Compensation for malpractice in aesthetic filler and Botox applications

What are the mistakes made with aesthetic fillers and Botox?

Aesthetic filler and Botox error refers to harm caused by a medical aesthetic procedure performed on the face, lips, jawline, cheeks, forehead, eye area, nose area, or other body area in a manner that violates medical standards, patient safety, informed consent procedures, or regulations. This harm sometimes manifests only as an aesthetic disfigurement; however, it can also lead to serious consequences such as infection, tissue loss, blood clots, permanent scarring, nerve damage, eyelid drooping, vision loss, allergic reactions, or psychological distress.

Filler and Botox injections are often viewed as "simple cosmetic procedures" in society. However, these procedures, which involve injections, intervention in body tissue, the use of drugs or medical products, and carry a risk of complications, may be considered medical interventions under health law. Law No. 1219 stipulates that in Türkiye, a physician must have the authority and necessary professional qualifications to treat patients and perform medical/surgical procedures. Therefore, filler, Botox, or similar injection procedures performed by unauthorized individuals can not only lead to poor aesthetic results but also raise concerns about unlawful medical intervention.

In every case, a patient is not entitled to compensation when the outcome of an aesthetic procedure is not as expected. However, a compensation claim may arise if the procedure was performed by an unauthorized person, if unsuitable products were used, if the patient was not adequately informed, if the procedure was performed using faulty techniques, if complications were detected late, if post-operative follow-up was not provided, or if the patient's bodily integrity or personal rights were harmed as a result of the procedure.

Are filler and Botox treatments considered medical procedures?

The first issue in the legal assessment of filler and Botox applications is whether these procedures are ordinary cosmetic procedures or medical interventions. The Patient Rights Regulation defines medical intervention as a physical or mental intervention performed by persons authorized to practice the medical profession, in accordance with professional standards, for the protection of health, diagnosis and treatment of diseases. The same Regulation covers all public and private institutions and organizations providing health services.

Botox and filler treatments require the injection of substances into the body, evaluation of facial anatomy, determination of dosage and application area, consideration of vascular and nerve structures, and intervention in case of potential complications. Therefore, performing these procedures in unauthorized locations outside of healthcare facilities or by individuals who are not healthcare professionals poses serious legal risks.

Liability may be assessed more severely, especially in cases of filler and Botox procedures performed by beauty salons, hairdressers, individuals offering services in homes, through social media, or unauthorized practitioners. This is because the patient may not only face a negative outcome but also be exposed to an unauthorized and unsafe procedure from the outset. In such cases, the practitioner, business owner, intermediary (if any), and the person supplying the product may face liability for compensation, administrative penalties, and criminal charges.

The Most Common Filler and Botox Mistakes

Errors in aesthetic filler and Botox applications can manifest in various ways. The most common errors in filler procedures include excessive swelling in the lips, asymmetry, clumping, filler displacement, disruption of the face's natural appearance, application to the wrong area, injection into a vein, skin discoloration, infection, necrosis, permanent scarring, hardening, allergic reactions, and delayed intervention when the filler needs to be dissolved.

Botox treatments can cause problems such as drooping eyebrows, drooping eyelids, a frozen facial expression, loss of facial expressions, asymmetry, smile disorders, difficulty speaking or swallowing, headaches, muscle weakness, application to the wrong muscle group, overdose, or underdose. While some Botox effects are temporary, if the procedure is done incorrectly, the person may have to live with an appearance that affects their social life for months.

The crucial point here is the difference between expected temporary side effects of a procedure and malpractice that gives rise to legal liability. Mild bruising, temporary swelling, or short-term tenderness may be considered normal for some procedures. However, if tissue loss due to vascular occlusion, serious infection, facial paralysis-like appearance, use of incorrect products, permanent scarring, or serious risks that were never explained to the patient occur, the matter goes beyond simple dissatisfaction and becomes a matter for compensation.

Complication or Malpractice?

In aesthetic procedure lawsuits, the most fundamental debate is distinguishing between "complication" and "physician/clinic error." A complication is an undesirable outcome that can occur despite a procedure performed according to medical standards. However, not every negative outcome can be explained as a "complication." For an outcome to be considered a complication, the procedure must have been performed by an authorized person, in a suitable environment, with appropriate products, using the correct technique, and with the informed consent of the patient.

For example, mild swelling and bruising after lip filler treatment can be considered normal. However, if whitening of the lips, severe pain, bruising, and circulatory problems develop after the procedure, this may indicate a blood clot. In such a case, the practitioner should immediately assess the patient, provide the necessary emergency intervention, or refer them to an appropriate healthcare facility. If the patient is sent home with the advice to "wait and it will pass," and tissue loss develops, then negligence in complication management becomes a concern.

A similar assessment is made regarding Botox. Temporary changes in effect may occur after the procedure; however, application to the wrong muscle group, overdose, failure to consider the patient's facial anatomy, or failure to evaluate post-procedure complaints can result in liability for the practitioner and the clinic.

The Importance of Informed Consent

In filler and Botox applications, the patient must be clearly and understandably informed before the procedure. According to the Patient Rights Regulation, the patient has the right to request information about the medical procedures to be performed, their benefits, possible disadvantages, alternative methods, the consequences of not accepting the treatment, and the course of the disease. The same Regulation stipulates that the patient's consent is required for medical interventions and that the patient has the right to review and obtain a copy of their medical file.

Informed consent is not simply a form signed by the patient. The patient must be informed about what product will be used, how much will be applied to which area, the expected results, the duration of the effects, the risks, the possibility of allergy, blood clots, infection, asymmetry, tissue loss, and potential outcomes such as muscle weakness or eyelid drooping after the procedure. The patient should also be informed about what symptoms require immediate medical attention after the procedure.

For example, if a patient is told that the procedure is "very simple and has no risks," but experiences serious complications afterward, a breach of the duty to inform can be alleged. Similarly, if a patient is misled with phrases like "guaranteed results," "guaranteed beauty," or "absolutely no side effects," this is problematic in terms of both informed consent and misleading advertising.

Filler or Botox Injections Performed by an Unauthorized Person

One of the most serious complications of filler and Botox procedures is when the procedure is performed by an unauthorized person. Medical aesthetic procedures involving injections are extremely dangerous when performed by individuals without proper medical training and authorization. An unauthorized practitioner may lack knowledge of facial anatomy, vascular and nerve structures, the pharmacological effects of the product, emergency complication management, and sterilization procedures.

In this case, the patient can argue that they were subjected to an unlawful intervention from the outset, not just due to a faulty aesthetic result. The fact that the procedure was performed in a beauty center, hair salon, at home, in a hotel, by someone contacted via social media, or in an unlicensed location can aggravate the liability. Regulations concerning private healthcare institutions providing outpatient diagnosis and treatment stipulate specific rules regarding the structuring, licensing, operation, and supervision of private healthcare institutions.

In addition to a compensation lawsuit for unauthorized practices, other avenues may include filing a complaint with the Provincial Health Directorate, a criminal complaint with the prosecutor's office, a consumer application, and administrative oversight. The process is considered more severe, especially if the source of the product used is unknown, if counterfeit or smuggled products were used, if sterilization was not performed, or if the patient was left in a disadvantaged state after the procedure.

Quality of the Product Used and Product Liability

The quality of the product used in filler and Botox applications is extremely important. The filler's content, brand, licensing status, expiration date, storage conditions, suitability for the application area, and the amount to be administered to the patient must be recorded. Similarly, for Botox products, the source of the product, cold chain conditions, dosage, and application site are crucial.

If the patient was not informed which product was used, if a product label was not provided, or if product information is missing from the invoice or transaction records, this may be considered against the clinic during the evidence-gathering process. This is because product information is necessary to determine whether a potential complication is product-related, technically procedural, or due to a patient-specific risk.

If counterfeit, smuggled, expired, or improperly stored products are used, liability may lie not only with the person performing the procedure but also with the business that supplied the product and provided the application environment. In such cases, the product box, label, barcode, invoice, procedure form, photographs, and clinical records must be collected.

Responsibility for Private Clinics and Beauty Centers

If filler and Botox procedures are performed in a private clinic, private hospital, medical center, or medical aesthetics center, the healthcare facility is responsible not only for the mistakes of the person performing the procedure but also for the entire organization of the service. This includes the patient admission process, information provision, sterilization of the treatment room, the safety of the products used, emergency response capacity, record keeping, post-procedure follow-up, and the evaluation of complaints.

Private healthcare institutions must provide patients with clear information about the cost, scope of the procedure, risks, alternatives, and expectations before the procedure. The Regulation on Promotion and Information Activities in Healthcare dated November 12, 2025, prohibits overt or covert advertising in the provision of healthcare services; it also defines the limits of promotional and informational activities carried out by private healthcare institutions and healthcare professionals.

Therefore, clinics using exaggerated results, misleading before-and-after images, promises of guaranteed results, and advertising language that encourages or directs patients to undergo procedures based on patient reviews in their social media posts can create legal problems. If a patient has undergone a procedure based on such advertising and has suffered harm, the misleading information can also be raised as a separate claim in a compensation lawsuit.

Defective Service from the Perspective of Consumer Law

Aesthetic filler and Botox applications are often performed for a fee in private clinics or centers. Therefore, consumer law provisions may also come into play depending on the specifics of the case. Law No. 6502 defines a defective service as a service that does not possess the characteristics specified in the contract or that it should objectively possess. Services that do not have the characteristics stated by the service provider, as advertised on their website, or in their advertisements, or services that reduce the benefit that the consumer reasonably expects, can also be considered defective services.

When undergoing filler or Botox treatments, patients act not only with the expectation of "beautification" but also with the expectation of receiving safe and professionally compliant healthcare services. If the procedure is performed incorrectly, the result differs from what was promised, the product quality is not disclosed, pricing is not transparent, post-procedure follow-up is not provided, or the patient is misled by deceptive advertising, a claim of defective service may arise.

Under Law No. 6502, consumers may have the right to choose between having the service performed again, free repair of the work resulting from the service, a price reduction proportional to the defect, or termination of the contract. However, in medical aesthetic procedures, a refund alone may not be sufficient. If the patient has suffered bodily harm, permanent scarring, loss of earning capacity, treatment costs, or moral damages, they may also claim additional compensation.

What types of compensation can be claimed?

Individuals who suffer harm due to errors in aesthetic filler and Botox procedures can claim both financial and non-financial compensation. Financial compensation may include the fee paid for the initial procedure, the cost of further treatment to correct the faulty procedure, filler dissolution procedures, dermatology or plastic surgery treatments, medication costs, hospital expenses, imaging and laboratory costs, psychological support expenses, loss of earnings, and travel expenses.

If the procedure results in permanent scarring, tissue loss, vision loss, facial asymmetry, expression disorders, nerve damage, or infection, compensation items are evaluated more broadly. When a patient suffers damage to the facial area, this is not only a matter of physical health; it also has serious consequences in terms of social life, work life, psychology, self-confidence, and the right to privacy.

Moral damages are claimed due to the pain, fear, shame, psychological trauma, social isolation, disfigurement, permanent facial scarring, unexpected serious complications, or loss of self-confidence experienced by the patient. Since the face is central to a person's interaction with the outside world, moral damages often become significant in cases of cosmetic surgery errors.

Evidence: How to Prove Faulty Filler or Botox Injections?

Gathering evidence is crucial in these types of cases. The patient should keep photographs and video recordings taken before and after the procedure, social media posts and advertisements of the clinic where the procedure was performed, WhatsApp messages, payment receipts, invoices, consent forms, procedure records, and information about the products used.

Furthermore, if complications develop after the procedure, a healthcare facility should be contacted immediately and a medical report obtained. Emergency room records, dermatology reports, plastic surgery evaluations, infection reports, prescriptions, imaging results, and photographs are important evidence for legal proceedings. Since the Patient Rights Regulation stipulates that the patient can review and obtain copies of their health file and records directly, through their representative, or legal guardian, all procedure records should be requested in writing from the clinic.

If the procedure was performed at an unauthorized beauty center, the center's signage, license, social media accounts, appointment correspondence, payment information, the name of the person performing the procedure, a photo of the product used, and witness statements become even more important. This is because the lack of record-keeping is a common problem in unauthorized practices.

The Importance of Expert Reports

In cases involving errors in fillers and Botox injections, expert reports often determine the outcome of the case. Depending on the nature of the incident, the expert panel should include specialists in plastic, reconstructive and aesthetic surgery, dermatology, forensic medicine, ophthalmology, neurology, or infectious diseases.

The expert report should seek answers to the following questions: Was the procedure performed by an authorized person? Was the application environment suitable for healthcare? Was the patient adequately informed? Was the product used appropriate? Was the application technique correct? Was the resulting outcome a normal complication, or was it due to malpractice or lack of follow-up? Was the complication detected and managed in a timely manner? Is there a causal link between the harm and the procedure?

Incomplete expert reports must be challenged. In particular, simply stating that "results are not guaranteed in aesthetic procedures" and closing the case is insufficient. If the issue at hand is not the failure to achieve expectations, but rather unauthorized procedure, incorrect technique, inadequate information, product defect, lack of follow-up, or permanent damage, the report must evaluate these specific allegations separately.

Can a criminal investigation be opened?

In some cases, errors in filler or Botox injections can also lead to criminal investigations. Specifically, criminal complaints may be filed with the prosecutor's office in situations involving unauthorized medical procedures, the use of counterfeit products, harm to the patient's bodily integrity, permanent scarring or loss of organ function, alteration of records, or providing false information to the patient.

In the Turkish Penal Code (TCK), negligent injury is one of the penal provisions that can be applied when a person suffers physical pain or their health is impaired. Article 89 of the TCK regulates negligent injury, and the penalty may be increased if the act causes serious consequences for the victim.

In criminal investigations concerning medical procedures and practices of healthcare professionals, the Professional Responsibility Board process may come into play under Article 18 of Law No. 3359. This process provides for a special permission mechanism in investigations conducted due to medical procedures and practices related to examination, diagnosis, and treatment by physicians and healthcare professionals.

However, if the procedure was performed by an unauthorized person, factors such as whether the perpetrator is a healthcare professional, the licensing status of the location where the procedure was performed, and the nature of the incident must be evaluated separately. Criminal investigations and civil lawsuits are different; a criminal case focuses on punishing the perpetrator, while a civil lawsuit aims to compensate the victim for their losses. However, expert reports and evidence from a criminal case can play a significant role in a civil lawsuit.

What should the patient do?

Individuals experiencing harm after filler or Botox injections should first document their medical condition. If symptoms such as severe pain, discoloration, bruising, numbness, vision problems, infection, fever, tissue loss, or difficulty breathing or swallowing occur, they should seek medical attention immediately. This is crucial both for treatment and as evidence.

Secondly, all relevant documents should be requested in writing from the place where the procedure was performed. This includes the consent form, procedure report, brand and serial number of the product used, invoice, payment receipt, before and after photos, and any inspection records if available.

Thirdly, evidence must be preserved. Social media advertisements, messages, promises of "guarantee" or "risk-free transactions," price lists, appointment records, witness information, and photographs should be kept safe. Taking screenshots is especially helpful since social media posts can be deleted later.

Fourthly, it must be clarified where and by whom the incident occurred. Was the procedure performed in a private hospital, a licensed clinic, a beauty center, or at home? Was the person performing the procedure a doctor, nurse, aesthetician, or someone without any medical qualifications? This distinction directly affects the legal process, identifying those responsible, and the criminal proceedings.

Conclusion: Liability for Filler and Botox Mistakes is Serious

Although aesthetic filler and Botox applications may seem like simple and short procedures from the outside, they are legally considered medical interventions that directly affect bodily integrity and personal rights. Therefore, the procedure must be performed by an authorized person, in a suitable healthcare environment, with reliable products, using the correct technique, and with the informed consent of the patient.

Not every aesthetic dissatisfaction warrants compensation. However, patients may claim financial and non-financial compensation in cases of unauthorized procedures, insufficient information, incorrect products, faulty techniques, infection, vascular occlusion, tissue loss, facial asymmetry, eyelid drooping, permanent scarring, or poor management of complications.

In private clinics, consumer law, health law, and breach of contract provisions can be considered together. However, in procedures performed by beauty centers or unauthorized individuals, unlawful medical intervention, tort, and criminal liability may arise more strongly. Misleading advertising, promises of "guaranteed results," or exaggerated promotion through social media may also give rise to liability.

Therefore, individuals harmed by filler or Botox treatments should immediately obtain medical reports, request documentation of the procedure, preserve photographs and correspondence, demand information on the products used, and pursue appropriate legal action. A strong case can claim not only a refund of the treatment cost but also reimbursement for medical treatment, corrective procedures, loss of earning capacity, psychological harm, and moral damages.