19 Sponsored by:COMMON MEDICO-LEGAL ISSUES IN FACIAL TRAUMA (PART ONE)By Mr Michael Perry, Consultant Oral and Maxillofacial Surgeon, Northwick Park HospitalThe treatment of facial injuries has evolved considerably over the last 30 or so years and many injuries can now be reliably repaired to a reasonable level of precision. However, patients’ expectations have also evolved in parallel. Together with the portrayal of the cosmetic industry by some elements of the media, this has resulted in a culture of high expectation and a demand for perfect results. Yet, the reality is that surgery is never free of risk and despite these advances, many patients will often be left with some stigmata of either their injury or its treatment. Some aspects of normal recovery (such as prolonged bruising or swelling) may also be perceived as complications if patients are not warned beforehand. Failure to meet such expectations can therefore result in disappointment and sometimes litigation. Furthermore, not all treatments are freely available in the NHS. Some dental treatments, rhinoplasties and scar revisions for example, are not always available and can be quite expensive privately. Understandably therefore, some patients may feel aggrieved when they are suddenly faced with the prospect of a sizeable fee (and the inconvenience of multiple visits) to repair or replace damaged teeth, or undergo treatment for a deformity. This may be compounded if (in the patient’s opinion) the injury was through no fault of their own, such as following an assault or accident. Consequently, they may seek retribution or compensation to ease their financial burden by any means possible, which may include clinicians or Trusts.For many patients, the treatment of their facial injuries can be a long and complicated process. For us, as clinicians, this process has the potential to be a medico-legal minefield. As an observation, the more common claims centre around:LEGAL MEDICOMAGAZINEMichael Perry is a Consultant Oral and Maxillofacial Surgeon at Northwick Park Hospital, and the clinical lead in facial trauma for the regional maxillofacial and trauma service for the North West of London. He has over 20 years hands-on experience in facial injuries, has lectured both nationally and internationally and has published extensively in this field, including several text books. In 2011 he was listed in The Times Magazine as one of the country's 50 top surgeons.