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Malpractice on the Rise with Growth in Cosmetic Dermatology

According to the American Society of Plastic Surgeons, the number of minimally invasive cosmetic procedures rose over 186% between 2000 and 2017. Not surprisingly, the largest increases included Botulinum treatments (Botox®, Dysport®, Xeromin®) which were up 819%, soft tissue fillers increased by 312%, and laser skin resurfacing more than doubled at 244%. These procedures are popular with our aging population and are seen as much less risky than plastic surgery. In addition, they are increasingly being offered in nonmedical settings which makes them much more accessible to a larger population. However, as more people undertake these treatments and more practitioners set out to perform them, the risks of malpractice and other types of liability also rise.

Dermatology is a medical specialty involving the evaluation and treatment of conditions related to skin, hair, and nails. Cosmetic Dermatology (also known as Aesthetic Dermatology) focuses on aesthetic procedures including dermal fillers, chemical peels, energy-directed skin treatments (radiofrequency, ultrasound), body contouring, laser skin rejuvenation, laser hair removal, and other treatments. While these procedures may be performed by a dermatologist, many practices delegate aesthetic procedures to mid-level providers such as physician assistants, nurses, and aestheticians. While laws regarding such practices vary from state to state, it is becoming increasingly common to see mid-level providers performing aesthetic dermatology procedures. In some states, there is little to no certification and training required for these individuals.

A study from 2015 compared lawsuits between dermatologists and nondermatologists for the procedure of laser hair removal. While board-certified dermatologists performed two-thirds of these procedures, they were responsible for only a quarter of the liability claims. Similarly, another study found that 43% of legal cases related to laser hair or scar removal involved someone other than a physician performing the treatment.

Although cosmetic dermatology procedures are typically non-invasive and low risk, when performed incorrectly, they can result in serious injuries including infection, change in skin color, scarring, burns, blisters, and ocular damage. Lawsuits against practitioners can be complicated because some procedures may not be considered medical treatment and do not fall under malpractice laws. However, a patient may still be able to sue under other theories such as negligence, battery, or deceptive advertising. There may also be product liability claims related to the chemicals or devices used in providing treatment. This is particularly true of newer devices which often circumvent rigorous FDA oversight through a pathway known as 510(k) premarket notification.

Regardless of the legal theory, expert witnesses are essential to proving or defending claims for injury during cosmetic dermatology. Board-certified Dermatologists can provide invaluable testimony regarding the duty of care, the skill level of the practitioner, causation, and damages. In addition, depending on the nature of the injury, Burn Surgeons, Plastic Surgeons, and Ophthalmologists may be needed to discuss the severity of the injury and prognosis. Depending on the case trajectory and statutory requirements, cases also may require Device Representatives, Aestheticians, Nurses, and other related personnel.

If you are involved with a claim based on cosmetic or aesthetic dermatology, contact Elite Medical Experts. We can help you find nationally recognized university-based expert witnesses with years of experience performing the specific type of cosmetic procedure at issue. 

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