A former patient is suing Paul Nassif for saying he inadvertently damaged his medial canthal tendon during rhinoplasty resulting in the patient not being able to close his eyes. Eyelid closure can be impacted by the medial canthal tendon however this is an extremely difficult to prove and receive compensation from.

Eyelid closure problems can cause problems with dry eye and vision. If the eyelid is not closing, the eye can dry out and become damaged. As a denver oculoplastic surgeon, I treat patients who have eyelid closure issues be it after cosmetic blepharoplasty, trauma, stroke or other conditions

The medial canthal tendon is the tendon that attaches the part of the eyelid near the nose to the nose. It maintains the eyelid appearance near the nose. If the nasal bone is broken, it can certainly damage the medial canthal tendon. The lacrimal crests are two parts where the medial canthal tendon are attached.

Indeed if the medial canthal tendon was damaged during surgery, it is possible to have this tendon fixed with a second surgery. This goes to highlight the inherent risks of rhinoplasty or surgery in general.

Surgery is not like changing a part in a car. Sometimes tissue does not react as it should. Tissue can tear. Bone can break despite all the care that is taken. During the vast majority of surgeries in Paul Nassifs career I am sure the nasal bone never broke. However, anything one works on any tissue inadvertent damage can occur despite all the care and concern that is taken.

We do not know the full details of the case but it sounds like the patient had previous trauma or surgery. If that is the case, all bets are off and it is very difficult to say if there was any negligence involved.

In short, Paul Nassif’s lawsuit from another cosmetic surgeon’s perspective seems to be unfounded. There are bad outcomes in all surgeries. I perform a great deal of revision eyelid surgery and I have never seen a situation where a surgeon has been negligent. I am sure that this exists but the cases I have seen, the surgeon has gone through the standard steps of surgery and the tissue did not react the way it was expected and there was a complication Sometimes in surgery, the tissue does not react the way it should or does not heal the way it should. In that case, care should be taken to fix the problem. It does not mean if there was a bad outcome, there was negligence or it was “botched”. These complications though uncommon do not mean that a mistake was made or “the doctor messed up”.

It is clear in this case that the prosecuting attorney associates a poor outcome with “mistake” or “negligence”. Most cosmetic surgeons or eyelid surgeons would completely disagree with this from an expertise perspective.