Expert Insight. Unbiased Testimony.
Expert Witness in Non-Surgical Cosmetic Procedures
Miss Brackenbury has extensive knowledge across all aspects of non-surgical aesthetic practice, supporting law firms through the provision of independent expert opinion, specialist reports, and credible evidence in cases involving alleged clinical negligence and cosmetic injury. She accepts instructions from both Claimant and Defendant representatives and maintains a balanced medico-legal caseload, currently comprising approximately 60% Claimant and 40% Defendant work. Julie is registered with the Information Commissioner’s Office (ICO), Registration Number: ZA721326.
Miss Brackenbury is formally trained in Civil Expert Witness Practice through Bond Solon. She maintains ongoing continuing professional development to ensure compliance with Civil Procedure Rules (Part 35), medico-legal reporting standards, and current clinical practice within the aesthetic sector. She is also happy to provide a screening report prior to engagement as a Part 35 Expert.
Areas of expertise:
Julie Brackenbury’s expertise spans the full scope of non-surgical aesthetic practice, with particular focus on complication management, clinical negligence, and regulatory standards across medical and non-medical aesthetic settings.
Injectable Treatments
Botulinum Toxin Type A (cosmetic and medical indications)
Hyaluronic acid dermal fillers
Tear trough filler treatments
Lip augmentation procedures
Body dermal fillers
Genital / intimate area dermal fillers
Polynucleotide injectable treatments
Skin boosters and biostimulatory injectables
Injectable lipolysis (fat dissolving treatments)
Platelet-rich plasma (PRP) therapies
Mesotherapy
Device & Energy-Based Treatments
Laser and energy-based devices
Laser and light-based hair removal
Tattoo removal
Radiofrequency microneedling
Microneedling treatments
Cryolipolysis (fat-freezing)
Fibroblast (plasma) treatments
Advanced / Surgical-Adjunct Procedures
Thread lift procedures (PDO, PLLA, PCL threads)
Non-surgical facial aesthetics
Injectable and device-based skin tightening treatments
Complication & Injury Expertise
Specialist assessment of:
Vascular scclusion and ischaemic injury
Infection and abscess formation
Granuloma formation and nodules
Delayed hypersensitivity reactions
Product migration and misplacement
Tissue necrosis
Scarring and disfigurement
Pigmentation disorders
Nerve injury
Thread Lift Complications
Infection and extrusion
Thread migration or visibility
Asymmetry and poor aesthetic outcome
Nerve involvement
Inappropriate patient selection
Technical placement failures
Clinical Negligence & Breach Analysis
Breach of duty
Causation analysis
Failure to recognise and manage complications
Delayed intervention
Inappropriate treatment planning
Consent, Assessment & Duty of Care
Inadequate consultation processes
Deficient consent and risk disclosure
Failure in medical history screening
Psychological suitability assessment
Aftercare and follow-up failures
Prescribing & Medicines Governance
Remote prescribing models
Prescribing accountability
Patient Group Directions (PGDs)
Prescription-only medicine compliance
Delegated prescribing frameworks
Product Safety & Regulatory Compliance
Expert assessment of:
Authenticity and sourcing of aesthetic products
Use of licensed vs unlicensed medicines
Counterfeit and grey-market injectables
MHRA and regulatory compliance
Product storage, handling, and cold-chain management
Expiry and batch traceability
Off-label product use and associated risk
Practitioner accountability in product selection
Device Safety & Clinical Governance
Safe operation of aesthetic devices
Treatment parameter selection
Skin typing and contraindication screening
Patch testing protocols
Maintenance and servicing compliance
CE / UKCA certification
Operator training and competency
Delegation and supervision frameworks
Training, Delegation & Supervision
Training standards and course provision
Competency assessment
Delegation frameworks
Supervision models
Scope of practice breaches
Regulatory & Clinic Governance
Clinical governance frameworks
Regulatory compliance
Record keeping standards
Infection prevention and control
Emergency preparedness protocols
“A doctor is not guilty of negligence if he has acted in accordance with a practice accepted as proper by a responsible body of medical men skilled in that particular art.” McNair J in Bolam v Friern Hospital Management Committee [1957]
Relevance: This quote introduced the Bolam Test, setting the standard for medical negligence by linking it to professional opinion.
Legal Standards Across the UK & Ireland
Ireland – Medico-Legal Test
Dunne v. National Maternity Hospital [1989] IR 91
The Dunne Principles govern medical negligence in Ireland and state the following:
A practitioner is not guilty of negligence if they act in accordance with a practice accepted as proper by a responsible body of skilled medical professionals in that field, even if others disagree.
The court must be satisfied that the practice relied upon has a logical and rational basis.
An error in diagnosis or treatment is not necessarily negligent if it is one that a competent practitioner could make. However, negligence arises if no competent practitioner would have made the same error.
If there is a general and approved practice that is not followed, the practitioner must justify why they departed from it.
Summary: Similar to Bolam and Bolitho in England, but explicitly stated through Dunne v NMH.
Scotland – Medico-Legal Test
Hunter v. Hanley [1955] SC 200
The Hunter v. Hanley test is applied in Scotland to assess professional negligence, including medical cases. It requires:
There must be a usual and normal practice.
The practitioner did not adopt that usual practice.
The course of action taken is one that no professional person of ordinary skill would have taken if acting with ordinary care.
Summary: while Hunter v. Hanley is broadly similar to the Bolam test, it is specific to Scotland and focuses on deviation from standard practice in a way that no reasonable practitioner would.
Comparison with England & Wales
England & Wales: Uses the Bolam and Bolitho tests (Bolam v Friern Hospital; Bolitho v City & Hackney HA) which establish that negligence occurs if a practitioner’s actions are not supported by a responsible body of medical opinion or lack logical defensibility.
Ireland: The Dunne Principles (Dunne v. NMH, 1989) function similarly to Bolam and Bolitho but are expressly established under Irish law.
Scotland: The Hunter v. Hanley test (Hunter v. Hanley, 1955) requires proof of usual practice, deviation from that practice, and that the deviation was unreasonable.
