Plaintiff’s Expert Not Qualified in Facelift Malpractice Suit in Texas

By Damian D. Capozzola, Esq., and Jamie Terrence, RN

News

A Texas appeals court has reversed a trial judge’s decision to let a facelift malpractice case proceed, ruling that the plaintiff’s chosen expert, a board-certified anesthesiologist, was not qualified to testify about the standard of care for a cosmetic surgeon or a surgery center. The decision underscores a critical point in medical malpractice litigation: that an expert’s qualifications must align with the type of care at issue. Simply holding a medical license or certification is not enough.

The plaintiff alleged she underwent what she thought would be a limited “Fresh Lift” skin-tightening procedure but instead received a more extensive deep-plane/superficial muscular aponeurotic system facelift (SMAS) with a brow lift. She claimed the surgeon injured her parotid gland and duct, causing lifelong complications, and that the surgery center staff mishandled her post-operative care. Her expert criticized the surgeon’s technique and the consent process but provided little detail in his curriculum vitae beyond being an anesthesiologist.

On appeal, the defendants argued the expert lacked relevant experience in facial plastic surgery or surgery-center standards, and the appellate panel agreed. The ruling highlights how vital it is for plaintiffs to secure experts whose training, experience, and curriculum vitae clearly demonstrate familiarity with the specific procedure and specialty at issue.

Background

The plaintiff visited a Texas cosmetic surgery center seeking a less invasive facial procedure marketed as a “Fresh Lift,” which she understood to involve removing excess skin from the lower face and neck. She alleged that, in consultations with clinic staff and later with the surgeon, she was never fully informed that he intended to perform a more extensive deep-plane/SMAS facelift, including a brow lift.

In April 2022, the surgeon performed the procedure at the clinic. During surgery, according to the plaintiff’s petition, the surgeon allegedly cut into her parotid gland and associated ducts or compressed them during tissue manipulation, resulting in ischemia and permanent damage. Afterward, she experienced swelling, drainage, and infection. She further claimed post-operative symptoms were dismissed by non-licensed staff at the clinic, delaying proper diagnosis and worsening her condition.

The plaintiff alleged direct injuries to the parotid gland and Stensen’s duct caused complications, such as saliva leakage, reduced gland function, and chronic syndromes, including Frey’s syndrome and “first bite syndrome.” She also claimed permanent scarring, chronic pain requiring ongoing treatment, and psychological harm. According to her, these issues would necessitate lifelong medical care, including pain management, Botox injections, wound care, and mental health treatment.

In August 2024, the plaintiff sued both the surgeon and the clinic, alleging three main failures. First, that she lacked informed consent, believing she had agreed to a limited “Fresh Lift” rather than the more extensive facelift performed; second, that the surgeon’s technique negligently injured her parotid gland and duct; and third, that post-operative care was negligent, with staff misdiagnosing complications and delaying treatment.

Texas law requires plaintiffs in healthcare liability cases to serve an expert report within 120 days of a defendant’s answer. The plaintiff submitted a report by an anesthesiologist, along with the expert’s curriculum vitae. The report criticized the surgeon’s surgical technique and the clinic’s post-operative care. It also raised concerns about the consent process, which the plaintiff claimed had been handled by a non-licensed consultant.

The defendants moved to dismiss, arguing the expert was not qualified to opine on the standard of care for either a facial plastic surgeon or a surgery center. His curriculum vitae showed only that he was a board-certified anesthesiologist. It did not connect his training or practice to facelift surgery, parotid gland injuries, or cosmetic-surgery consent processes. Nor did it show he had knowledge of surgery-center standards or post-operative protocols relevant to the case.

The trial court denied dismissal, but the surgeon and clinic appealed. The appellate court reversed, finding that the expert lacked the qualifications required by Texas statute. The case was remanded to the trial court to decide whether to allow the plaintiff a 30-day extension to cure the deficiencies.

What This Means for You

Medical malpractice lawsuits often hinge on technical issues that ordinary jurors cannot evaluate without expert guidance. Was the surgical technique appropriate? Were complications handled according to professional standards? These are not questions of common knowledge. For that reason, Texas, like other states, requires plaintiffs to produce an expert who can explain what the standard of care required and how it was allegedly breached. The expert serves as the voice translating medical standards into legal claims. Without a qualified expert, malpractice cases typically cannot proceed.

Legislatures impose these expert-qualification statutes for important policy reasons. They are designed to weed out meritless claims at the front end, conserve judicial resources, and protect physicians and hospitals from fishing expeditions where plaintiffs file broad allegations without medical backing. By forcing plaintiffs to produce a qualified expert early, courts can focus their time on disputes with genuine evidentiary support while healthcare providers are shielded from years of litigation over claims that lack medical merit.

The concept of “standard of care” is central to these cases. In malpractice law, it refers to what a reasonably prudent provider in the same specialty would do under similar circumstances. That means the benchmark is not a general medical obligation but a specialty-specific yardstick. What a cardiologist must do to read an electrocardiogram is not the same as what a plastic surgeon must do to perform a facelift. Expert witnesses inform jurors of the expectations that applied to the defendant and allow jurors to measure the defendant’s conduct against that yardstick.

Not every physician is qualified to testify in every malpractice case. In Texas, the expert must be practicing medicine at the time of testimony or when the claim arose, must have knowledge of accepted standards of medical care for the diagnosis or treatment involved in the claim, and must be qualified by training or experience to offer an opinion on those standards. These rules prevent experts from straying outside their fields. An anesthesiologist might be well-qualified to testify about airway management or anesthesia risks, but not on a surgeon’s obligations during a deep-plane facelift. The legislature does not want experts offering opinions far outside of their training.

In the case at hand, the plaintiff’s expert was a board-certified anesthesiologist. His report criticized the surgeon’s operative technique and the clinic’s handling of post-operative complications. But his curriculum vitae provided no indication that he had ever performed, assisted in, or studied facelift surgery or parotid gland anatomy in the context of cosmetic surgery. Nor did it show familiarity with surgery-center standards or cosmetic-surgery consent practices. The appellate court held that these omissions were fatal. To qualify, the expert needed to demonstrate knowledge of what a facial plastic surgeon or cosmetic-surgery clinic would do in the same situation. Without that, his opinions could not establish a breach of the standard of care.

This case illustrates how critical the expert’s curriculum vitae is. Courts review not only the opinions in the report but also whether the curriculum vitae shows training and experience relevant to the specific issues. A bare statement of board certification rarely is enough. The curriculum vitae should document cases handled, surgeries performed, or specialized training that connects directly to the alleged malpractice. Plaintiffs’ counsel often supplement curricula vitae with detailed affidavits, lists of procedures performed, or practice history to ensure the judge can clearly see the expert’s familiarity with the procedure. A well-drafted curriculum vitae can tip the balance between surviving an early dismissal motion and seeing the case collapse before it begins.

For plaintiffs, this means selecting experts whose backgrounds align tightly with the procedure at issue and ensuring their curricula vitae demonstrate that alignment. For example, if the case concerns a facelift, the expert should be a surgeon who regularly performs facelifts or has otherwise acquired practical knowledge of facial plastic surgery standards. Medical standards of care are not one-size-fits-all. Even within surgery, procedures vary. What is expected in neurosurgery is not the same as in cosmetic surgery. This requirement is not just formality. It protects both plaintiffs and defendants by ensuring jurors hear from professionals who truly know what the defendant’s peers would have done in the same situation.

For plaintiffs, the lesson is clear. Selecting the right expert is not just about credibility but about matching the expert’s qualifications to the precise specialty and procedure at issue. Their curriculum vitae should make that alignment unmistakable because defense counsel will almost certainly comb through the report for weaknesses and move to dismiss if they see a mismatch. For defendants, that same scrutiny can be a powerful tool. Challenging an expert’s report and curriculum vitae early on can derail a case or at least force the plaintiff to find a new expert. And for both sides, the expert’s report and curriculum vitae are not ancillary paperwork but the foundation of the litigation. Without that foundation, even a strong factual claim can end before reaching a jury.

Finally, note that, too often in surgical centers, non-licensed medical practitioners take on para-medical responsibilities to handle more patients expeditiously and economically. Unfortunately, patients may not be aware of the qualifications or credentials of these staff. While informed consent is the sole responsibility of the physician, it often is actually obtained from the patient by a staff member who is not an independent licensed practitioner. In addition, as in this case, the patient may see an unlicensed staff member on a return post-operative visit or an unscheduled appointment due to a potential complication. These are very high-risk practices that may result in patient harm and/or potential litigation.

Damian D. Capozzola, Esq., The Law Offices of Damian D. Capozzola, Los Angeles

Jamie Terrence, RN, President and Founder, Healthcare Risk Services, Former Director of Risk Management Services (2004-2013), California Hospital Medical Center, Los Angeles

Reference

• Decided on Sept. 9, 2025, in the Court of Appeals for the Fifth District of Texas at Dallas, Case No. 05-25-00354-CV.