Assessment Task 3: Case Study Analysis – Management of a Patient Requesting Revision Facelift Surgery

Course Details

Course Code: PLS802
Course Name: Advanced Aesthetic Facial Surgery
Level: Postgraduate (Master’s level)
Assessment Type: Written Case Study Report
Weighting: 50%
Word Limit: 2500 words (±10%)
Submission Format: Word document, 12-point Arial or Times New Roman, double-spaced, referenced in Harvard style

Assessment Overview

This assessment requires you to analyse a clinical case involving a patient seeking revision facelift surgery. You must demonstrate critical understanding of ethical issues, patient assessment, therapeutic options, and outcome measures in aesthetic facial surgery. The report should integrate current evidence and guidelines relevant to practice in Australia, the UK, the US, Canada, or comparable jurisdictions.

Case Scenario

A 45-year-old woman presents for a second opinion three months after a primary facelift. She expresses significant dissatisfaction with the outcome, reporting that the original surgeon conducted only one consultation, performed surgery one week later, and provided inadequate consent. She has no documentation from the previous procedure, refuses to return to the original surgeon, and declines permission for you to contact them.

She requests revision surgery and mentions recent consultations with two other surgeons. She presents an advertisement offering £1000 discount for late-bookings and asks if you can match this, while pressing for the earliest possible surgery date.

On examination, the result appears reasonable, and a revision, if undertaken, would be technically straightforward. You advise that the outcome is acceptable and recommend time for further settling. She insists that, as the patient, her perception of an unsatisfactory result overrides clinical opinion.

You document the consultation, obtain photographs, discuss risks, and suggest delaying surgery. She remains eager to proceed and wishes to book revision facelift for the following week.

Task Requirements

Write a 2500-word report addressing the following:

• Identify and discuss your clinical and ethical concerns regarding this patient and her previous management. Explain how you would manage her care moving forward.
• Evaluate the advantages and disadvantages of revision facelift surgery, focusing on short-term and long-term risks and complications.

Assessment Criteria

Background Discussion of Topic (20 marks)

• Effective summary of issues related to consent for surgical procedures
• Demonstrates the importance of a cooling-off period
• Describes key aspects of advertising regulations in cosmetic surgery
• Shows understanding of patient-reported and clinician-reported outcome measures

Patient Assessment (25 marks)

• Outlines appropriate assessment for facial rejuvenation surgery
• Describes expected postoperative appearance and recovery after facelift
• Demonstrates comprehensive consultation skills, including the role of psychological evaluation
• Identifies features of the at-risk patient

Therapeutics (25 marks)

• Evidence of understanding the complexities of revision surgery
• Discusses non-surgical alternatives and adjuncts such as autologous fat transfer
• Details undesirable outcomes of revision facelift
• Explains normal postoperative recovery and techniques to optimise scarring and contour

Discussion and Interpretation of Results (25 marks)

• Summarises assessment findings and treatment options
• Differentiates between patient-reported and clinical outcomes
• Addresses the potential need for formal psychological evaluation
• Manages unrealistic expectations, including the role of second opinions

Structure and Style (5 marks)

• Clear grammar and spelling
• Logical sequencing of arguments
• Clear explanation of concepts
• Appropriate use of references
• Clear separation of personal opinion from evidence

The patient exhibits multiple red flags that warrant cautious management. Previous care appears to have bypassed essential steps in informed consent and allowed insufficient reflection time before surgery. Regulatory guidelines stress minimum cooling-off periods to support deliberate decision-making and reduce regret. Promotional discounts tied to rapid booking create undue pressure and conflict with ethical advertising standards. Revision facelift carries elevated short-term risks compared with primary procedures, including hematoma rates up to 5.8% and potential nerve injury due to scar tissue (Albornoz-Cruz et al., 2021, doi:10.1097/GOX.0000000000003154). Long-term concerns include recurrent skin laxity, visible scarring, and contour irregularities requiring further intervention. Non-surgical options such as dermal fillers or fat grafting often provide safer initial alternatives. Thorough psychological screening remains critical, given prevalence rates of body dysmorphic disorder in aesthetic patients exceeding 15% in some cohorts.

References

1. Albornoz-Cruz, V., Vidiri, A., McGowan, K., Purnell, C.A. and Russo, M. (2021) ‘Evaluating Facelift Complications and the Effectiveness of the American Society of Plastic Surgeons’ Guidelines for Facelift Surgery’, Plastic and Reconstructive Surgery – Global Open, 9(9), e3154. doi:10.1097/GOX.0000000000003154.
2. Rohrich, R.J., Savetsky, I.L. and Avashia, Y.J. (2019) ‘Getting Better Results in Facelifting’, Plastic and Reconstructive Surgery – Global Open, 7(6), e2270. doi:10.1097/GOX.0000000000002270.
3. Sweeting, J. and Cadd, B. (2024) ‘A Systemic Review of the “Informed Consent” Process for Aesthetic Surgery’, Aesthetic Surgery Journal Open Forum, 6, ojae048. doi:10.1093/asjof/ojae048.
4. Ribeiro, R.V. (2024) ‘Body Dysmorphic Disorder in Aesthetic and Reconstructive Plastic Surgery: A Systematic Review and Meta-Analysis’, Healthcare, 12(13), 1333. doi:10.3390/healthcare12131333.
5. Medical Board of Australia (2023) Guidelines for registered medical practitioners who perform cosmetic medical and surgical procedures. Available at: https://www.medicalboard.gov.au/Codes-Guidelines-Policies/Cosmetic-medical-and-surgical-procedures-guidelines.aspx (Accessed: 10 February 2026).