Can a Patient Claim Compensation When the Expected Result Is Not Achieved After Cosmetic Surgery?

A patient undergoes rhinoplasty expecting a smaller and symmetrical nose. Another patient undergoes breast augmentation but is left with visible asymmetry. A facelift results in scarring, or liposuction creates irregularities that did not exist before the operation.

The doctor responds:

“There was no medical error. This is a recognised complication.”

Does that automatically end the patient’s compensation claim?

Under Turkish law, particularly in light of recent Court of Cassation decisions, the answer is increasingly clear:

No.

Failure to achieve the expected aesthetic result is not necessarily “medical malpractice” in the traditional sense of a negligent medical act. However, where the procedure was performed principally for cosmetic purposes, Turkish courts frequently classify the relationship as a contract for work (eser sözleşmesi) rather than an ordinary medical mandate.

This distinction can dramatically change the outcome of the case.

In fact, recent Court of Cassation decisions demonstrate that a doctor may potentially face civil liability even where the medical procedure itself was technically performed according to medical standards, if the promised aesthetic result was not achieved.

1. What Is Medical Malpractice?

Medical malpractice generally refers to damage caused because a physician fails to comply with accepted medical standards while performing diagnosis, treatment, surgery or follow-up care.

Typical examples include:

• performing an incorrect surgical technique;
• failing to take necessary pre-operative precautions;
• damaging an organ through negligent surgery;
• failing to diagnose a condition;
• using an inappropriate implant;
• failing to treat an infection;
• failing to monitor post-operative complications;
• administering the wrong medication;
• failing to react appropriately to bleeding; or
• performing surgery without adequate professional competence.

The central issue in traditional malpractice cases is usually fault.

The court asks:

Did the doctor act in accordance with the medical knowledge and professional standards applicable at the time of the intervention?

Cosmetic surgery litigation, however, introduces an additional question:

Even if the doctor acted medically correctly, did the doctor actually produce the aesthetic result promised to the patient?

This second question is what distinguishes many cosmetic surgery cases from ordinary medical malpractice claims.

2. Turkish Courts Frequently Treat Purely Cosmetic Surgery as a Contract for Work

Article 470 of the Turkish Code of Obligations No. 6098 defines a contract for work as an agreement under which the contractor undertakes to produce a work in return for payment.

In ordinary medical treatment, the physician generally undertakes to provide treatment carefully and professionally. The physician does not guarantee that the patient will recover.

For example, an oncologist cannot normally guarantee that cancer treatment will succeed.

A surgeon performing medically necessary heart surgery cannot guarantee that the patient will obtain a particular biological outcome.

Purely cosmetic surgery is treated differently in a substantial line of Court of Cassation jurisprudence.

Where the principal objective is to produce a particular appearance, the physician is not considered merely to have undertaken an activity. The physician may be considered to have undertaken the production of a specific result.

The Court of Cassation, 6th Civil Chamber, reaffirmed this approach in its decision dated 17 November 2025, E. 2024/3670, K. 2025/3903. The Court held that cosmetic surgical procedures fall within the concept of a contract for work and emphasised the physician’s obligation concerning the promised result. The Court reversed the dismissal of the patient’s action even though the lower court had concluded that the remaining scars were not attributable to medical malpractice.

This is one of the most practically significant developments in aesthetic surgery litigation.

3. Therefore, “No Medical Error” Does Not Necessarily Mean “No Liability”

This distinction should be understood carefully.

Consider the following example.

A patient undergoes breast-lift surgery purely for cosmetic reasons.

After surgery:

• the operation is technically performed correctly;
• no infection develops;
• there is no nerve injury;
• the surgical technique complies with medical standards;

but substantial and aesthetically disturbing scars remain.

An expert report may state:

“There is no medical malpractice because scarring is a possible consequence of the procedure.”

Traditionally, a court might consider such a report sufficient to dismiss the lawsuit.

Recent Court of Cassation jurisprudence suggests that this analysis may be incomplete.

In the 17 November 2025 decision, the Court expressly criticised an approach focusing only on whether medical malpractice existed. It considered whether the aesthetic result undertaken under the contract for work had actually been achieved.

Accordingly, two separate questions must be asked:

Question 1 — Medical Standard:
Was the operation performed according to accepted medical standards?

Question 2 — Contractual Result:
Was the aesthetic result promised to the patient actually achieved?

A doctor may potentially satisfy the first requirement while failing the second.

4. A Recent Court of Cassation Decision Makes This Distinction Particularly Clear

The Court of Cassation, 6th Civil Chamber, in its decision E. 2023/3390, K. 2024/5053 dated 23 December 2024, examined claims concerning several aesthetic procedures, including removal of abdominal fat and cosmetic procedures involving the breasts and genital area.

The lower courts had relied on expert reports focusing principally on whether the physician had performed a medically improper intervention.

The Court of Cassation found this insufficient.

It stated that, because the relationship constituted a contract for work, the assessment also had to determine whether the patient’s expectations and the promised aesthetic outcome had been fulfilled.

The allegations included:

• breasts remaining disproportionately large;
• persistent abdominal irregularities;
• problems relating to sutures;
• residual aesthetic defects; and
• failure to perform part of the agreed cosmetic procedure.

The Court held that merely determining that the intervention was medically appropriate did not adequately resolve whether the contractual result had been achieved.

For cosmetic surgery litigation, this is a crucial distinction.

5. Is Every Patient Who Is Unhappy With the Result Entitled to Compensation?

No.

The Court of Cassation’s approach should not be interpreted as creating an unlimited guarantee of subjective satisfaction.

A patient cannot necessarily establish liability merely by stating:

“I do not like my new nose.”

There must normally be an objectively assessable relationship between:

• the appearance promised before surgery;
• the purpose of the operation;
• the patient’s condition before surgery;
• the result achieved after surgery; and
• the medical and aesthetic characteristics of that result.

A court will therefore distinguish between subjective dissatisfaction and an objectively defective aesthetic result.

Examples potentially supporting a stronger claim include:

• significant asymmetry;
• visible deformity;
• excessive or abnormal scarring;
• a nose visibly inconsistent with the agreed correction;
• implants placed at materially different levels;
• deformities created by liposuction;
• an agreed area not being treated at all;
• facial irregularity created by the procedure;
• eyelids failing to close properly after blepharoplasty;
• an objectively unsuccessful hair transplant;
• unexpected loss of tissue; or
• a second corrective operation becoming medically necessary.

By contrast, minor differences between a patient’s subjective ideal and an objectively successful result will not necessarily create liability.

6. The Difference Between Cosmetic and Medically Necessary Surgery Is Critical

Not every plastic surgery procedure should automatically be classified as a contract for work.

The purpose of the surgery matters.

Consider two rhinoplasty procedures.

Scenario A — Purely Cosmetic Rhinoplasty

The patient has no breathing problem.

The operation is performed solely to:

• reduce the size of the nose;
• correct the tip;
• change the profile; and
• obtain a particular appearance.

This relationship is much more likely to be assessed under the contract-for-work principles applied by the Court of Cassation.

Scenario B — Functional Nasal Surgery

The patient suffers from severe breathing problems due to a deviated septum.

The primary purpose is medical treatment.

This is closer to the traditional physician-patient relationship where the physician undertakes professional care rather than guaranteeing a particular result.

Turkish legal scholarship also emphasises this distinction, noting that procedures performed without a medical necessity and specifically aimed at producing a desired external appearance are more appropriately analysed under contract-for-work principles.

In practice, many procedures are mixed.

A rhinoplasty may involve both functional breathing correction and cosmetic reshaping.

Such cases require careful examination of the actual agreement between the parties.

7. “It Was a Complication” Is Not Always a Complete Defence

One of the most common defences in malpractice litigation is:

“The outcome was a recognised complication.”

A complication is generally an undesirable consequence that may occur despite medically appropriate treatment and reasonable care.

Where ordinary medical treatment is concerned, establishing that an outcome was an unavoidable complication may substantially weaken a malpractice claim.

But cosmetic surgery is different.

The Court of Cassation, 6th Civil Chamber, in E. 2023/2664, K. 2024/5122, considered a case involving tissue necrosis and haematoma following cosmetic surgery. Expert evidence had regarded these conditions as complications that could arise despite appropriate care.

Nevertheless, the Court criticised the dismissal of the claim because the analysis failed adequately to address the fact that the cosmetic operation constituted a contract for work and whether the promised aesthetic result had actually been achieved.

This creates an important practical rule:

A finding that an adverse outcome is a complication does not necessarily resolve an aesthetic surgery dispute.

The court should additionally consider:

1. whether the complication was adequately disclosed;
2. whether it was properly managed;
3. whether the promised aesthetic result was nevertheless achieved; and
4. whether the resulting work should be considered defective.

8. Complication Management Can Itself Become Malpractice

Even when the initial complication is unavoidable, what happens afterward may create liability.

Suppose a patient develops an infection after breast augmentation.

An infection may occur despite appropriate surgery.

But if the physician:

• ignores the patient’s symptoms;
• refuses to examine the patient;
• delays antibiotic treatment;
• fails to order necessary tests;
• does not remove an infected implant when medically necessary; or
• leaves the patient without proper post-operative monitoring,

the management of the complication itself may constitute malpractice.

The Court of Cassation has repeatedly required courts dealing with cosmetic procedures to examine not only whether a complication arose, but also whether appropriate precautions were taken and whether the complication was properly managed.

Therefore:

Complication does not equal malpractice.

But:

Negligent management of a complication may constitute malpractice.

9. Informed Consent Is a Separate Basis of Liability

Even a perfectly performed operation can create legal liability if the patient was not properly informed.

Article 15 of the Patient Rights Regulation requires patients to be informed about matters including:

• the nature and course of the condition;
• how and by whom the intervention will be performed;
• alternative treatment options;
• benefits and risks;
• potential effects;
• significant characteristics of medications; and, critically,
• possible complications.

Article 24 separately establishes the principle that medical interventions require the patient’s consent.

Accordingly, obtaining a signature on a one-page standard form shortly before surgery does not necessarily establish valid informed consent.

The key question is whether the patient was actually given sufficient information to make an informed decision.

10. A Standard Consent Form Does Not Automatically Protect the Doctor

Consider a facelift operation resulting in permanent numbness.

The hospital produces a signed consent form.

The relevant complication is not mentioned.

Can the hospital merely argue:

“The patient signed a consent form.”

Not necessarily.

The Court of Cassation, 6th Civil Chamber, in E. 2023/1864, K. 2024/4484 dated 28 November 2024, examined aesthetic procedures including facelift and liposuction. Among the issues identified was that certain complications, including numbness, were not included in the informed consent documentation. The Court emphasised both the aesthetic result and informed-consent dimension of the dispute.

The Constitutional Court has also referred to Court of Cassation jurisprudence placing importance on adequate informed consent and has recognised the constitutional significance of properly addressing claims that a patient was not informed about foreseeable risks and complications.

For a cosmetic procedure — where there is frequently no medical necessity — the quality of informed consent becomes even more significant.

A healthy person is voluntarily exposing his or her body to surgical risk.

The decision must therefore be genuinely informed.

11. Before-and-After Photographs Can Become Critical Evidence

One unusual feature of cosmetic surgery litigation is that the result is frequently visible.

Photographs therefore become especially important.

A patient considering a claim should preserve:

• photographs taken immediately before the procedure;
• clinic photographs;
• photographs taken during the recovery process;
• photographs showing the final result;
• photographs documenting scars or asymmetry;
• videos demonstrating functional problems; and
• dated photographs showing how the condition evolved.

The best evidence will generally allow the expert and the court to compare:

before surgery → promised result → actual result.

This can sometimes be more useful than a generic expert conclusion stating merely that the surgical technique complied with medical standards.

12. WhatsApp Messages and Social Media Promises May Be Important

A patient’s case may also depend heavily on what the physician promised before surgery.

Evidence may include:

• WhatsApp conversations;
• Instagram messages;
• emails;
• consultation notes;
• drawings made during consultation;
• computer-generated simulations;
• written treatment plans;
• invoices;
• promotional materials;
• clinic advertisements; and
• messages describing the expected appearance.

Suppose the doctor tells the patient:

“There will be almost no visible scar.”

If a significant permanent scar subsequently develops, that representation may become highly relevant when determining the contractual result and the scope of informed consent.

The same applies where a doctor explicitly promises:

• complete symmetry;
• a specific nose profile;
• no visible scarring;
• removal of a particular deformity; or
• treatment of several specific body areas.

For this reason, pre-operative correspondence should not be deleted.

13. What Can the Patient Claim?

Where liability is established, several remedies may become available depending on the factual and contractual structure.

Under the Turkish Code of Obligations, defective performance under a contract for work can give rise to remedies associated with defective work, including certain rights concerning repair, reduction of the price or withdrawal from the contract, where the statutory requirements are satisfied.

In cosmetic surgery disputes, claims commonly focus on material and moral damages.

Material Damages

These may include:

• the amount paid for the unsuccessful procedure;
• corrective surgery costs;
• hospital expenses;
• medication costs;
• physical therapy expenses;
• psychological treatment expenses;
• travel costs for corrective treatment;
• loss of earnings;
• costs of future operations; and
• other medically necessary expenditure caused by the unsuccessful procedure.

In Yargıtay 6th Civil Chamber, E. 2024/1771, K. 2025/2009, the Court stated that treatment expenses arising from the consequences of an aesthetic procedure — including physical rehabilitation and psychological treatment where properly proven — had to be investigated when calculating material loss.

Moral Damages

A failed cosmetic procedure may have considerable psychological consequences.

The patient may experience:

• loss of self-confidence;
• humiliation;
• social withdrawal;
• anxiety;
• depression;
• distress caused by permanent scars;
• reduced quality of life; or
• psychological suffering caused by a visible deformity.

Where the legal requirements are established, an appropriate amount of moral compensation may therefore be claimed.

Recent Court of Cassation decisions expressly indicate that moral damages should be evaluated where the promised aesthetic result has not been achieved.

14. Corrective Surgery Costs May Be Particularly Important

Suppose the first cosmetic procedure costs TRY 200,000.

The patient subsequently consults another surgeon, who determines that correcting the defect will require two operations costing TRY 500,000.

The patient’s damage is not necessarily limited to refunding the original TRY 200,000.

If the corrective procedures are necessary because of the defective first operation, the reasonable cost of those procedures may potentially constitute part of the recoverable material damage.

Future treatment should therefore be documented through:

• physician reports;
• treatment plans;
• quotations;
• medical imaging;
• expert evidence; and
• invoices where treatment has already been performed.

15. Who Can Be Sued: The Doctor, the Hospital or Both?

Where the procedure is carried out in a private hospital or private medical institution, liability should be analysed separately for:

• the operating physician;
• the private hospital or clinic; and
• where applicable, other healthcare professionals involved.

Depending on the contractual relationship and the factual basis of liability, claims may be brought against both the physician and healthcare provider.

Court of Cassation decisions in cosmetic surgery disputes frequently concern claims brought against both the physician and private hospital, and in appropriate cases compensation has been considered on the basis of joint liability.

Identifying the correct defendant is therefore important before filing suit.

16. Which Court Deals With Cosmetic Surgery Claims?

For cosmetic services obtained from private healthcare providers by an individual patient, recent Court of Cassation cases demonstrate that these disputes are frequently heard by Consumer Courts.

For example, the Court of Cassation’s recent aesthetic surgery cases reviewed decisions originating from Istanbul and Samsun Consumer Courts.

Under Article 73/A of the Consumer Protection Law No. 6502, mediation is generally a condition for bringing proceedings before a Consumer Court, subject to statutory exceptions, including matters within the jurisdiction of Consumer Arbitration Committees.

The competent procedural route should nevertheless be determined according to the amount claimed, identity of the healthcare provider and characteristics of the specific case.

Claims concerning treatment provided through public hospitals require a different analysis because administrative liability and administrative-court procedures may become applicable.

17. An Expert Report Must Ask the Correct Question

One of the most important lessons from recent Court of Cassation jurisprudence concerns expert evidence.

An expert report should not merely answer:

“Was there medical malpractice?”

In cosmetic surgery disputes, the report should also address:

• What was the patient’s condition before surgery?
• What was the purpose of the procedure?
• What result was promised?
• Was that result medically achievable?
• Was the operation performed according to medical standards?
• Did a complication occur?
• Was the patient informed about that complication?
• Was the complication properly managed?
• What is the patient’s current aesthetic and functional condition?
• Does the final result satisfy the promised aesthetic objective?
• Is there an objectively defective result?
• Can the defect be corrected?
• What treatment will be necessary?
• What will corrective treatment cost?
• Is any damage permanent?

Recent Court of Cassation decisions have repeatedly reversed judgments where expert reports focused solely on technical medical fault while failing to address the result obligation arising from the contract for work.

This can be decisive when challenging an unfavourable expert report.

18. Practical Example: “The Operation Was Successful, But the Nose Is Still Crooked”

Consider the following scenario.

A patient consults a private plastic surgeon for purely cosmetic rhinoplasty.

The patient has no respiratory condition.

Before surgery, the surgeon explains that:

• the nasal hump will be removed;
• the tip will be corrected;
• the nose will become symmetrical; and
• the overall profile will become substantially straighter.

After the healing period, the patient’s nose remains visibly crooked and a new asymmetry has developed.

An expert concludes:

“The surgical technique complies with medical standards. There is no conventional medical malpractice.”

Under the current Court of Cassation approach, the case should not necessarily end there.

The court should also investigate:

Was the cosmetic result contractually undertaken by the surgeon actually achieved?

If not, the resulting work may potentially be considered defective even though no traditional technical malpractice is established.

That distinction can support claims for:

• the cost of corrective rhinoplasty;
• repayment or reduction of the original fee;
• related medical expenses; and
• appropriate moral compensation.

19. Practical Example: The Result Is Unsatisfactory but the Doctor Never Promised Perfection

Now consider the opposite situation.

A patient undergoes cosmetic surgery.

Before surgery, the doctor clearly explains that:

• perfect symmetry is biologically impossible;
• some degree of scarring is inevitable;
• the patient’s skin characteristics create particular limitations;
• the expected improvement is limited;
• photographs are illustrations rather than guarantees; and
• specific complications may arise.

The surgery complies with medical standards.

The resulting appearance is objectively improved and within the scope discussed before surgery.

The patient nevertheless states:

“I expected to look better.”

Such subjective dissatisfaction alone is considerably less likely to establish liability.

The patient’s expectations must be assessed in light of the actual contractual undertaking and objective medical evidence.

Therefore, not every disappointing cosmetic result is malpractice or defective performance.

20. What Should a Patient Do After an Unsuccessful Cosmetic Operation?

A patient who believes that a cosmetic procedure has failed should first preserve evidence before undergoing corrective treatment.

Important material includes:

• the complete patient file;
• operation reports;
• anaesthesia records;
• informed-consent forms;
• invoices;
• payment receipts;
• laboratory results;
• implant information;
• pre-operative photographs;
• post-operative photographs;
• WhatsApp conversations;
• emails;
• advertisements and promotional representations;
• hospital records;
• control-visit records;
• prescriptions;
• expert opinions from other physicians; and
• documents showing corrective treatment costs.

Article 16 of the Patient Rights Regulation gives patients the right to inspect and obtain copies of medical records relating to their condition.

Records should preferably be obtained before a dispute escalates.

Conclusion: A Bad Aesthetic Result Can Create Liability Even Without Traditional Medical Malpractice

The question:

“The cosmetic surgery did not produce the expected result. Is this malpractice?”

does not have a simple yes-or-no answer.

Under Turkish law, three different forms of potential liability should be examined separately:

1. Medical malpractice:
Did the physician violate medical standards?

2. Defective aesthetic performance:
Where the operation was performed for cosmetic purposes under a contract-for-work relationship, was the promised result actually produced?

3. Informed-consent liability:
Was the patient properly informed about realistic outcomes, alternatives, risks and complications before agreeing to the procedure?

Recent Court of Cassation jurisprudence makes one point particularly important:

In a purely aesthetic intervention, the absence of conventional medical malpractice does not automatically eliminate civil liability.

Where a particular aesthetic result was undertaken but the result was not achieved, the physician and, depending on the circumstances, the private healthcare institution may still face liability under the rules governing contracts for work.

Therefore, the most important question in cosmetic surgery litigation is often no longer merely:

“Did the doctor make a medical mistake?”

It is also:

“What exactly did the doctor promise — and is that what the patient actually received?”