Study Type: Retrospective Review Category Aesthetic
Hypothesis: This study was undertaken to 1) review cosmetic surgery cases that have resulted in lawsuits the United States which have proceeded to trial. 2) To document the incidence of these procedures.3) to investigate the common denominators in the cause of action
Methods: A team of lawyers solely engaged in the practice of medicolegal defense for the Cleveland Clinic Foundation, performed a search of legal data bases for aesthetic malpractice cases. ASAPS data estimating the total number of aesthetic procedures performed during the years 2000-2004 was collected to calculate the incidence of litigation involving each aesthetic surgery procedure type.
Results, 40 cases of breast augmentation, 36 liposuction, 14 breast reduction, 9 facelifts and 8 rhinoplasties and were identified by our search. Breast Augmentation had the highest incidence of litigation (1/38,913) followed by breast reduction (1/51,844), facelifts (1/69670), liposuction (1/99,886) and lastly rhinoplasty (1/101,099). Liposuction cases involving a plaintiff settlement resulted in a mean award of $4,402,453.The main indications were lack of informed consent and uneven contours. For cases involving breast augmentation the mean award was $255,761. The major indications were scarring, lack of informed consent and asymmetry. With regards to rhinoplasty the mean award was $305,000. Major indications were lack of informed consent, difficulty breathing and/or nasal valvular collapse, or dissatisfaction. In breast reduction, the mean award was $302,483. The indications were scarring, lack of informed consent, or asymmetry. For facelifts, the mean award was $400,077 with the main reasons being lack of informed consent or scarring.
Discussion: The most common aesthetic procedure resulting in litigation going to trial is breast augmentation, in addition, it is the aesthetic procedure with the greatest likelihood of litigation occurring. Lack of informed consent remains the most common reason for a lawsuit occurring in spite of documentation with a signed consent form. It is suggested that the plastic surgeon be aware of this increased incidence and take particular care the pre operative consent of these patients giving as detailed account of the procedure and adverse outcomes to help educate the patient. This may help decrease the incidence of legal action and avoid litigation.