Today’s (27.09.11) Herald reports on the unfortunate case of a young woman who was burnt during a dental procedure.
Accidents happen, but the professional involved must be held responsible. No doubt.
But my question is: how did the repair of this burn cost $15,000 for such an equivocal result??
The post-op photo demonstrates a distorted nasolabial fold and a “T”-shaped scar with which the patient must live.
The pre-op photo demonstrates a full-thickness (“3rd degree”) burn of approximately 1.5 – 2.0 cm in diametre of the right upper white lip. It appears the injury had occurred about a week prior to the photo.
This burn could have been managed in several ways. Allowing it to granulate and heal of its own accord was a reasonable option. A simple purse-string suture would have hastened this process and resulted in a smaller scar. It appears, however, that a small flap was used. This has resulted, on the one hand, in quicker healing and a narrower scar, but, on the other hand, distortion of the nasolabial fold and a longer scar.
One could argue as to whether the surgical intervention actually resulted in a better, or worse, outcome aesthetically. Personally, I think she would have been better off allowing it to granulate up, thus avoiding nasolabial distortion.
But my question is: where oh where is there $15,000 worth of work here?
The newspaper credulously reports that “hours” of plastic surgery was required, along with specialist nerve treatment to “correct” the damage that had occurred.
The damaged area is supplied by end-fibres of the infraorbital nerve. I anaesthetise this nerve regularly when augmenting an upper lip, and would be interested to know exactly what sort of therapy would alter the natural history of spontaneous repair of these nerve fibrils sufficiently to justify a $15,000 fee.
No wonder insurance premiums are what they are.
