Contract for Services in Cosmetic Surgery: What Does the Promise of "Beautification" Mean Legally?

The most critical question in disputes related to cosmetic surgery is this: Is the doctor-patient relationship a "mandate" or a "contract for services"? This classification the legal standard of expected outcomes, the evidence regime, rights against defective performance , and statutes of limitations .

In the Turkish Code of Obligations, a contract for work is defined as a contract in which the contractor undertakes to "create a work," and the client undertakes to pay the price. In aesthetic procedures, the "work" is not a physical structure; it is often discussed as the change in appearance/aesthetic result requested by the patient . In the Supreme Court's practice, there is a strong tendency to consider aesthetic procedures, especially those solely aimed at beautification , as approaching a contract for work to the extent that they are directed towards a specific result .

Below, I examine the connection between cosmetic surgery and contracts for services in terms of litigation strategy and contract structure, in a way that is "useful to the case"

1) Why is the medical contract generally referred to as agency, but in aesthetics, why is it called a work of art?

In classic treatment relationships (diagnosis/treatment of illness), physicians often undertake a duty of diligent medical practice rather than "guaranteeing the outcome ." Therefore, in many disputes, the physician-physician relationship is evaluated according to agency provisions; there are also examples of Supreme Court decisions that address the private hospital-patient relationship within the framework of agency.

However, cosmetic surgery differs particularly under the following conditions:

• the primary aim of the intervention is beautification rather than treatment ,

• If the patient requests a specific result, such as "this nose tip, this symmetry, this appearance," and the process is planned according to this goal,

• If the doctor/hospital clarifies the expected outcome through introduction, initial consultation, simulation, and photographs ,

In a significant number of disputes, the relationship a contract for services , and the Supreme Court has rulings in this direction.

While the concept of "Agency = standard of diligence" prevails, the debate on "Work = conformity to the result" comes to the forefront.

2) The biggest impact of classifying it as a contract for work: the "defective performance" mechanism

In a contract for work, if there is a defect in the work, the client the optional rights (such as rescission of the contract, reduction of price, or remedy of the defect, depending on the circumstances).

When we apply this to cosmetic surgery, the term "shame" often presents itself with the following claims:

• The result to the agreed/promised goal (asymmetries, significant deformity, permanent deformity),

• The result shows a degree of negligence that cannot be explained by medical technique ,

• Imposing a fait accompli without carrying out the planned procedure

• The emergence of the need for revision and its relationship to material/technical defects

The critical point here is: not every dissatisfaction is "shameful." Especially in medicine, where the healing process varies from person to person, and factors such as swelling, tissue response, and unexpected complications can occur, the assessment of "shameful" must always be made within the framework of medical standards + informed consent + clear objective

3) Statute of Limitations: Is it a contract for work or a tort?

The statute of limitations for defective performance in construction contracts is regulated in Article 478 of the Turkish Code of Obligations; generally, it is 2 years, 5 years, 20 years .

In cosmetic surgery, "delivery" and "the appearance of defects" often take time (healing, stitches settling, the final shape becoming apparent). Therefore, in practice, lawyers often contractual liability and tort liability together; evidence is collected accordingly (surgical reports, photo series, discharge summaries, consent forms, correspondence, advertising content, simulation printouts).

4) Informed consent: The “key evidence” in aesthetic cases

In cosmetic surgery, the obligation to inform patients becomes even more apparent compared to conventional treatments, because patients often undergo procedures out of "choice" rather than "necessity.".

• In patient rights regulations, the validity and form of consent are addressed within the framework of situations where consent may be problematic due to "coercion/deception/incomplete information.".

• The Turkish Medical Association's professional ethics texts also informed consent and the patient's right to information.

The consent form alone is not a "lifesaver." Especially in cosmetic cases, courts examine whether the consent was given clearly and understandably, whether the possibility of complications was concretely explained, and whether practical considerations such as the "possibility and cost of revision" were discussed. Therefore, the contract and the consent text should be prepared together and consistently.

5) Revision (corrective surgery) issue: If not clearly stated in the contract, it becomes a matter for litigation

One of the most contentious issues in cosmetic surgery revision surgery. If these points aren't clearly defined in writing beforehand, the "improperty-defect-cost" debate can escalate later.

• Risks that may require revision (edema, tissue response, healing asymmetry),

• In what situations will the revision free of charge ?

• In what situations would revision surgery subject to a fee (e.g., if the patient does not follow the recommended care, disrupting the healing process)?

• Who will carry out the revision and according to what standard?.

In the context of a contract for work, the right to "remedy of defects" can arise within the framework of Article 475 of the Turkish Code of Obligations; therefore, the revision clause is essentially for the management of defects .

6) The private hospital/clinic aspect and the possibility of consumer law

healthcare services provided in private hospitals or clinics can be considered, in some aspects, consumer transactions and therefore subject to consumer law jurisdiction; consumer law assessments are made within the context of private hospital "full hospital admission contracts".

Therefore, the following distinction becomes practically important in this case:

• Is the defendant solely a physician, or also a hospital/clinic?

• Who will be covering the cost of the package deal (surgery + hospital stay + supplies)?

• Who made the advertisement/promise/preliminary information?

Before entering into a debate about jurisdiction and authority, the specific relationship must be correctly analyzed; otherwise, the case may be delayed on "procedural" grounds.

7) Litigation and evidence strategy: 7 pieces of evidence that determine winning in an aesthetic surgery case

1. Initial consultation records: WhatsApp/email, clinic messages, price/promise content.

2. Advertising and promotion: Claims such as "100% results," "guaranteed," and "leaves no trace."

3. Consent + information set: Not just a single-page signature; includes risk, alternatives, revisions, and recovery period.

4. Surgical report/epicrisis: What was performed, what technique was used, what materials were implanted.

5. Photo chronology: Before and after photos taken from the same angle/lighting standard.

6. Expert examination: The questions are clear: distinguish between "medical standard," "expected outcome," and "defect/fault."

7. Damages include: revision costs, loss of earning capacity, medical expenses, emotional distress, and cosmetic loss.

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Conclusion: While cosmetic surgeries are considered "medical interventions," their potential for evaluation under the Turkish Code of Obligations' (TBK) contract for work structure increases when they are aimed at beautification and focus on a specific outcome . This classification leads to very concrete consequences, such as rights to defective performance (TBK Article 475) and the statute of limitations regime (TBK Article 478) . The most critical point in a case is often the scope of informed consent and how "concrete" the expectation was.