Hypothesis: Cosmetic surgery lawsuits in the United States which proceeded to trial were reviewed to document the incidence and investigate any common denominators in the cause of action.

Methods: A team of lawyers performed a search of legal data bases between 2000-2004 and used ASAPS data to calculate incidence of malpractice.

Results: 40 breast augmentations, 36 liposuctions, 14 breast reductions, 9 facelifts and 8 rhinoplasties were identified. Breast augmentation had the highest incidence of litigation (1/38,913), followed by breast reduction (1/51,844), facelifts (1/69,670), liposuction (1/99,886) and rhinoplasty (1/101,099). Liposuction cases resulted in a mean award of $4,402,453 with the main reasons being lack of informed consent and uneven contours. Breast augmentation was $255,761 due to scarring, and lack of informed consent. Rhinoplasty was $305,000 due to lack of informed consent, difficulty breathing. Breast reduction was $302,483 due to scarring and lack of informed consent. For facelifts this was $400,077 due to lack of informed consent or scarring.

Discussion: The most common aesthetic procedure going to trial is breast augmentation, which also has the greatest incidence of litigation. Lack of informed consent remains the most common reason for a lawsuit occurring in spite of documentation with a signed consent form.