title: From the operating room to the courtroom: a comprehensive characterization of litigation related to facial plastic surgery procedures.
abstract: OBJECTIVE
  Malpractice litigation has increased in recent decades, contributing to higher health-care costs. Characterization of complications leading to litigation is of special interest to practitioners of facial plastic surgery procedures because of the higher proportion of elective cases relative to other subspecialties. In this analysis, we comprehensively examine malpractice litigation in facial plastic surgery procedures and characterize factors important in determining legal responsibility, as this information may be of great interest and use to practitioners in several specialties.
  
  
  METHODS
  Retrospective analysis.
  
  
  METHODS
  The Westlaw legal database was examined for court records pertaining to facial plastic surgery procedures. The term "medical malpractice" was searched in combination with numerous procedures obtained from the American Academy of Facial Plastic and Reconstructive Surgery website.
  
  
  RESULTS
  Of the 88 cases included, 62.5% were decided in the physician's favor, 9.1% were resolved with an out-of-court settlement, and 28.4% ended in a jury awarding damages for malpractice. The mean settlement was $577,437 and mean jury award was $352,341. The most litigated procedures were blepharoplasties and rhinoplasties. Alleged lack of informed consent was noted in 38.6% of cases; other common complaints were excessive scarring/disfigurement, functional considerations, and postoperative pain.
  
  
  CONCLUSIONS
  This analysis characterized factors in determining legal responsibility in facial plastic surgery cases. Several factors were identified as potential targets for minimizing liability. Informed consent was the most reported entity in these malpractice suits. This finding emphasizes the importance of open communication between physicians and their patients regarding expectations as well as documentation of specific risks, benefits, and alternatives.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark, New Jersey 07103, USA.
authors.forename: Peter F
authors.initials: PF
authors.lastname: Svider
authors.forename: Brieze R
authors.initials: BR
authors.lastname: Keeley
authors.forename: Osvaldo
authors.initials: O
authors.lastname: Zumba
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Mauro
authors.forename: Michael
authors.initials: M
authors.lastname: Setzen
authors.forename: Jean Anderson
authors.initials: JA
authors.lastname: Eloy
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005145:Face / Q000601:surgery*; D005260:Female; D006801:Humans; D016365:Liability, Legal; D008297:Male; D008318:Malpractice / Q000331:legislation & jurisprudence*; D008875:Middle Aged; D009873:Operating Rooms / Q000331:legislation & jurisprudence*; D010820:Physicians / Q000331:legislation & jurisprudence*; D012189:Retrospective Studies; D013518:Surgery, Plastic / Q000331:legislation & jurisprudence*; D055815:Young Adult
keywords: Medicolegal; facial plastic surgery malpractice; liability; litigation