title: Mammaplasties and medicolegal issues: 50 cases of litigation in aesthetic surgery of the breast.
abstract: BACKGROUND
  Aesthetic surgery procedures are increasing all over the world, and so are related medicolegal questions and litigation cases. Aesthetic mammaplasties represent a very important part of this field and consequently many cases of error appear. Most of these errors lead to litigation from which plastic surgeons rarely can be exonerated. The aim of this article was to evaluate different errors ascribed to the plastic surgeon, the rate of cases in which professional responsibility has been identified, and the type of guilt imputed.
  
  
  METHODS
  Each case is based on the evaluation of both documentation used by the judge and the relationships of two specialists involved in the assessment of the presumed error. In every case, problems complained about by the patient and the eventually related error of the surgeon were analyzed. Moreover, the eventual identification of professional responsibility, the quantified damage, and its possible reduction by another corrective operation were considered.
  
  
  RESULTS
  The cases studied (N=50) were divided into 34 cases of augmentation mammaplasty, 11 cases of reduction mammaplasty, and 5 cases of mastopexy. Most of the problems complained about by patients were in the preoperative and intraoperative phases. In only 10% of the cases was the informed consent contested and an expected reduction of the damage was individuated in less than half of cases.
  
  
  CONCLUSIONS
  The evaluation of aesthetic damage is a tricky question due to different aspects such as the psychological component or the frequent lack of adequate photographic documentation of the patient before the operation. Moreover, whenever possible reduction of the damage is proposed, the patient's willingness to undergo another operation, with all its related costs and benefits, must be considered.
authors: Department of Plastic and Reconstructive Surgery, I.R.C.C.S. Policlinico San Donato, Piazza Edmondo Malan, 20097, San Donato Milanese, MI, Italy. ilmarchesiandrea@gmail.com
authors: A
authors: A
authors: Marchesi
authors: M
authors: M
authors: Marchesi
authors: F C
authors: FC
authors: Fasulo
authors: O
authors: O
authors: Morini
authors: L
authors: L
authors: Vaienti
mesh_terms: D001940:Breast / Q000601:surgery*; D001941:Breast Diseases / Q000523:psychology / Q000601:surgery; D005260:Female; D006801:Humans; D007258:Informed Consent / Q000331:legislation & jurisprudence; D007558:Italy; D016365:Liability, Legal; D016462:Mammaplasty / Q000331:legislation & jurisprudence* / Q000523:psychology; D019300:Medical Errors / Q000331:legislation & jurisprudence*; D010817:Physician-Patient Relations; D013518:Surgery, Plastic / Q000331:legislation & jurisprudence*