On June 1, 2009, plaintiff Stephanie Nickerson, 25, a bartender and student, presented to Dr. Tony Pham for a preoperative visit after electing to have an abdominoplasty, also known as a tummy tuck. During the visit, Pham informed Nickerson where he envisioned making the surgical incision. Nickerson initially presented to Pham on April 13, 2009, for a plastic surgery consultation because she was unhappy with abdominal stretch marks and excess skin left over from her pregnancy. She was also interested in getting a breast augmentation, as she felt she had lost considerable breast volume after her pregnancy. Pham subsequently talked to her about the options of an abdominoplasty and breast augmentation. Nickerson told him that she was going to consider the options and get back to him if she decided to have surgery. She later contacted his office and elected to undergo an abdominoplasty. As a result, a preoperative visit was scheduled for June 1, 2009, during when Pham sketched on Nickerson’s abdomen where he envisioned making the incision based upon the amount of skin laxity she had. On June 9, 2009, Nickerson underwent the abdominoplasty, but after the dressing was removed at the post-operative visit, she saw that the scar was in the middle of her stomach and not where she thought it was going to be. Nickerson sued Pham. She alleged that the defendant misinformed her about where the surgical scar was going to be. Thus, she claimed that Pham failed to get her informed consent and that this failure constituted medical malpractice. Nickerson also sued the place where the procedure was performed, Forest Surgery Center, but it was ultimately dismissed from the case early in the suit. Nickerson claimed that during the preoperative visit on June 1, 2009, Pham sketched on her abdomen where he envisioned making the incision and that she, thereafter, went home and took a picture of the sketch on her body. She alleged that upon looking at the picture, she was pleased with where the intended incision would be and agreed to proceed with surgery. Nickerson also claimed that during the preoperative visit, Pham told her that he would make the scar as low as possible, but that the final result would depend on how she healed. She claimed that she subsequently asked him if the scar would be “below the bikini line,” to which he said it would be. The plaintiff’s mother also testified that Pham essentially promised her daughter that the scar would be below the “bikini line.” The plaintiff’s plastic/reconstructive surgery expert testified that Pham performed a standard abdominoplasty procedure. However, the expert opined that because of Nickerson’s unusual anatomy, which included a high umbilicus and her being long waisted, the standard of care required a modified abdominoplasty procedure. Pham testified that the incision was where he told Nickerson it would be placed and that the term “bikini line” did not describe any particular anatomic structure. He also claimed that he had informed the plaintiff during the preoperative visit that the location of the scar would depend on how much skin laxity was present during the surgery and denied making any statements to Nickerson about the scar being “below the bikini line” during the pre-operative visit or on the date of the surgery. He also denied making any promises about the outcome and claimed that he went over the consent form carefully with Nickerson. However, Pham acknowledged that Nickerson did not get a good cosmetic result, but that he felt he could have improved it if she had continued to see him. Pham noted that the consent form signed by Nickerson included clauses that said “visible and palpable wrinkling of skin can occur,” and “although good wound healing after a surgical procedure is expected, abnormal scars may occur within the skin and deeper tissues. Scars may be unattractive and of different color than surrounding skin.” Defense counsel contended that there was also a paragraph about unsatisfactory results, which stated, “there is no guarantee or warranty, expressed or implied, on the results that may be obtained.” Counsel further contended that the paragraph also stated that “additional surgery may be required to improve results.” The defense’s plastic/reconstructive surgery expert testified that there was nothing unusual about Nickerson’s anatomy, that Pham performed the proper procedure, and that Nickerson experienced scar migration, which is a rare but known risk of an abdominoplasty. The expert also testified that Nickerson’s scar could greatly be improved with revision surgery., Nickerson had a poor cosmetic result, with an irregular scar high on her abdomen. She also claimed the scar around her umbilicus had a poor appearance. Specifically, she was left with a scar across her entire abdomen, five centimeters below her umbilicus, 28 centimeters long, with an irregular zigzag pattern. It is 3.5 centimeters at its widest dimension. According to Pham’s notes there was expected post-operative swelling and bruising. A few weeks after the surgery, Pham noted that Nickerson’s scar was becoming hypertrophic and recommended a steroid injection, to which she agreed. Nickerson’s last visit with Pham was on Aug. 10, 2009. Thereafter, she had some additional hypertrophic scarring and received another steroid injection. In January 2010, Nickerson consulted with her expert and subsequent treating physician in plastic/reconstructive surgery about her abdomen scar, as well as for a breast augmentation. The expert characterized the abdominoplasty scar as “horrible,” and noted that it was very high on the abdomen. He also felt the appearance could be improved with revision surgery. Plaintiff’s counsel noted that the surgery would cost $30,000 and would reduce the appearance of the scar, but not eliminate it. Thus, Nickerson claimed emotional distress and embarrassment as a result of the scarring. She claimed that as a result, she avoids wearing bathing suits and would even wear a shirt when being intimate with her boyfriend. Defense counsel noted that Nickerson’s boyfriend testified that he had never seen Nickerson’s scar, even though they have been together for over a year. Pham and the defense’s expert both claimed that Nickerson’s scar could greatly be improved with revision surgery.