Claims insights: plastic, reconstructive and cosmetic surgeons

Find out the underlying themes and insights from our analysis to reduce your risk of claims and complaints. What are the main issues driving claims and complaints and how many surgeons are affected?

Tuesday, 2 July 2024

Overview

Practice points

Most claims and complaints related to procedural/surgical issues (72%) followed by consent issues (13%).
The predominant issue was surgical performance, skill, or competence due to outcomes such as deformity or problems with symmetry, size, shape or texture.
Almost half of the claims and complaints in procedural/ surgical claims were about breast procedures, and more than a third were about skin, general plastic and cosmetic procedures.
The claims and complaints analysed here relate to treatment provided before the introduction of the Medical Board's cosmetic surgery guidelines on 1 July 2023.

Patient dissatisfaction with the outcome and their appearance post-procedure drives claims and complaints.
This highlights the importance of carefully managing patient expectations through good communication, providing examples of realistic results, a thorough consent process and clear documentation.
In almost 60% of claims and complaints, surgeons were found to have met the standard of care.
All doctors performing cosmetic surgery are expected to comply with the Medical Board of Australia’s guidelines for performing cosmetic surgery and advertising cosmetic surgery.

_{Incidence and breakdown by type of matter are based on all matters indemnified by Avant for plastic, reconstructive and cosmetic surgeons from FY2019–23. Underlying themes and assessment of care are based on Avant claims and complaints closed during the period FY2019–23.}

1 in 3*

Avant plastic, reconstructive and cosmetic surgeon members had a medico-legal matter raised about the provision of their care, each year (* five-year average).

The types of matters included claims for compensation (49%), regulatory complaints (41%), employment disputes (4%) and other matters (5%).

_{Percentages may not total 100 due to rounding.}

Types of compensation claims and regulatory complaints

Procedural/surgical issues

Of all procedural/surgical claims and complaints, 49% were for breast procedures and 36% were for skin, general plastic and cosmetic procedures, with the following breakdown:

Breast procedures

Skin, general plastic and cosmetic procedures

Breast procedures

Skin, general plastic and cosmetic procedures

Most common issues were:

allegations of poor surgical performance, skill or competence (e.g. breast deformity, issues with outcome such as in the symmetry/size/shape/texture of breasts, post-operative complications)
allegations of improper selection, misuse or insertion of implants (e.g. issues with the outcome in relation to the implant such as its symmetry/size/shape/texture).

Most common issue was:

allegations of poor surgical performance, skill or competence (e.g. disfigurement, issues with outcome such as in its symmetry/shape/texture, post-operative complications).

Consent issues

Consent issues account for 13% of claims and complaints. The most common allegations included risks not adequately discussed or that a clear explanation of the procedure or treatment was not provided.

Assessment of the care provided

Experts and/or regulators assessed the care provided, with the following results: 42% below standard and 58% met the standard of care (where the assessment of the expected standards on the main factor is known).

Our data

This retrospective review is of routinely collected and coded data and is based on matters involving Avant plastic, reconstructive and cosmetic surgeon members from across Australia. The analysis excludes cosmetic practitioners not fellowed with RACS.

Glossary

Matters include claims, complaints, coronial cases and other matters such as employment disputes and Medicare.
Claims refers to claims for money, compensation and civil claims.
Complaints relates to formal complaints to regulators.
Employment disputes are matters where Avant defends members against complaints or supports members to resolve employment issues.
Medicare matters include Medicare investigations and audits.

More information

For medico-legal advice, please contact us on nca@avant.org.au or call 1800 128 268, 24/7 in emergencies.

Disclaimers

IMPORTANT: Avant routinely codes information collected in the course of assisting member doctors in medico-legal matters into a standardised, deidentified dataset. This retrospective analysis was conducted using this dataset. The findings represent the experience of these doctors in the period of time specified, which may not reflect the experience of all doctors in Australia. This publication is not comprehensive and does not constitute legal or medical advice. You should seek legal or other professional advice before relying on any content, and practise proper clinical decision-making with regard to the individual circumstances. Persons implementing any recommendations contained in this publication must exercise their own independent skill or judgement or seek appropriate professional advice relevant to their own particular practice. Compliance with any recommendations will not in any way guarantee discharge of the duty of care owed to patients and others coming into contact with the health professional or practice. Avant is not responsible to you or anyone else for any loss suffered in connection with the use of this information. Information is only current at the date initially published [July 2024].

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Claims insights: plastic, reconstructive and cosmetic surgeons