"I'm pretty much a blind person," she added. "I'm very worried about the health and deterioration of my eyesight."
The jury began deliberating the case last week.
Parker's lawyer told the jury that Parker presented Leisz with a standard consent form, with the warnings and risks of the procedure. But Leisz said Parker never went over the risks, except for some swelling and bruising after the first few days of surgery.
As he said in his statement, Parker is certified by the American Board of Plastic Surgery. Board certified plastic surgeons are required to help patients understand the risks of any surgery.
"The Center considers presurgical counseling as important as the surgery itself and conducts extensive interviews with all prospective patients," Parker said. "We never overlook this vital step."
According to the American Society of Plastic Surgeons, there were 13.1 million cosmetic procedures and 208,764 eyelid surgeries done in the United States in 2010.
"With all the money plastic surgeons are making, you wouldn't think there is so much prejudice out there of cosmetic procedures," said Leisz, referring to negative comments made in online stories that have covered the trial.
"Ultimately, patients do assume some risk in choosing to have these procedures and doctors need to operate on the right people for the right reasons," said Dr. John Millard, president of Millard Plastic Surgery Center in Denver, who is not involved with the case.
"It appears that too much skin was re-sected from her upper eyelids," added Millard. "It is a risk of the blepharoplasty procedure. It is commonly covered in the consent, assuming the doctor used a standard consent."
Doctors Weigh In
Leisz's attorney played a video for the jury of another doctor who weighed in on the procedure. The physician said Leisz was not a good candidate for another eye procedure because of her prior surgeries and the possible lack of skin around the eye.
But Millard said that she still may have been a good candidate for the procedure if she had excess, overhanging or upper eyelid skin, regardless of how many procedures she had in the past.
"Simply put, there would have been an amount of skin that, when removed, would have allowed her to close her eyes," said Millard. "If she didn't have any excess skin and this was done unnecessarily, then it would have been an inappropriate procedure in the first place."
However, Dr. Michael Olding, director of the Cosmetic Surgery and Laser Center at George Washington University, said that it is difficult to make assumptions about the surgery in hindsight.
"Just because other doctors have the advantage of looking at it retrospectively with its resultant complication does not mean that she was not a candidate for the procedure," Olding said. "But if she had undergone the same procedure previously, one must be very cautious not to overdo the skin resection."
Plastic surgeons said that complications are much more likely the second and third time around.
"Complications do occur, and it is our obligation to inform patients of the complications, and then they make an educated decision about whether or not to proceed," said Olding. "It's informed consent."
Olding noted that it is difficult to comment without knowing the exact procedure with before-and-after results, but he was willing to comment on what may have happened for Leisz's lids to become deformed.
"It looks like she has ectropion and shortening of the lower lid, which is the rolling out and pulling down of the lower lid below its normal position, causing more exposure of the globe and the cornea, which then gets dry and causes her symptoms," said Olding.
"She might have had too much skin removed, which pulled down on the lower lid, but she might also have had some bleeding at the site post op, which could have resulted in more lid contracture and shortening," Olding said.
A Fixable Dilemma, Doctors Say
Despite the botched lids, Dr. Garry S. Brody, a professor emeritus at the Division of Plastic Surgery at the University of Southern California's Keck School of Medicine, said the mistakes still are fixable.
"What is most likely is that too much skin was taken in the last procedure," said Brody. "This can be corrected by adding skin grafts from behind the ears, which will leave an extra fine scar that can be easily covered with makeup.
"Other possible, but much less likely scenario, is that the muscles that open the lids were somehow scarred," Brody added. "Also fixable."
But Leisz now fears going under the knife. Right now, she said, she is not mentally or physically strong enough to get the reconstructive skin graft surgery.
"My eyesight may not even last to watch my grandchildren grow up, and it scares me to death," said Leisz. "I may not have a choice in the matter or my eyes will dry up like raisins."
Millard said that he would refer Leisz to an oculoplastic surgeon, a doctor that specializes in surgical procedures that deal with the eye socket, tear ducts, eyelid and face.
"My guess is that she went to someone who didn't do a lot of eyes," said Millard. "A surgeon should see if they can close their eyes post-op before throwing the skin away because he could have regrafted it."
But other plastic surgeons aren't having it.
"Tip your head back and try to close your eyes," said Dr. Henry Kawamoto, clinical professor of plastic surgery at UCLA. "[It's] not easy for even those who have not had an upper blepharoplasty. Lack of full closure is not unheard of as a temporary phenomenon, and most surely she was told pre-operatively. A nonsense suit."
Stigma of Vanity
Leisz said it's difficult to deal with a plastic surgery case because of the stigma of vanity.
"I felt embarrassed because they think I'm such a fool," she said. "You go in to look better and you come out worse than you came in."
Now, Leisz, unhappy with the verdict, said she wants to make Parker miserable.
"I want to pull out a full-page ad about this doctor, telling people what he did," she said. "I want to make him suffer. It wouldn't be for the money, it would be just to make him suffer, if that's even possible."