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    Courts say body dysmorphic disorder may impact validity of informed consent


    David Goldberg, M.D., J.D.
    Jane Cosmetic is a 40-year-old longtime cosmetic patient of Dr. Derm. Every time a new filler, botulinum toxin or energy-based device becomes available, she is first in line for treatment.

    Irrespective of new technologies, Jane appears in his office every three months for some cosmetic treatment, and has done so for the past 15 years. She has had virtually every Food and Drug Administration-approved cosmetic filler, botulinum toxin and facial cosmetic laser treatment, and she is in the office on a yearly basis for a liposuction "touch-up."

    Last year, Jane was injected with a dermal filler and, unfortunately, had filler-induced skin necrosis, which led to a permanent, disfiguring scar. She is devastated. Although Dr. Derm shares her concern, he reminds her that over the course of the last 15 years, she has signed innumerable consent forms that document the risk of scar formation from her varied cosmetic procedures.

    Jane seeks a second opinion from both a plastic surgeon and a cosmetic dermatologist. Neither criticizes Dr. Derm but both tell her that, in their opinion, she suffers from body dysmorphic disorder (BDD) and should seek psychiatric help. Both refuse to treat her.

    She seeks legal advice and files a lawsuit against Dr. Derm. The basis of her lawsuit is that because she suffers from BDD, she lacks the capacity to give informed consent; therefore, Dr. Derm breached the standard of care in treating her. Can Dr. Derm lose such a lawsuit?


    David J. Goldberg, M.D., J.D.
    Dr. Goldberg is Director of Skin Laser & Surgery Specialists of New York and New Jersey, Director of Mohs Surgery and laser research, ...

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