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The downside of luscious lips

01 August 2003

In the early 1990s Ms H wanted plumper lips and consulted Mr M, a cosmetic surgeon, who recommended silicone and collagen injections. After having three collagen injections over three months, she complained that the effect was too short-lived.

Dr M suggested that she try silicone oil injections instead and she agreed.

Over the next 11 months, Ms H’s lips were injected four times with silicone oil. These treatments were all well documented by Dr M, who kept excellent records of all patient encounters.

During the course of treatment, Ms H suffered an itching rash diagnosed as pityriasis rosea. In her subsequent claim against Mr M she described fatigue, disturbed sleep, malaise, back pain, nausea, blurred vision, slurred speech, disorientation and tremor of her trunk. She attributed these symptoms to the course of silicone oil injections.

About four years later Ms H suffered neurological symptoms and was diagnosed as having benign, non-progressive multiple sclerosis. Later that year she was diagnosed as suffering from Raynaud’s phenomenon.

Ms H later became aware of the potential controversial association between the use of silicone in breast implants and some connective tissue diseases, particularly discussed in the USA.

She alleged that Mr M had been negligent in using silicone injections despite the known risks of its use, which had led to her subsequent episodes of ill health.

Expert opinion

The experts we consulted were supportive of Mr M; he had carried out the procedures according to standard practice and kept careful records. They were satisfied with the quality of lip augmentation produced by the procedures.

Our lawyers, supported by experts in epidemiology and rheumatology, vigorously contested the unproven association between silicone use and Ms H’s illnesses. Although there has, in recent years, been much controversy surrounding the issue, there was no proven association between silicone use and multiple sclerosis.

Ms H’s counsel accepted the argument and agreed that the claim should not proceed on that basis. However, it transpired that the silicone oil Mr M had been using was not licensed as a medicinal agent at that time in the UK.

Mr M had not been aware of this, and had thought that the product was a bona fide medical-grade oil. Because of this we agreed to pay Ms H £5,000 as compensation for a small period of pain and suffering.

Learning points

  • Mr M’s defence was greatly aided by the quality of his notes.
  • Clinical negligence claims are often brought years after the alleged negligent incident. Regardless of the current state of knowledge or beliefs, the claim can only be judged according to what was commonly accepted practice at the time of the incident.
  • MPS indemnity for cosmetic surgery varies, depending on the procedure. We advise members to ensure we are fully informed of the nature of procedures they carry out.