David Topchian worked for almost three years to transform a 21-year-old Melbourne woman from a shy pet-shop assistant to a model gracing the cover of men's magazines.
But after the first of three breast augmentations, things got heated and, for Dr Topchian, unprofessional. As a cosmetic surgeon, he was banned from sexual relationships with patients.
Between April 2007 and January 2010, Dr Topchian treated the woman and performed three breast augmentations, five lip fills and a labiaplasty. After the first breast augmentation, the woman started sending Dr Topchian naked photographs of herself when she modelled for professional photographers. Dr Topchian was complimentary.
In July 2009, Dr Topchian invited the woman, who cannot be named, to dinner at a restaurant. Over the next month, they sent emails and text messages to each other and spent time on Skype. The evening before her third breast augmentation and a lip fill, the sexual relationship began.
Dr Topchian was living in Brisbane with his wife, where he worked part-time at a clinic, as well as working part-time in Melbourne. He and the woman spent a weekend in Brisbane together and he later gave her a laptop.
Soon after, he ended the sexual relationship, but, as the Victorian Civil and Administrative Tribunal recently heard, Dr Topchian continued to email and phone his patient despite being warned by a colleague that he was jeopardising his career.
For several months at the start of 2010, there was no contact between the two, but in July, she sent him an email, outlining her financial problems, that her car had been damaged and she needed his help.
"Think very carefully about how you respond," she wrote. Dr Topchian told the tribunal that he saw this as a threat and emailed her back. "I will help in any way that I can."
He engaged his lawyers to negotiate with the woman: she was to sign an agreement to be paid not to disclose their illicit affair and delete incriminating evidence from her mobile and her laptop.
But, in September 2010, when negotiations broke down over her payment – she wanted $50,000, he offered $20,000 – Dr Topchian reported the relationship to the Medical Board of Australia. He told her there would be no payment and no meeting because he had told authorities. She said she would tell his wife and associates and the medical ombudsman. She never did.
The tribunal has suppressed the identity of the woman.
In its decision published this month, the tribunal condemned Dr Topchian's attempts to hide the relationship as careful and systematic.
"Dr Topchian made grave errors of ethical judgment in having the relationship and trying to prevent his conduct being exposed," VCAT senior member Ian Proctor and members Drs Barbara Burge and Aruna Reddy said in their published decision.
"A cosmetic surgeon operates in one of the most sensitive fields in medical practice, akin to psychiatrists and psychologists. They alter people's appearance to which self worth is often inextricably linked, perhaps particularly to the people who consult them."
The members said that the woman told two anaesthetists before surgery that she was taking antidepressants.
They said that the woman was likely to have been emotionally scarred at the way Dr Topchian ended the relationship.
"It is reasonable to speculate that the experience of being physically transformed, apparently leading to a transformation of life circumstances and experiencing an intense short relationship with the person who transformed her could cause psychological difficulties for her," the members said.
Dr Topchian had his registration suspended for one year, to begin at the start of next month. He was reprimanded and made to consult a mentor each month for the next three years.
An earlier version of this story suggested that Dr Topchian was a plastic surgeon. This has now been corrected.