Lawsuits after dermal filler injection registered in the state Court of São Paulo

The search for aesthetic procedures in the health sector have increased in the last years. The increase in the number of procedures brought together a higher number of lawsuits, especially when it comes to the injection of dermal fillers. This study aimed to revisit the jurisprudence of the State Court of São Paulo, Brazil, to investigate the risk factors behind the lawsuits and convictions of health care professionals after the injection of dermal fillers. The sample consisted of 46 lawsuits published between 2000 and 2022 in the State Court of São Paulo, Brazil. Data extracted from each lawsuit were: the year of publication, the reason behind the lawsuit, the defendant (individual or legal entity), sex of the plaintiff, type of dermal filler, whether there was a technical legal/forensic examination of the case and conviction. Most of the lawsuits were published between 2020 and 2022 (n = 26, 56.52%). The presence of intercurrences was the most common reason behind the lawsuits (n = 27, 58.69%). The defendants were mostly health care providers (n = 16, 34.78%), individually, and their combination with legal entities (n = 16, 34.78%), separately (the rest was legal entities alone). Female plaintiffs were predominant (n = 36, 78.26%), as well as the use of hyaluronic acid as dermal filler (n = 35, 76.08%). Technical legal/forensic examination was registered in 34 lawsuits (73.91%). Most of the defendants were convicted (n = 25, 54.34%). The chance of conviction was 3,9 times higher if the case was judged between 2017-2019 compared to 2020-2022 (p = 0.05); and 3,4 times higher if the case was based on intercurrences (p = 0.05). It is estimated that convictions in lawsuits after dermal filler injections might decrease in more recent cases. However, higher chances of conviction might be expected in the presence of intercurrences (e.g. accidents or complications) in the State São Paulo, Brazil.