Litigation Arising From Minimally Invasive Cosmetic Procedures: A Review of the Literature

Abstract

BACKGROUND Minimally invasive cosmetic procedures are on the rise. To meet this rising demand, increasing numbers of physicians and nonphysicians are performing these procedures. Understanding malpractice trends and reasons for litigation in cosmetic medicine is important to establish safeguards for patient care and minimize liability. OBJECTIVE Perform a comprehensive review of the literature on litigation associated with minimally invasive cosmetic procedures and discuss strategies to avoid facing a lawsuit. MATERIALS AND METHODS The authors searched PubMed databases using a variety of keywords to identify studies of lawsuits arising from minimally invasive cosmetic procedures through December 2020. RESULTS A total of 12 studies of litigation meeting inclusion criteria were identified: botulinum toxin (1), soft tissue fillers (3), lasers (5), body contouring/liposuction (1), chemical peels/dermabrasion (1), and sclerotherapy (1). Principle factors associated with litigation included negligence, lack of informed consent, vicarious liability for action of delegates, lack of communication, poor cosmetic result, failure to inform of risks, inappropriate treatment or dose, and failure to recognize or treat injury. CONCLUSION Understanding malpractice trends and reasons for litigation in minimally invasive cosmetic procedures can strengthen the patient–provider relationship, establish safeguards for patient care, and may minimize future risk of a lawsuit.

Informed consent in dermatology: a narrative review

“…For laser therapy, two of five cases were due to inadequate informed consent. Chemical peels and dermabrasions had six malpractice lawsuits favoring the plaintiff, and four were related to inadequate informed consent 48 . Some of the harm done to patients from these cases includes: permanent facial disfigurement, scarring, nerve damage, tissue necrosis, and depigmentation, to name a few adverse outcomes.…”

Commentary on “Soft Tissue Dermal Filler-Associated Necrosis and Impending Necrosis: A Systematic Review of the Literature”

“…2 A number of factors suggest we can expect to observe an increase in the number of these adverse events and ensuing litigation: filler treatments are becoming increasingly mainstream among the public; the number of marketed products and associated advertising is increasing; and the number of injectors is rapidly multiplying, including not only core specialists, but also noncore physicians and physician extenders with varying degrees of training and expertise. 3,4…”

“…2 A number of factors suggest we can expect to observe an increase in the number of these adverse events and ensuing litigation: filler treatments are becoming increasingly mainstream among the public; the number of marketed products and associated advertising is increasing; and the number of injectors is rapidly multiplying, including not only core specialists, but also noncore physicians and physician extenders with varying degrees of training and expertise. 3,4 We have a wealth of literature that promotes increased safety through best practices to avoid intravascular injection, and importantly, raising awareness of how to recognize and treat impending necrosis when it occurs. 5 With appropriate treatment, progression to necrosis should be rare.…”