Aesthetic medical interventions have been practiced since ancient times and have evolved significantly over the years. Particularly during the First and Second World Wars, plastic surgeries were developed to repair body deformities and organ losses caused by injuries. These efforts marked the beginning of advancements in the aesthetic field, which, in recent years, has made substantial progress worldwide, with a notable increase in the number of aesthetic surgeries. The growth of this field is attributed to changing values in modern life, as well as advancements in medicine and science. But what exactly are aesthetic medical interventions, which have been present in our lives for centuries and have recently seen significant development?

Aesthetic medical interventions are those carried out to correct perceived appearance defects or, even in the absence of such defects, to enhance a person’s beauty. These procedures include rhinoplasty (nose job), breast augmentation or reduction using silicone implants, ear reduction or correction of protruding ears, and aesthetic abdominoplasty (tummy tuck), among others.

Aesthetic medical procedures can be performed both for therapeutic and beautifying purposes, or they may serve both functions simultaneously.

The distinction between aesthetic and therapeutic medical interventions is also reflected in the legal context. In medical interventions, the legal relationship between the doctor and the patient is a contractual one. While therapeutic medical interventions fall under the scope of a mandate contract, aesthetic procedures are classified as a “work contract” (eser sözleşmesi).

Work Contract in Aesthetic Interventions

Since aesthetic procedures are considered a work contract, the doctor is responsible for delivering the promised result. Unlike other medical interventions, where the doctor must simply act with due care, in aesthetic procedures, the doctor is obligated to achieve the desired result that was agreed upon with the patient.

For example, in a legal case decided by the Turkish Court of Cassation, it was clarified that an aesthetic procedure, such as surgery, falls under the provisions of a “work contract,” and the doctor is required to guarantee the outcome:

“The agreement made for the aesthetic intervention is considered a work contract. Based on the nature of the contract, it is understood that the relationship between the doctor and the patient is not the same as a medical treatment contract, and the provisions of the work contract should apply. According to Article 470 of the Turkish Civil Code, the contractor is required to deliver a finished work, and the client undertakes to pay for it. Due to the nature of the work contract, the contractor guarantees the result.”
(T.C. Court of Cassation, 15th Civil Chamber, E. 2018/18, K. 2019/930, T. 4.3.2019)

The Doctor’s Legal Responsibility

In aesthetic surgeries, the primary obligation of the surgeon, as established by the contract, is to deliver the agreed-upon result. In addition to this primary obligation, the surgeon also has secondary duties that arise from the contract. These include diagnosing the patient, choosing and applying the most appropriate treatment, performing the procedure personally, informing the patient, maintaining confidentiality, and ensuring the patient’s safety and well-being.

For the treatment to be considered in accordance with the contract, the surgeon must fulfill both the primary and secondary obligations. If the surgeon fails to meet these obligations, legal responsibility may arise.

Conditions for Legal Liability in Aesthetic Procedures

In aesthetic surgeries, the doctor’s legal responsibility arises under certain conditions. First, the doctor must act in a negligent or intentional manner that is in violation of the contract. This faulty behavior must result in harm to the patient, and there must be a causal link between the doctor’s actions and the harm suffered. If these conditions are met, the doctor can be held legally responsible.

For example, if the outcome of an aesthetic procedure does not meet expectations—such as an unnatural-looking, overly lifted nose, excessive fat removal during liposuction, or unsatisfactory results from a hair transplant—the doctor may be held liable for the damage caused.

Conclusion

Aesthetic surgeries are considered work contracts, which means that the doctor guarantees the outcome of the procedure. If the results are not as expected, or if the patient does not achieve the promised aesthetic outcome, the doctor may be legally responsible. If the doctor’s negligence or intentional fault causes harm to the patient, and there is a causal link between the doctor’s actions and the resulting harm, the patient may demand compensation for both material and non-material damages from the doctor who performed the intervention.

Av. Şefik ZİROĞLU & Stj. Av. Neslihan Öykü ŞAHİN