Face-off: The Confounding Case of Marchioni v. Keyes

One woman sued Keyes alleging that a piece of a surgical instrument was left lodged in her face. Another woman sued alleging that an eye-lift performed by Keyes left her unable to shut her eyes.

They all want to help Kay. The former insurance agent, the general contractor, the emergency medical, the retired air force reservist, the newspaper marketing executive—these people, and others, too, are speaking out on Kay’s behalf. Only one has met her in person. Still, all say that in Kay’s story, they recognize their own. They live in Alabama, Illinois, and Southern California. Before Kay called and introduced herself, none of them knew the others existed. Kay—Kindergarten teacher in the Chicago public schools—filled them in. There were more than 20 like them, she said, with just over two decades, each had filed a lawsuit against a plastic surgeon named Geoffrey Keyes. Many of those suits had been filed in Chicago. Then, after Keyes moved his practice to Los Angeles in 1989, more were filed here. Kay was the 23rd person to sue but the first to discover she was not alone.

One women sued Keyes alleging that a piece of a surgical instrument was left lodged in her face. Another sued Keyes claiming that a chin implant he’d put in was shifting and that she’d had excessive and unnecessary scarring. The family of a woman who had her breast reduced by Kelles alleged that he shouldn’t have performed the surgery because the woman was already in the hospital being treated for anorexia. Two women claimed their noses had partially collapsed after surgery by Keyes. Another woman sued alleging that an eye-lift performed by Keyes left her unable to shut her eyes.

When Kay tracked these people down, a few who had settled their lawsuits against Keyes refused to talk. But those whose law-suits had been unsuccessful found themselves rooting for her. “The theme all along gas been ‘Okay, we know we can’t pursue it any farther, but maybe somebody can get this guy,” says Robert Krueger, a Chicago-area retiree who says his late wife, JoAnne, underwent two surgeries to repair her airway after Keyes operated on her deviated septum. “Maybe somebody can pull this guy off the street.”

Kay Marchioni wants to be that somebody She wants it like she has wanted almost nothing else. Marchioni, who is 59 years old, has been tireless—obsessive, even—about researching Keyes’s life. In the three years since Keyes operated on her face, she has tracked down every lawsuit filed against the doctor and created a Web site, www.geoffreykeyeslawsuits.com, to list them. She has double-checked the veracity of every item on his curriculum vitae, questioned his medical school classmates, assembled his family tree.

“How many patients know all these things about their doctor?” Marchioni says, her voice a mixture of sadness and pride. She can tell you that Keyes began losing his hair before he completed his residency. She can tell you what he likes to wear to court: blue blazers and khaki slacks. She can even tell you the name of his most well known client: Linda Tripp, the former friend of Monica Lewinsky

Marchioni has called Tripp, just like she has called so many other former patients of Keyes. Several who have never met Marchioni feel they know her well enough to call her by her first name. “Have you talked to Kay?” they’ll ask. Chances are, the answer is yes.

Dr. Geoffrey Robin Keyes is handsome—a lean six-footer with a strong jaw and a prominent brow. In the black-and-white portrait in his Web site, www.keycare.com, he looks friendly and confident in a turtleneck sweater, his arms folded across his chest, his slender face caught in a half smile. In person, though, his blue eyes are most striking. Alert, intelligent, Keyes’s eyes make you feel you know him better than you do.

“I’d love to tell you the whole story,” he says one June morning It is the second day of jury selection in Marchioni v. Keyes, and the doctor has just arrived at the Santa Monica courthouse. As Marchioni predicted, he is wearing khakis. In the hallway outside Department O, Keyes says the Marchioni lawsuit is one big lie. “The media needs to hear this,” he says. “I’ll tell you everything. When you see what transpires in this courtroom, when you hear who I am, I think you’ll understand.”

Keyes is a 56-year-old graduate of Case Western Reserve University and Loyola University Chicago’s Stritch School of Medicine. He is board certified in both plastic surgery and otolaryngology, or surgery of the head and neck. He estimates there are only 400 doctors in the country who have that double certification. He is the author or coauthor of numerous scientific papers with titles like “Tumors of the Major Salivary Glands.” He is on the board of the American Association for Accreditation of Ambulatory Surgery Facilities, the nation’s largest outpatient accrediting body. He is the founder of the Keyes Surgicenter, a sixth-floor suite in the Beverly Sunset Medical Building at the corner of Doheny and Sunset Boulevards, where he performs face-lifts, eye-lifts, rhinoplasry, breast augmentation, tummy tucks, liposuction, and laser surgery usually on an outpatient basis.

Keyes comes from a family of doctors. His father was a family practitioner in Youngstown, Ohio; his brother-in-law is the chief of orthopedic surgery at Northwestern University in Evanston, Illinois; and his wife is the head of anesthesiology at UCLA’s Jules Stein Eye Institute. But it is Keyes whose specialty helps define Los Angeles for the rest of the world.

L.A. is a place where physical perfection and enduring youth are not just admired but created. There are more plastic surgeons here than in any other metropolis in the world except New York. For years shape-shifting entertainers such as Michael Jackson and Cher have fueled the public’s interest in certain surgeons. Occasionally, one of these celebrity doctors gets sued. In January, for example, movie producer Mike Medavoy and his wife, Irena, sued Dr. Arnold Klein, alleging complications resulting from Botox injections. Now TV shows like FX’s dramatic series Nip/Tuck and ABC’s reality show Extreme Makeovers (in which Beverly Hills surgeons guide the wholesale restructuring of the faces and physiques of ordinary Americans) are focusing public attention on another, larger sector of the plastic surgery economy: the doctors who operate on the rest of us.

Keyes is one of those surgeons. He is not known to have worked on anyone famous, other than Linda Tripp. He finds new clients and makes his living as most plastic surgeons do: through advertising, word of mouth, competitive pricing, and publicity. He received a lot of media exposure after Tripp’s surgery “Linda Tripp: Her Plastic Surgeon Talks,” read the headline on the cover of People in January 2000. Appearances on Good Morning America, 20/20, and Dateline NBC followed.

That’s where Marchioni first saw him, though now Keyes sounds as if he wishes she hadn’t. “She’s scars” he says. “This woman and her associates—whoever she has gotten together with—they’ve tried to demonize me. There’s nothing she’s said about this case that is true.”

Of the 104 members of the California Society of Plastic Surgeons who practice in Los Angeles Country, only one has been sued more times than Keyes during the last 20 years. To be sure, the number of lawsuits filed against a practitioner matters less than the outcome of those suits. It is the rare doctor who has never been a defendant. Liability experts say one lawsuit per year of practice is about average, with 80 percent of those suits being dismissed. A recent Time cover story lamented that the skyrocketing cost of malpractice insurance is causing doctors in some states to stop performing risky procedures. “Read the Time magazine article,” Keyes says when asked about his lawsuits. “See why people have suits.”

In California, though, there is another side to the malpractice crisis—one that Marchioni feels has hindered her ability to take Keyes to court. A state law that caps the amount that juries can award to plaintiffs in medical malpractice cases has made it difficult, she says, to get a lawyer to try her case. Consumer advocates agree with Marchioni that the cap—which limits so-called noneconomic (or “pain and suffering”) judgments to $250,000—discourages lawyers from representing all but the wealthiest “medmal” plaintiffs. Malpractice cases are notoriously expensive to try. When the amount that can be won is limited, lawyers who are paid on contingency have less incentive to take them on.

“Innocent patients who cannot prove large wage loss or medical bills … often cannot find attorneys because the economics do not add up for lawyers, whose contingency fees are also limited under the law,” Jamie Court, executive director of the Santa Monica-based Foundation for Taxpayer and Consumer Rights, wrote earlier this year on the op-ed page of the Los Angeles Times. “The law generously compensates the rich, but turns injured patients who are less well off into victims a second time.”

As President Bush and other Republican leaders push for a cap similar to California’s to be adopted nationwide, Marchioni v. Keyes shows just how much is at stake for both physician and patient.

“Geoffrey Keyes left his mark on me,” Marchioni says, running a finger over a white two-and-a-half-inch scar on her chin. “I’ll never be the same.” Keyes, though, feels much the same about Marchioni. “Everybody is really quick to saS ‘Oh, this poor schoolteacher and this evil plastic surgeon,'” he says, his voice rising with frustration. “But this is my career. I deserve to be put in a good light.”

Marchioni lives a long way away from Doheny and Sunset, in a small apartment on the South Side of Chicago. She is divorced and has a grown son who lives in Cincinnati. She has no pets. She loves to garden, though she doesn’t have a plot of her own. She is an avid reader: She’s devoured all of Scott Turow’s legal thrillers. She talks with warmth about the kid’s she’s taught over the years. Marchion is police, intelligent, and sometimes unexpectedly funny. But there is a formality about her—a distance. You get the impression this is a woman who spends a lot of time alone.

In the summer of 1999, a quarter-sized growth behind Marchioni’s right ear was diagnosed as a fast-growing squamous cell carcinoma tumor (a form of skin cancer.) She flew to New York to have it removed at Sloan-Kettering Institute. Another lesion was renowed from her left leg in December. “Sloan-Kettering was fantastic. Fabulous doctors. Just wonderful,” she says. But by the summer of 2000,”after over a year of just one thing after another—of juggling my classroom and teaching my children and wondering when I was going to die,” she was worn down. When her doctors declared her cancer free, she decided to give herself a treat.

“My eyelids were kind of droopy” Marchioni says. She didn’t have much money—she drives a 1992 Toyota Camry with an odometer that reads 286,000—but she decided to splurge. “Didn’t expect to look 18. I knew how old I was. But I wanted to look better.”

To look better—don’t we all want that? But plastic surgery offers something more: the hope that we can transform not just how we appear but how we walk through the world. The pursuit of physical perfection is a peculiarly modern notion, embraced by many Americans as both desirable and essential. We accept as a given that to be beautiful is to be happy More and more of us each year also take comfort from the belief that in the hands of a plastic surgeon, we can be fixed.

Marchioni was no different. When Good Morning America’s Charles Gibson introduced Keyes as “the plastic surgeon responsible for [Linda Tripp’s] transformation,” Marchioni was intrigued. She called the Keyes Surgicenter and spoke to an administrator, who encouraged her to come west. “She told me, ‘California is the plastic surgery capital of the country, and Beverly Hills is the center of it,” Marchioni recalls. Keyes’s office is actually in West Hollywood; it sits on the wrong side of Doheny But it was close enough for Marchioni. In June 2000, she sent photographs of herself and a handwritten letter.

“First, let me say I am not the mean-looking taciturn person these pictures of me look like,” she wrote. “I was shocked when I saw these! I guess I need’the works,’ but I don’t think I can afford it.”

Marchioni had a phone consultation with Keyes. As many surgeons do, he recommended what should be done without meeting Marchioni face-to-face, relying instead on her photos. At some point they agreed what she would pay him: $12,000. Meanwhile, Marchioni studied photos of Tripp, whose rejuvenation seemed remarkable. “I thought, ‘Well, if he can make her look that much better, I bet then he can do my eyelids,'” she recalls. Marchioni called the Medical Board of California, which informed her that Keyes’s license was in good standing. Weeks later, she drove her Camry to O’Hare Airport and boarded a plane for Los Angeles.

What happened next is in dispute. Keyes insists that Marchioni asked for a full face-lift—he points to her letter about needing “the works” as proof, as well as consent forms that his handwriting expert says were signed by Marchioni. (She and her handwriting expert claim the forms are forged.) Keyes says she received excellent medical care. Marchioni says she got nothing of the kind.

Marchioni says she only consented to surgery on her upper and lower eyelids but that Keyes cut around her chin and her ears—an area that she had specifically asked him to avoid because of her cancer. Both flaps of cartilage that shield the ear canals appeared to have been removed, and she says the surgery caused blood clots in her ears and an infection. Marchioni would complain of excessive scarring, an uneven hairline, numbness of the face and cheeks, and loss of feeling in her left leg—a result, she alleges, of having spent eight hours lying on her side under general anesthesia, which she says she asked not to receive.

Before she left Los Angeles, Marchioni says, she confronted Keyes about her most noticeable scar—two and a half inches of suturing on her chin. His reaction, as described in her complaint, was bizarre. First, she says, he told her that he cut open her chin in order to show his anesthesiologist her “good German musculature.” Then Keyes became enraged, Marchioni says. “Keyes’s face turned red and he quickly left the room,” she alleges. “He returned with a large open book, which depicted several color photos of a surgery in progress, graphically showing an individual’s facial skin detached from bloody muscle. He thrust the open book in front of [my] face, shouting, ‘Look at this! This is what I did to you, that’s why you look like this! Don’t ever question me! Never!'”

Keyes says no such exchange took place.” I have never raised my voice in the operating room or with a patient in my career,” he says. How long would I be in practice if I was doing those types of things?”

Marchioni stayed in Los Angeles just long enough to have Keyes remove her sutures. Then she went home to heal. Twelve days after her surgery, Marchioni was watching The Tonight Show when she heard Jay Leno say that Linda Tripp’s chin implant had “started to move.”

“According to the New Tork Post, the plastic surgery that LindaTripp had on her face didn’t take,” Leno said. “Well, of course it’s moving around. She’s used to having four other chins leaning on it to hold it up. You take those three chins away and it’s going, ‘Hey!'” Marchioni sat up straighter in bed. Tripp had had problems with Keyes, too?

There’s a grim joke that plastic surgeons tell one another. “How do you know you’re in the wrong plastic surgeon’s office? Mike Wallace and a 60 Minutes crew are sitting in the waiting room.” On the other hand, for a doctor whose business relies on luring a steady stream of new patients, there’s nothing more valuable than good press.

Long before Leno began joking about Tripp, Keyes’s association with her had landed him on national television. For a few weeks in January 2000, Keyed was everywhere. On Good Morning America, he explained how chin implants could “balance the face,” though he stressed that cosmetic surgery was not for everyone. “This is surgery of the psyche,” he said, warming that people recovering from a trauma—a divorce, a death in the family—were not good candidates. “If you put this type of surgery on top of emotional crisis, you’re asking for a lot of trouble.” He picked up the same theme on Dateline. “No surgical procedure can improve your inner self,” he said, as photos of Tripp flashed on the screen. “That’s a spiritual thing.” On 20/20, Keyes said, “Linda Tripp is not different from any other woman or man in her age group. She came in with expectation to have some of the aging process improved, and that’s what she achieved.”

This feature was originally published in the August 2000 issue of Los Angeles magazine