Negligent Injury Cosmetic Surgery: Legal Rights Against Substandard Procedures and Malpractice

The increasing demand for aesthetic and medical procedures in recent years has unfortunately led to serious bodily harm caused by unregulated businesses and unauthorized individuals. Tissue loss, nerve damage, and permanent deformities resulting from surgical operations that violate medical standards or faulty procedures performed by individuals without medical qualifications are considered, under criminal law, as the crime of negligent injury through cosmetic surgery . However, the first step to properly initiate the legal process and avoid loss of rights is to clarify whether the harm resulted from a medical error or from an unauthorized intervention that is considered a crime under the law.

The Legal Difference Between Medical Operation and Unlicensed Procedures

In the legal system, not all aesthetic grievances are evaluated on the same legal grounds.

According to the law, there are fundamental differences, both criminally and administratively, between an operation performed by a licensed surgeon in an operating room and interventions performed by someone with the title of aesthetician in an unlicensed center.

• Medical malpractice: This refers to a physician, holding a medical degree and relevant specialization, acting contrary to professional standards, medical science, and the duty of care during diagnosis, treatment, or surgical procedures. While a physician is fully authorized to practice medicine, if they cause harm to a patient by violating their duty of care and diligence, they are held liable under Article 89 of the Turkish Penal Code (TCK) for negligent injury.

• Unauthorized Medical Intervention (Violation of Law No. 1219): According to Law No. 1219 on the Manner of Practice of Medicine and Related Professions ; any invasive procedure involving injections that penetrate the skin, such as Botox, fillers, mesotherapy, anti-aging vaccines, and surgical incisions, can only be performed by medical doctors. It is directly against the law for aestheticians to perform these procedures in beauty salons, hairdressers, or unlicensed establishments known as "underground" businesses. The performance of needle-based procedures by unauthorized individuals in these centers is not merely a professional misconduct; it constitutes a usurpation of medical authority and a crime punishable under the Turkish Penal Code.

• The Fine Line Between Complication and Error: A complication is an undesirable event foreseen in medical literature that can occur despite strict adherence to medical standards and the physician taking all necessary precautions. If the physician has informed the patient of these risks beforehand through an "informed consent form," direct criminal liability may not arise due to the complication. However, the "complication" defense is not legally valid in cases of damage occurring at an unauthorized beauty center. Since the actions of a person lacking the capacity to perform medical procedures are unlawful from the outset, all resulting bodily harm is directly subject to criminal sanctions under the crime of negligent (and, depending on the circumstances of the case, conscious negligence) injury.

What does this mean?

If you have received Botox or filler injections from an unlicensed aesthetician or staff member at a beauty salon, and you experience facial asymmetry, tissue death (necrosis), or infection, this is not simply an "unfortunate incident" or an "ordinary risk." The other party cannot evade responsibility by saying, "This was a possible side effect" or "It was written on the document you signed." It is directly against the law for a non-physician to use needles on your body; therefore, the bodily harm you suffered is not a medical complication but a direct crime of negligent injury in the eyes of the prosecutor's office.

How is faulty aesthetic treatment evaluated within the scope of negligent injury cosmetic surgery?

Cosmetic surgeries and medical aesthetic procedures affect not only a person's physical appearance but also their bodily integrity and quality of life. Therefore, both surgeons performing surgical operations and practitioners carrying out medical procedures in a clinical setting have a duty to exercise the highest level of care and diligence . The crime of negligent injury, regulated in Article 89 of the Turkish Penal Code (TCK), occurs when a person, acting contrary to their duty of care and diligence, unintentionally causes harm to another person's bodily integrity, resulting in injury or impairment of their health.

In the context of aesthetic procedures, the commission of this crime is examined within the framework of the following legal elements, depending on the nature of the act and the severity of the resulting harm:

• Violation of the Duty of Care and Diligence: Acting contrary to the rules of medical science, surgical protocols, and professional standards constitutes negligence. Incomplete preoperative tests, incorrect anesthesia administration, performing surgery contrary to anatomical rules, or failure to provide timely medical follow-up and intervention after the procedure are all violations of this duty.

• Types of Bodily Harm Occurring: Asymmetry and permanent shortness of breath developing after faulty rhinoplasty (nose surgery), severe deformities in breast implant operations, vascular occlusion and tissue necrosis (tissue death) due to faulty filler injections, sensory loss or facial paralysis due to nerve damage are examples of conditions that constitute the direct material consequences of the act of causing injury.

• Causal Link: It must be proven, through reports from the Forensic Medicine Institute (ATK) or a panel of expert witnesses, that the resulting harm directly stemmed from the faulty cosmetic procedure.

• Aggravating Circumstances and Reasons for Increasing the Punishment (Turkish Penal Code Article 89/2 and Article 89/3): The legislator increases the punishment by half or by one fold, depending on the severity of the bodily harm beyond the basic form of the crime of negligent injury. As a result of faulty cosmetic surgery;

  • The victim experiences a permanent weakening or loss of function in one of their senses or organs (for example, permanent loss of vision or sensation),

  • Contracting an incurable disease,

  • Causing permanent scarring or disfigurement to the face ,

  • In cases where life is endangered, the aggravating circumstance under Article 89 of the Turkish Penal Code is applied directly to the perpetrator, and the minimum sentence is increased.

What does this mean?

The doctor or person performing the procedure cannot escape punishment by saying , "I didn't do it intentionally, I had no malicious intent," or "It was an unforeseen incident." Criminal law focuses not on intent, but on whether the person exercised the necessary professional care. If a needle-based or surgical aesthetic procedure results in permanent scarring, sagging, loss of sensation, disproportion, or tissue death on your face or body, the other party, even unintentionally, will be prosecuted under the Turkish Penal Code for failing to exercise the necessary care required of their duty, and may face imprisonment or a fine.

The Criminal Aspects of Filler, Botox, and Laser Burns Caused by Unlicensed Centers

Unlicensed beauty salons, hairdressers, and unlicensed individuals posing as "expert aestheticians" who attract customers through unauthorized advertisements on social media are causing increasingly irreversible health problems. Subcutaneous hyaluronic acid fillers, botulinum toxin (Botox) injections, suspension threads, or high-energy medical laser devices, when applied without medical supervision, can lead to severe conditions such as necrosis, permanent vision loss, facial asymmetry, and second or third-degree deep laser burns.

In legal terms, damages occurring in such centers are subject to much more severe criminal penalties than standard medical malpractice.

• According to Article 25 of Law No. 1219 on the Manner of Practice of Medicine and Related Professions , individuals who accept patients while falsely claiming the title of physician or performing medical procedures within their authority without a medical degree are subject to imprisonment for 2 to 5 years. Since this crime directly concerns public order, it is not subject to complaint; prosecutors and Provincial Health Directorates initiate investigations ex officio as soon as they detect the situation.

• The Transition from Negligence to Conscious Negligence and Possible Intent: For a business owner or aesthetician without medical training and knowledge of anatomy and vascular structure to administer injections, or for unlicensed personnel to use a laser device without knowing its settings, cannot be considered simple carelessness. If the practitioner acted believing "nothing will happen" despite foreseeing that this unauthorized procedure could cause bodily harm, they are prosecuted for conscious negligence (Turkish Penal Code Article 22/3) ; if they disregarded the possibility of the outcome from the outset, they are prosecuted for intentional injury (Turkish Penal Code Article 86), depending on the specific circumstances of the case. These classifications lead to a significant increase in the penalty for cases of injury due to negligent aesthetic procedures .

• Crimes Related to Unlicensed Medical Products and Counterfeit Drugs (Turkish Penal Code Article 187) : Counterfeit Botox and filler substances of unknown origin, without invoices, or with broken cold chains, used in unlicensed centers, are subject to separate investigation under Article 187 of the Turkish Penal Code, which defines the crime of "Manufacturing or Selling Drugs in a Manner that Endangers the Life and Health of Individuals," and the Law No. 5607 on Combating Smuggling.

• Closure of the Workplace and Administrative Sanctions: In addition to filing a criminal complaint with the Public Prosecutor's Office, when centers performing unauthorized medical procedures are reported to the Provincial and District Health Directorates and municipalities, sanctions such as suspension of operations, sealing, and administrative fines are immediately applied against the business.

What does this mean?

If the person who performed the procedure on you is not a medical doctor, your case will not proceed as slowly as a typical "medical malpractice" case; it will directly escalate into a serious criminal investigation. A person who performs a needle procedure or causes deep burns with an uncontrolled device in a beauty salon will be prosecuted and face imprisonment not only for harming your body but also for practicing medicine without a license. In such a situation, the other party's defenses such as "We had you sign a consent form" or "These kinds of side effects are normal" will be completely invalid before the prosecutor and the criminal court.

Evidence Gathering and Prosecutor's Complaint Stages to Avoid Loss of Rights

The most common mistake made by individuals who suffer bodily harm following cosmetic procedures is falling for delaying tactics from the other party, thus allowing legal deadlines to expire or creating opportunities for the destruction of evidence. In a criminal investigation based on the charge of negligent injury resulting from cosmetic surgery , the prosecutor's and the court's opinion is directly determined by technical and concrete evidence.

To ensure that allegations do not remain abstract and that those responsible are punished, the legal process must be meticulously planned.

• Monitoring the 6-Month Complaint Period: The crime of negligent injury, regulated under Article 89 of the Turkish Penal Code, is generally categorized as a crime subject to complaint. The victim must file a complaint with the Public Prosecutor's Office or law enforcement units within 6 months of learning of the act and the perpetrator. This period is a forfeiture period; if missed, it is generally impossible to initiate a criminal investigation. However, in cases involving unlicensed practices (violation of Law No. 1219) or elements of conscious negligence, the case may be pursued ex officio (automatically); nevertheless, to avoid the risk of loss of rights, the 6-month period should never be exceeded.

• Official Health Institutions Issue a Medical Examination Report: When damage occurs following a botched procedure, the first step is to immediately seek treatment at the emergency or plastic surgery clinic of a fully equipped state or university hospital, rather than having the clinic perform further procedures. Here, the physician should be informed that the situation is a "legal case," and a detailed medical excision report (patient discharge summary) should be prepared, indicating the extent of tissue necrosis, infection, loss of sensation, or burns.

• Securing Visual Documentation: Clear photographs taken before the intervention, as well as high-resolution, dated photographs and videos showing the deformation that occurred after the faulty procedure, should be archived. These visuals are the most essential materials proving the progression of the damage.

• Digital Communication and Appointment Records: Unlicensed centers and doctors often resort to the defense of "This patient did not come to us for such a procedure." To refute this denial, appointment correspondence via WhatsApp, Instagram, SMS, or email, complaint notifications, staff responses, and procedure suggestions should be recorded by taking screenshots.

• Financial Records and Payment Documents: Bank transfer/EFT statements, credit card slips, invoices, or receipts should be included in the file. In cases where payment was made in cash, the amount and messages confirming the payment can be presented as evidence.

• Prosecutor's Complaint and Forensic Medicine Institute (ATK) Referral Procedure: All evidence, along with the prepared criminal complaint petition, is submitted to the Chief Public Prosecutor's Office. The prosecutor takes the suspect's statement and refers the victim to the Forensic Medicine Department for assessment of the damage to their body. The Forensic Medicine Institute records in an official report whether the injury can be treated with simple medical intervention (BTM), whether there are permanent facial scars or organ dysfunction, and the degree of negligence of the practitioner.

What does this mean?

When you encounter a faulty procedure, instead of angrily going to the center and arguing, you should calmly gather evidence.

To avoid losing the advantages you have, follow this practical checklist:

• Don't Miss the Deadline: You have six months to file a legal complaint from the moment you learn about the incident and the perpetrator; don't let the business stall you by saying, "It will pass, just wait."

• Go to a State Hospital Immediately: Register the injuries sustained at an independent state or university hospital and obtain your forensic medical report.

• Don't delete the records: Back up all payment receipts, WhatsApp conversations, appointment confirmations, and dated photos of your face/body.

• Wait for the Official Report: Once you file a complaint with the prosecutor's office, the Forensic Medicine Institute will examine your injuries and prepare the official fault report that the court will use to make its ruling.

Criminal Case as well as Claims for Material and Moral Damages

The investigation initiated by the Public Prosecutor's Office and the subsequent criminal trial aim to punish the perpetrator with imprisonment or a fine. However, criminal courts do not directly compensate the victim for material losses or emotional distress. Therefore, individuals who have suffered injury due to negligent cosmetic surgery must file a lawsuit for material and moral damages in civil courts, either simultaneously with the criminal sanctions or based on evidence in the criminal case file.

Forensic reports, witness statements, and prosecutor's findings obtained in criminal investigations constitute the strongest evidentiary backbone in compensation cases. According to Article 74 of the Turkish Code of Obligations (TBK), while an acquittal decision by a criminal judge is generally not binding on a civil court, the final factual findings of the criminal court regarding the commission of the act and the fault of the perpetrator are binding on the civil court.

In compensation claims, the competent court to handle the process and the items to be claimed are structured as follows:

• Determining the Competent Court

  • Consumer Court: Cosmetic surgeries performed by licensed physicians, private hospitals, or medical centers are generally considered consumer transactions under the legal nature of a "contract for services" or "agency contract." It is mandatory to complete the mediation process, which is a prerequisite for filing a lawsuit, before initiating legal proceedings.

  • Civil Court of First Instance: In cases of invasive procedures performed by individuals without medical authorization or in beauty salons, often referred to as "underground" or unlicensed practices, the provisions of Article 49 of the Turkish Code of Obligations concerning "tort" apply directly, and the case is heard in the Civil Court of First Instance.

  • Administrative Court: If the procedure was performed by public employee physicians in public or university hospitals, a "full judicial review case" should be filed based on administrative negligence.

• Scope of Monetary Compensation

  • Refund for Incorrect Procedure: All fees paid for unsuccessful or harmful surgery.

  • Revision (Corrective) Costs: The costs of corrective surgeries, medical treatments, creams, medications, and dressings required to repair damage, tissue necrosis, permanent scarring, or deformation.

  • Disability and Loss of Earnings: Compensation for loss of earnings for days unable to work due to prolonged recovery or permanent disability/function, as well as compensation for future loss of working capacity (loss of effort).

• Scope of Non-Pecuniary Damages: The primary goal of aesthetic procedures is physical and visual improvement. However, a faulty procedure resulting in permanent scarring, loss of facial expression, asymmetry, or tissue deformation can lead to severe anxiety, depression, and social isolation. Non-pecuniary damages are monetary amounts collected from the negligent party to alleviate, to some extent, the profound psychological trauma, distress, and suffering experienced by the victim.

What does this mean?

Filing a complaint with the prosecutor's office and initiating criminal proceedings against the other party does not automatically guarantee a refund of the money you paid or the costs of recovering your health. The criminal court punishes the perpetrator; to get your money back, you must file a separate civil lawsuit for damages.

With this lawsuit, you can request the following:

1. Financial Compensation: The full amount you paid for the procedure, the costs of revision surgery to other doctors to correct the damage, and lost wages for the days you were unable to work.

2. Emotional Compensation: The price paid for the permanent scars and asymmetry on your body, and the trauma, stress, and sadness this process has caused your mental well-being.

Legal Process Management and Ways to Seek Justice in Aesthetic Disorder Cases

Disputes arising from medical malpractice and unauthorized beauty treatments are among the most sensitive types of lawsuits, where criminal law, contract law, and medical science intersect, and technical details are crucial. On one hand, there's the case of negligent injury resulting from faulty cosmetic procedures , investigated by the prosecutor's office; on the other hand, there's the lawsuit for material and moral damages in civil courts – two separate legal processes that directly influence each other. Managing these processes without conflict and employing the correct procedural strategy directly determines the outcome of the case.

The fundamental legal dynamics that necessitate conducting the legal process through a specialist lawyer are as follows:

• Objections to Technical Expert and Forensic Medicine Reports: During the trial process, the case is referred to the Forensic Medicine Institute's Specialized Boards or expert panels from the medical faculties of universities. These reports may portray the physician's actions as conforming to medical rules, or incorrectly categorize the situation as a "normal complication." Identifying these inconsistencies, discrepancies with medical literature, and deficiencies in the assessment of fault requires expertise to submit reasoned objections within the legal timeframe.

• Preventing Errors in Jurisdiction and Procedure: In compensation claims, it is essential to correctly distinguish between the Consumer Court, Civil Court of First Instance, or Administrative Court according to the nature of the dispute; and to fully comply with the mandatory pre-litigation mediation requirement. Cases filed in the wrong court may be dismissed due to lack of jurisdiction, leading to years of wasted time and fees.

• The protection of statute of limitations and forfeiture periods, including the complaint periods under Article 89 of the Turkish Penal Code, the Consumer Protection Law, and the statute of limitations for torts and breach of contract under the Turkish Code of Obligations, must be meticulously followed. Failure to submit evidence within the prescribed time limit or missing deadlines may result in the dismissal of the case on procedural grounds, regardless of the severity of the harm caused.

• Evidence Gathering and Establishing Causal Link: It is common for the opposing party to alter documents, delete transaction records, or deny the causal link. Requesting "evidence gathering" from the court urgently and proving with legal evidence that the permanent bodily harm resulted directly from the faulty intervention is a cornerstone of the case.

What does this mean?

Being in the right and being able to legally prove your right are entirely different matters. Even if you have suffered serious physical harm, filing a complaint with the wrong court, submitting an incomplete petition, failing to submit documents in your favor in a timely manner, or failing to object to a forensic medical report that is unfavorable to you within the prescribed time can lead to the rejection of your just cause. Working with a lawyer specializing in this area ensures that the process is handled professionally, without procedural irregularities, without the destruction of evidence, and without any loss of rights.

The Importance of Legal Expertise in Cases of Aesthetic Disputes Due to Faults

Medical malpractice and bodily harm caused by unauthorized persons are cases where criminal procedure, contract law, and forensic medicine intersect, and technical procedural rules are decisive. Interpreting medical terminology in Forensic Medicine Institute reports with legal fault, proving the practitioner's negligence or lack of authority, monitoring statutes of limitations, and conducting both criminal and civil claims with a strategy that does not conflict with each other directly requires expertise. Even the slightest procedural error during the process, such as applying to the wrong court or failing to submit a reasoned objection within the prescribed time to an expert opinion that is unfavorable, can lead to the loss of all rights and compensation claims, even in a case where one is in the right. Therefore, working with an expert lawyer in the field prevents irreparable losses by ensuring the identification of the victim, the legal securing of evidence, and the complete execution of the process.

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Frequently Asked Questions (FAQ)

What is the statutory deadline to file a criminal complaint for a botched aesthetic procedure?

Under Turkish Penal Code Art. 89, the statute of limitations for filing a complaint for negligent injury is 6 months from the date the incident and perpetrator become known.

Is it a crime for an aesthetician in a beauty center to perform botox or filler injections?

Yes. Under Law No. 1219, all invasive dermal injections must strictly be performed by licensed medical doctors. Procedures performed by non-physicians constitute an illegal practice of medicine and a criminal offense.

Are material and moral damages automatically awarded in a criminal case?

No. Criminal courts only rule on the penalty of the offender. To recover corrective surgery costs, treatment expenses, and moral suffering, a separate civil compensation lawsuit must be filed.

Why is a Forensic Medicine Council (ATK) report mandatory in medical aesthetic lawsuits?

Whether the damage is an acceptable complication or medical negligence, as well as the causality and permanent scars, can only be officially verified through a Forensic Medicine Council report.