Plastic Surgery and Medical Malpractice

Some plastic procedures are undertaken for cosmetic reasons. Others are essential for reconstruction following injuries or the correction of congenital conditions.

Whether cosmetic or reconstructive, plastic surgery can go wrong.

In some cases, complications can result in scarring, deformity or other long-term consequences that significantly affect quality of life.

Below we cover:

• statistics on plastic surgery malpractice and risks
• examples of notorious South African cases
• types of complications that may be grounds for a claim
• who can be held liable and what’s needed for a successful claim.

If you may have a valid medical negligence claim against a doctor, hospital or other healthcare provider in South Africa, contact us at DSC Attorneys for expert legal advice and representation.

Plastic surgery and medical malpractice claims

All surgery carries inherent risks. This means that not all negative outcomes are the result of malpractice.

However, where negligence by medical professionals leads to avoidable harm, patients may have grounds to claim compensation. This applies whether a procedure was elective or medically necessary.

How common is malpractice in plastic surgery?

Plastic surgery is not the highest-risk specialty, but malpractice is a recognised and growing concern worldwide – particularly as the demand for cosmetic procedures increases.

In high-demand countries, research indicates that 13% to 15% of plastic surgeons are involved in at least one malpractice claim annually.

In South Africa, an added concern is that not all procedures are performed by qualified specialists.

According to a 2025 IOL article, a growing number of so-called “cosmetic specialists” lack any formal training in plastic or reconstructive surgery. They continue to offer procedures – often at reduced cost – to unsuspecting patients.

Plastic surgery complications that can give rise to claims

A review of 415 claims by a U.S. malpractice insurer identified a wide spectrum of patient injuries.

Key findings from the review:

• the most frequent injuries were scarring (24%), cosmetic injury (16%), infection (13%) and tissue necrosis (8%)
• 33% of claims involved emotional trauma
• 31% of claims involved a need for further procedures
• less common but significant injuries included burns and nerve damage (each ~5%)
• death occurred in 4% of claims, linked to complications like pulmonary embolism, blood loss or medication-related respiratory depression.

In South Africa, reliable industry-wide statistics are limited. However, reported cases and litigation trends indicate that serious incidents of plastic surgery malpractice do occur. Read some notable examples below.

High-risk plastic surgeries

Procedures associated with a high risk of complications include:

• Brazilian Butt Lift (BBL) surgery:This has thehighest mortality rate of any cosmetic procedure. A life-threatening risk is fat embolism (fat traveling to the heart or lungs and causing a blockage).
  
  A 2023 Mail & Guardian article highlighted the risks associated with BBL procedures in South Africa.
  
  
• Eye colour change surgery (iris implants or tattooing): a very high percentage of patients experience complications like glaucoma, corneal damage or vision loss.
  
  
• Body contouring: procedures like abdominoplasty (tummy tucks) and thigh lifts are associated with high rates of infection, skin necrosis and deep vein thrombosis.
  
  
• Liposuction:especially when extensive or combined with other procedures, liposuction can lead to potentially fatal embolisms and kidney or heart problems due to fluid shifts. Among other risks are internal punctures and contour irregularities.
  
  
• Calf or bicep implants: these can rupture or shift, requiring revision surgery. Risks also include infection and nerve damage.
  
  
• Facelifts and eyelid lifts: Although common, these procedures can have complications like nerve damage, asymmetry and significant scarring.

Examples of medical malpractice cases involving plastic surgery in South Africa

We outline several notable examples of plastic surgery malpractice in South Africa.

The Butcher of Benoni: botched cosmetic surgeries

In 2020, plastic and reconstructive surgeon Luke Gordon was struck off the medical roll following complaints from more than 50 patients.

One patient required a leg amputation after a failed calf implant procedure, while several others experienced severe scarring and deformities following breast reconstruction surgery.

Gordon reportedly paid approximately R4.5 million in damages to affected patients.

Defective breast implants in South Africa

Defective silicone breast implants supplied by Poly Implant Prothèse (PIP) were used in breast augmentation surgeries involving hundreds of women.

The implants were found to contain industrial-grade silicone and were linked to health risks, prompting litigation and compensation claims worldwide.

Although the scandal first emerged in 2010, its legal and medical consequences have continued for years.

Fatality following liposuction

In a serious case of medical negligence, a woman died following liposuction surgery in 2001.

It was alleged that Dr Jan van Almenkerk failed to respond appropriately when the patient’s condition deteriorated after the procedure. He was subsequently found guilty of culpable homicide.

Another notorious plastic surgeon in South Africa

Another South African plastic surgeon, Hennie Roos, faced 28 complaints over a four-year period.

In one case, a patient was awarded damages of R692,000 after a face and forehead lift resulted in severe scarring.

Who may be liable for plastic surgery malpractice

Victims of plastic surgery malpractice may be able to claim compensation from the surgeon who performed the procedure, other involved medical professionals and/or the hospital or medical facility.

Where a procedure occurs in a state hospital, the relevant provincial Department of Health or Member of the Executive Council (MEC) for Health may be liable.

What’s needed for a successful claim

For a claim to be successful, it must be shown that negligence occurred and caused harm.

Examples of negligence may include:

• failure to obtain informed consent
• errors in diagnosis or treatment
• administrative errors affecting care
• inadequate care before, during or after the procedure
• improper monitoring and/or premature discharge.

If you believe you may have grounds for a claim, you are entitled to access your medical records and related information.

Medical malpractice claims are often complex and may take time to resolve. Strong legal representation and expert medical evidence are essential.