Saule A Mussabekova, Yuliya Menchisheva, Álvaro Varela Morillas
{"title":"美体手术引起的诉讼和并发症:系统综述。","authors":"Saule A Mussabekova, Yuliya Menchisheva, Álvaro Varela Morillas","doi":"10.1007/s00266-025-05276-y","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Aesthetic body surgeries such as liposuction, abdominoplasty, gluteoplasty, and breast augmentation have seen a global rise. However, the growing popularity of these procedures has led to increased reports of postoperative complications and medico-legal disputes.</p><p><strong>Objective: </strong>To systematically review complications and litigation outcomes associated with aesthetic body surgeries and identify the most common risk factors contributing to legal claims.</p><p><strong>Methods: </strong>A systematic review was conducted in accordance with PRISMA guidelines (registration on PROSPERO ID: CRD420251043585). Forty-one studies published since between 2020 and 2025 were included. Complications, allegations, and legal outcomes were extracted and analysed. Risk of bias was assessed using JBI and ROBINS-I tools.</p><p><strong>Results: </strong>Infection (48.7%), fat embolism (26.8%), and hematoma (21.9%) were the most frequent complications. Gluteal fat grafting had the highest mortality and legal risk, with a 7.77% incidence of fat embolism. Inadequate informed consent was a leading allegation in over 50% of cases. Claims most often resulted in dismissal (45-76%), but 20-40% led to settlements or plaintiff verdicts, especially in cases of severe complications such as embolism or disfigurement. The pooled average of favourable verdicts for surgeons was 54.3% (95% CI: 49-59%). Publication bias was suggested by asymmetrical funnel plot distribution and high heterogeneity (I<sup>2</sup> > 90%).</p><p><strong>Conclusion: </strong>Medico-legal disputes in aesthetic body surgery commonly arise from preventable complications, especially when informed consent is inadequate or postoperative care is substandard. Standardised consent process, improved documentation, procedure-specific risk communication, and regulation of outpatient practices are critical to reducing litigation risk.</p><p><strong>Level of evidence iii: </strong>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .</p>","PeriodicalId":7609,"journal":{"name":"Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":2.8000,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Litigation and Complications Arising from Aesthetic Body Surgery: A Systematic Review.\",\"authors\":\"Saule A Mussabekova, Yuliya Menchisheva, Álvaro Varela Morillas\",\"doi\":\"10.1007/s00266-025-05276-y\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Aesthetic body surgeries such as liposuction, abdominoplasty, gluteoplasty, and breast augmentation have seen a global rise. However, the growing popularity of these procedures has led to increased reports of postoperative complications and medico-legal disputes.</p><p><strong>Objective: </strong>To systematically review complications and litigation outcomes associated with aesthetic body surgeries and identify the most common risk factors contributing to legal claims.</p><p><strong>Methods: </strong>A systematic review was conducted in accordance with PRISMA guidelines (registration on PROSPERO ID: CRD420251043585). Forty-one studies published since between 2020 and 2025 were included. Complications, allegations, and legal outcomes were extracted and analysed. Risk of bias was assessed using JBI and ROBINS-I tools.</p><p><strong>Results: </strong>Infection (48.7%), fat embolism (26.8%), and hematoma (21.9%) were the most frequent complications. Gluteal fat grafting had the highest mortality and legal risk, with a 7.77% incidence of fat embolism. Inadequate informed consent was a leading allegation in over 50% of cases. Claims most often resulted in dismissal (45-76%), but 20-40% led to settlements or plaintiff verdicts, especially in cases of severe complications such as embolism or disfigurement. The pooled average of favourable verdicts for surgeons was 54.3% (95% CI: 49-59%). Publication bias was suggested by asymmetrical funnel plot distribution and high heterogeneity (I<sup>2</sup> > 90%).</p><p><strong>Conclusion: </strong>Medico-legal disputes in aesthetic body surgery commonly arise from preventable complications, especially when informed consent is inadequate or postoperative care is substandard. Standardised consent process, improved documentation, procedure-specific risk communication, and regulation of outpatient practices are critical to reducing litigation risk.</p><p><strong>Level of evidence iii: </strong>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .</p>\",\"PeriodicalId\":7609,\"journal\":{\"name\":\"Aesthetic Plastic Surgery\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2025-10-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Aesthetic Plastic Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00266-025-05276-y\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Aesthetic Plastic Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00266-025-05276-y","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
Litigation and Complications Arising from Aesthetic Body Surgery: A Systematic Review.
Background: Aesthetic body surgeries such as liposuction, abdominoplasty, gluteoplasty, and breast augmentation have seen a global rise. However, the growing popularity of these procedures has led to increased reports of postoperative complications and medico-legal disputes.
Objective: To systematically review complications and litigation outcomes associated with aesthetic body surgeries and identify the most common risk factors contributing to legal claims.
Methods: A systematic review was conducted in accordance with PRISMA guidelines (registration on PROSPERO ID: CRD420251043585). Forty-one studies published since between 2020 and 2025 were included. Complications, allegations, and legal outcomes were extracted and analysed. Risk of bias was assessed using JBI and ROBINS-I tools.
Results: Infection (48.7%), fat embolism (26.8%), and hematoma (21.9%) were the most frequent complications. Gluteal fat grafting had the highest mortality and legal risk, with a 7.77% incidence of fat embolism. Inadequate informed consent was a leading allegation in over 50% of cases. Claims most often resulted in dismissal (45-76%), but 20-40% led to settlements or plaintiff verdicts, especially in cases of severe complications such as embolism or disfigurement. The pooled average of favourable verdicts for surgeons was 54.3% (95% CI: 49-59%). Publication bias was suggested by asymmetrical funnel plot distribution and high heterogeneity (I2 > 90%).
Conclusion: Medico-legal disputes in aesthetic body surgery commonly arise from preventable complications, especially when informed consent is inadequate or postoperative care is substandard. Standardised consent process, improved documentation, procedure-specific risk communication, and regulation of outpatient practices are critical to reducing litigation risk.
Level of evidence iii: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
期刊介绍:
Aesthetic Plastic Surgery is a publication of the International Society of Aesthetic Plastic Surgery and the official journal of the European Association of Societies of Aesthetic Plastic Surgery (EASAPS), Società Italiana di Chirurgia Plastica Ricostruttiva ed Estetica (SICPRE), Vereinigung der Deutschen Aesthetisch Plastischen Chirurgen (VDAPC), the Romanian Aesthetic Surgery Society (RASS), Asociación Española de Cirugía Estética Plástica (AECEP), La Sociedad Argentina de Cirugía Plástica, Estética y Reparadora (SACPER), the Rhinoplasty Society of Europe (RSE), the Iranian Society of Plastic and Aesthetic Surgeons (ISPAS), the Singapore Association of Plastic Surgeons (SAPS), the Australasian Society of Aesthetic Plastic Surgeons (ASAPS), the Egyptian Society of Plastic and Reconstructive Surgeons (ESPRS), and the Sociedad Chilena de Cirugía Plástica, Reconstructiva y Estética (SCCP).
Aesthetic Plastic Surgery provides a forum for original articles advancing the art of aesthetic plastic surgery. Many describe surgical craftsmanship; others deal with complications in surgical procedures and methods by which to treat or avoid them. Coverage includes "second thoughts" on established techniques, which might be abandoned, modified, or improved. Also included are case histories; improvements in surgical instruments, pharmaceuticals, and operating room equipment; and discussions of problems such as the role of psychosocial factors in the doctor-patient and the patient-public interrelationships.
Aesthetic Plastic Surgery is covered in Current Contents/Clinical Medicine, SciSearch, Research Alert, Index Medicus-Medline, and Excerpta Medica/Embase.