Cosmetic Surgery Malpractice in Türkiye: Why an Aesthetic Procedure Is Judged Differently

Turkish law does not judge a purely cosmetic operation by the rule that governs ordinary medical treatment. Ordinary treatment is a mandate contract (vekâlet sözleşmesi): the physician undertakes careful conduct, not a result, and that is why an unsuccessful outcome is not by itself a breach. Where the aesthetic aspect of an intervention predominates, the Court of Cassation applies the works contract (eser sözleşmesi) of art. 470 of the Turkish Code of Obligations No. 6098 instead, holding that the relationship differs from the mandate contract covering treatment performed out of medical necessity, and that the contractor guarantees the result (6th Civil Chamber, 2 October 2025, E. 2024/2312, K. 2025/3241). The practical consequence is the one that matters: the patient does not have to prove that the surgeon fell below the standard of care. Non-achievement of the agreed result is itself non-performance.

That single shift explains most of what is distinctive about aesthetic-surgery litigation in Türkiye — what is owed, what has to be proved, what remedies are available, and which limitation rule is argued over. This guide sets out the characterisation and why it matters, informed consent and where the burden of proving it sits, the evidence that decides these files, and the position of a patient who travelled to Türkiye for the procedure. It is a companion to the wider guide to medical malpractice law in Türkiye, which deals with malpractice generally, and to the guides on how to sue a hospital or doctor in Türkiye and on what a malpractice claim can recover. The field as a whole is described on the firm’s health and medical law page.

Ordinary treatment or aesthetic procedure — the characterisation that decides the case

The two contracts sit side by side in the Code of Obligations and impose different things. Art. 470 defines the works contract as an agreement under which the contractor undertakes to produce a work and the owner to pay a price for it; art. 471 measures the contractor’s duty of care against the professional and technical conduct expected of a prudent contractor undertaking similar work. Art. 502 defines the mandate as an agreement under which the agent undertakes to carry out a piece of business or a transaction for the principal; arts. 506(2) and (3) impose loyalty and care measured against the conduct of a prudent agent undertaking similar work — a standard of conduct, with no result owed.

The Assembly of Civil Chambers states the baseline for ordinary medicine in terms: because the physician assumes an obligation of careful performance and not an obligation of result, the contract is generally accepted in Turkish law as a mandate (22 March 2022, E. 2020/592, K. 2022/356). The same idea is codified far earlier, in art. 13(1) of the Medical Deontology Regulation of 1960, which provides that a physician who diagnoses and treats in accordance with the requirements of science cannot be reproached, in deontological terms, merely because the treatment did not result in a cure.

	Ordinary medical treatment	Predominantly aesthetic procedure
Contract type	Mandate (vekâlet), TBK arts. 502, 506	Works contract (eser), TBK arts. 470, 471
What is owed	Careful, loyal conduct measured against a prudent practitioner in the field — an obligation of means	The agreed, defect-free result; the contractor guarantees the result
What the patient must establish	That the recognised standard of care was departed from, and that the departure caused the harm	That the agreed result was not achieved — no separate proof of a breach of the standard of care is required
Who must disprove fault	The debtor, under TBK art. 112, in both contractual characterisations — compare tort, where art. 50(1) puts damage and the defendant’s fault on the injured party to prove	The debtor, under TBK art. 112; once non-achievement is shown, a causation-breaking defence or the patient’s own fault falls to the defendant
Effect of a complication	A recognised complication, properly managed and properly disclosed, is not a breach	Complications do not of themselves excuse: the duty to inform and the correct management of the complication remain the contractor’s responsibility
Remedies	Damages under the general provisions	The elective rights of TBK art. 475 — rescission, price reduction, free repair — with damages under the general provisions preserved
Limitation	Five years for claims arising from a mandate contract (TBK art. 147(5))	Contested. TBK art. 147(6) (five years, save gross fault), art. 146 (ten years), art. 478 (two years from delivery, twenty on gross fault); art. 72 (two and ten years) is pleaded in the alternative
Forum	Consumer court for a private provider (Law No. 6502, arts. 3(1)(l), 73(1))	Consumer court — works contracts are named in art. 3(1)(l) alongside mandate

Two clarifications belong with that table, because both are commonly overstated.

The first concerns the burden of proof. The works-contract characterisation does not reverse the burden compared with a mandate. Art. 112 already provides that where an obligation is not performed, or not performed properly, the debtor is liable for the creditor’s resulting loss unless the debtor proves that no fault can be attributed to it — and that applies to a mandate just as much as to a works contract. What actually changes is the content of what the patient must show at the threshold. Under a mandate the patient has to identify a departure from the standard of care; under a works contract the patient points to the promised result and shows it was not delivered. That is a difference in what is in issue, not a difference in who bears the risk of non-persuasion on fault.

The second concerns how far the guarantee goes. The Yargıtay’s formula is that the contractor guarantees the result and that non-achievement means the contractor is taken not to have performed. It is not a guarantee that the patient will be pleased. Nor is the liability strict: in the 2 October 2025 judgment the court reached its conclusion by recording that the defendants had neither raised a valid defence breaking the causal link nor proved the claimant’s own fault — which is a statement about where the burden lies once non-achievement is shown, not a statement that no defence exists. Art. 476 makes the point from the other direction: the owner cannot exercise the defect rights where the defect arose from an instruction the owner gave despite the contractor’s express warning, or is otherwise attributable to the owner.

The test is fact-specific, and the judge applies it

There is no rule that every operation performed by a plastic surgeon is a works contract. The question the court asks is whether the aesthetic aspect predominates, and it answers it on the file — including on what the patient said they went in for.

The 2 October 2025 judgment is instructive precisely because the courts below had gone the other way. The first-instance court had treated a septorhinoplasty as reconstructive, and therefore governed by the mandate rules, because it also addressed the consequences of a childhood fracture. The Yargıtay reversed, finding on the file and on the claimant’s own statements that the aesthetic aspect of the procedure performed predominated, and that the works-contract provisions had to be applied. The same judgment records that legal characterisation of the relationship is the judge’s own duty under art. 33 of the Code of Civil Procedure No. 6100 — so the outcome does not depend on the label the parties, or the clinic’s paperwork, attached to the arrangement.

The doctrine is not confined to rhinoplasty. In a case concerning a breast lift, arm lift and liposuction, the same chamber held that where the patient had gone to the defendant for an aesthetic purpose, the achievement of the agreed and desired good appearance, and the healthy conclusion of the process, were plainly the subject matter of the works contract between the parties (13 June 2024, E. 2022/5247, K. 2024/2204). That judgment also makes an evidential point that matters a great deal in practice: an expert finding that the intervention was technically lawful is not sufficient, because the court must also examine whether the result the patient asked for was achieved.

Mixed reconstructive-and-aesthetic procedures are therefore the real battleground, and a claim that assumes the answer in advance — in either direction — is a claim that has skipped the first contested issue in the case.

What can be claimed once the work is held defective

If the work is found defective (ayıplı), art. 475 gives the owner a choice between three elective rights:

1. Rescission of the contract, where the work is so defective, or so contrary to the contract, that the owner cannot use it or cannot in fairness be compelled to accept it;
2. Retention with a price reduction proportionate to the defect;
3. Free repair at the contractor’s cost, provided this does not require excessive expenditure.

The article then preserves expressly the owner’s right to claim damages under the general provisions — which is how a defective-work finding and a compensation claim sit together in the same file rather than as alternatives. What the heads of damage are, and how the amount is fixed, is a separate subject dealt with in the compensation guide.

Two adjacent provisions catch claimants out. Art. 474 requires the owner, after delivery, to inspect the work as soon as the ordinary course of business allows and to notify any defects to the contractor within a reasonable time; either party may also require, at its own cost, an examination by an expert and a report on the result. Art. 477 then provides that after express or implied acceptance the contractor is discharged from all liability, except for defects deliberately concealed and those that could not have been noticed on a proper inspection; that an owner who neglects to inspect and notify is deemed to have accepted the work; and that where a defect appears later the owner must notify the contractor without delay, failing which the work is again deemed accepted. In an aesthetic case, where the outcome often declares itself over months rather than days, the timing and the recording of that notification are not a formality.

Informed consent: the burden sits with the physician

Consent is the second axis of these cases, and it runs independently of the contractual characterisation.

The Assembly of Civil Chambers holds that the burden of proving the duty to inform lies on the physician, for two reasons. The first is the legal presumption under art. 24 of the Civil Code that a person has not consented to an interference with their personality rights. The second is the record-keeping and archiving duty of the physician and the institution: breach of that duty creates a factual presumption in the patient’s favour. The decision puts it plainly — whether or not there is a contractual relationship between patient and physician, the physician must prove that the patient was enlightened and that informed consent was obtained (22 March 2022, E. 2020/592, K. 2022/356).

The same decision resists the two absolutes that circulate about consent forms. It holds that although written consent is required for certain interventions, no rule requires the enlightenment itself to be in writing: the physician may prove that the duty to inform was discharged by any evidence. And it holds that the adequacy of the enlightenment is assessed against the individual patient’s education, age and cultural level, together with the records kept. A signed form neither defeats a claim on its own nor counts for nothing; it is weighed with the rest of the file.

The statutory basis is art. 70 of Law No. 1219, which requires physicians and dentists to obtain the consent of the patient — or of the parent or guardian where the patient is a minor or under legal incapacity — for every procedure they perform, and requires that consent to be in writing for major surgical operations. Since the amendment made by Law No. 7557 of 21 July 2025, that consent may also be taken electronically, using identity-verifying documents, biometric methods or electronic identity verification.

What the regulation actually requires

The content of the enlightenment is set out in art. 15 of the Patient Rights Regulation (Official Gazette of 1 August 1998, No. 23420), in the form it has had since 8 May 2014. The patient is to be informed of the probable causes and course of the condition; by whom, where, how and for how long the intervention will be performed; the other diagnostic and treatment options with their benefits, risks and probable effects; the probable complications; the benefits and risks of refusing treatment; the important properties of the medicines to be used; critical lifestyle advice; and how to reach further medical help.

Art. 18 governs how it is given, and it is stricter than the practice in some clinics. The information must be given orally, as a rule by the health professional who will actually perform the intervention — another professional competent to give it may do so only where circumstances make that unavoidable, and the patient must be told why — in language suited to the patient’s social and cultural level, in a suitable and private setting. Except in emergencies, the patient must be allowed a reasonable period — a requirement that is difficult to reconcile with a signature taken on the morning of the operation. The patient may also seek a second opinion, and price information is supplied on request by the provider’s relevant unit.

Art. 26 deals with the form itself. A consent form containing the art. 15 information must be prepared for interventions prescribed by legislation and for those that are medically likely to give rise to a dispute; the contents must be conveyed orally and the form signed; it is signed in two copies, one placed in the patient file and one given to the patient; it is signed by the health professional who gave the information and will perform the procedure; and the health professional concerned is responsible for the accuracy of the information given. Art. 31 adds that enlightenment is essential when consent is taken, and that the intervention must stay within the limits of the consent given — a point with obvious bite where more was done in theatre than was discussed beforehand.

Above all of this sits the European Convention on Human Rights and Biomedicine, whose ratification was approved by Law No. 5013, published in the Official Gazette of 9 December 2003, No. 25311. The Yargıtay records in both the 2024 and 2025 aesthetic-surgery judgments that the Convention forms part of Turkish domestic law; that its art. 4 requires any health intervention to be carried out in accordance with the relevant professional obligations and standards; that its art. 5 regulates the requirement of informed consent; and that it must be accepted as applying to aesthetic interventions of a works-contract character as well.

What evidence decides these cases

Aesthetic-surgery files turn on documents assembled long before anyone reaches an expert report.

• The complete medical file — pre-operative assessment, operative note, anaesthesia record, nursing notes, prescriptions, discharge summary and the follow-up record. The Assembly of Civil Chambers ties the consent burden directly to the record-keeping and archiving duty, so gaps in the file are not neutral.
• The consent documentation, read against arts. 15, 18, 26 and 31 of the Patient Rights Regulation: who gave the information, when, in what language, how long before the procedure, and whether the intervention stayed within the limits of what was consented to.
• What result was actually agreed. This is the pivotal document set in a works-contract case, because it defines the thing that either was or was not delivered. The 13 June 2024 judgment is explicit that an expert report confirming technical lawfulness does not close the case; the court must still examine whether the requested result was achieved.
• Before-and-after imagery, and the rules that govern it. Since 12 November 2025 this material is tightly regulated, which incidentally makes it far more useful as evidence.
• The management of any complication — because under the works-contract characterisation the duty to inform about complications and the correct handling of them remain the contractor’s responsibility.

The imagery point deserves its own note, because almost every online summary is now out of date on it. The Regulation on Promotion and Information Activities in Health Services published in the Official Gazette of 12 November 2025, No. 33075 entered into force on publication and, by its art. 13, expressly repealed the 2023 regulation of the same name. Under art. 5(1) of the new text, covert or open advertising in the provision of health services is prohibited; information may be given only within listed limits, which include a bar on advertising-style posts built on patient or relative thank-you or satisfaction statements, a bar on content that steers patients directly or indirectly to a particular professional or facility, a bar on claiming a “specialist” title on the basis of certificates outside the main and sub-specialties defined by Law No. 1219, a bar on making health services the subject of promotional draws or gifts, and a rule that promotional and information activities may not carry price, discount, campaign or promotion information.

Art. 7(1) then regulates before-and-after visuals in detail. Patient images require the patient’s or guardian’s explicit consent, taken on the visual-content consent form set out in Annex 1 to the Regulation; the patient may view the material in advance and withdraw permission at any time without formality; no payment, discount or gift may be given in exchange for that consent; misleading make-up is prohibited, as is any subsequent technological alteration or retouching; the pre-procedure and post-procedure images must be taken in the same environment and under the same technical conditions, and both the date of the procedure and the dates the images were taken must be stated; images of the patient taken during a medical intervention, procedure or operation may not be shared; sponsored or paid publication of such visuals is prohibited; and domestic promotional visuals must carry a mandatory warning that results may vary from person to person and that detailed advice should be obtained from one’s physician before the procedure. Material that does not meet those requirements is itself a fact in the file.

Forum, mediation and the consumer-law layer

Aesthetic-surgery claims against private providers are consumer disputes, and the Consumer Protection Law No. 6502 brings both characterisations inside it. Art. 3(1)(l) defines a consumer transaction as any contract or legal transaction between a consumer and a person acting for commercial or professional purposes, including works, carriage, brokerage, insurance, mandate, banking and similar contracts — so it makes no difference to the forum whether the relationship is characterised as eser or as vekâlet. A consumer is a natural or legal person acting for non-commercial and non-professional purposes (art. 3(1)(k)); a service is the subject matter of any consumer transaction other than the supply of goods (art. 3(1)(d)); and a supplier includes public legal persons supplying services to consumers for commercial or professional purposes (art. 3(1)(ı)). Art. 2 states that the Law covers every kind of consumer transaction and practices directed at consumers.

The consequences follow directly:

• Jurisdiction. Art. 73(1) gives the consumer courts jurisdiction in actions concerning disputes arising from consumer transactions and practices directed at consumers. This is borne out in the case files themselves: the first-instance courts in the 6th Civil Chamber judgments of 2 October 2025 and of 12 January 2026 (E. 2025/674, K. 2026/108) were consumer courts.
• No court fees for the consumer. Art. 73(2) exempts actions brought before the consumer courts by consumers from the fees regulated in the Fees Act. The 12 January 2026 judgment records the consequence in the order itself, directing return of the advance fee to the claimant as a consumer on request.
• Venue at the consumer’s residence. Art. 73(5) permits the action to be brought where the consumer resides, in addition to the ordinary venues.
• Mediation before suit. Art. 73/A, added by Law No. 7251 of 22 July 2020, makes an application to a mediator a procedural pre-condition in disputes heard by the consumer courts, subject to listed exceptions including disputes within the remit of the consumer arbitration committee and objections to that committee’s decisions. The general framework is set out in the guide to mandatory mediation in Turkish law.
• The arbitration-committee threshold. Where the amount in dispute is small, application to a consumer arbitration committee is compulsory instead (art. 68(1)), and the threshold is revalued each calendar year at the revaluation rate under repeated art. 298 of the Tax Procedure Law No. 213. For the 1 January to 31 December 2026 period it is 186,000 TL, set by the communiqué published in the Official Gazette of 23 December 2025, No. 33116, reflecting the 2025 revaluation rate of 25.49%. That is a jurisdictional line, not a benchmark for what a claim is worth, and it changes every 1 January.

One further point of housekeeping, because published material is behind on it: which chamber of the Court of Cassation hears these files has changed. The 3rd Civil Chamber transferred such a file on 13 May 2026 (E. 2026/4414, K. 2026/3021), recording that the dispute concerned compensation arising from an aesthetic operation — that is, from a works contract — and that under the Grand General Assembly’s work-distribution decision of 26 June 2025, No. 1, the examination belongs to the 6th Civil Chamber. Earlier decisions in this line came from the 15th and 13th Civil Chambers, neither of which now hears these files.

Limitation: describing the framework honestly

There is no settled single period for aesthetic-surgery claims, and any source that gives one without qualification is overstating the law. Four rules are in play:

• Art. 147(6) — five years for claims arising from a works contract, except where the contractor failed to perform, or to perform properly, through gross fault;
• Art. 146 — the general ten-year period, which is what art. 147(6) leaves in place in the gross-fault case;
• Art. 478 — for actions based on the contractor having produced a defective work: two years from delivery for works other than immovable structures, five years for immovable structures, and twenty years regardless of the nature of the defective work where the contractor is grossly at fault;
• Art. 72 — the tort period of two years from learning of both the damage and the person liable, and ten years in any event, which defendants routinely plead in the alternative — in the 2 October 2025 case both defendants pleaded the two-year tort period, and the claim had been brought roughly four years after the operation.

Art. 148 prevents any of these being varied by agreement. The 12 January 2026 judgment shows how live the question is in practice: a consumer court had dismissed the joined money claim in an aesthetic rhinoplasty case as brought after the five-year period of art. 147(6), and the Yargıtay set that dismissal aside — but on a different ground altogether, namely that limitation is a personal defence under art. 164(1) available only to the co-defendant that actually pleaded it, so the co-defendant clinic company that had not pleaded it could not take the benefit. The judgment therefore does not resolve which period governs. It is a reminder that the deadline in these cases is argued, not assumed.

Where insurance and the criminal track sit

Compulsory professional liability insurance stands behind aesthetic practice in the same way as behind other specialties. Supplementary art. 12 of Law No. 1219, added by Law No. 5947 of 21 January 2010, obliges physicians, dentists and specialists working in private health institutions or practising independently to carry medical professional financial liability insurance covering damage caused by medical malpractice and recourse claims. For those working in private institutions the policy is taken out by the institution and half the premium is borne by the practitioner, and the employer’s share may not be deducted from the practitioner’s pay under any name.

Two details are worth stating because the opposite is often assumed. First, the Tariff and Instruction annexed to the compulsory medical malpractice insurance rules does not set one figure for all practitioners: it sorts specialties into risk groups in its Annex-1 and fixes a separate maximum cover and premium for each. Under the communiqué published in the Official Gazette of 7 August 2025, No. 32979, in force from 1 November 2025, the total payable under a single contract may not exceed 9,000,000 TL. The per-event cover and the premium depend on the risk group the specialty falls into; the group tables are published as images in the annex and are revised periodically, so the applicable group and the current amounts must be read off the tariff in force at the relevant date rather than assumed. Second, clause A.3 of the General Conditions, in the form it has had since 26 July 2014, lists only four categories outside cover — activity outside the insured’s professional activity as bounded by legal or ethical rules; activity outside the responsibility area of the institutions within the policy, save humanitarian assistance; all administrative and judicial fines, penalties and penalty clauses; and claims arising from experimentation outside the framework set by legislation. Cosmetic and aesthetic procedures are not among the exclusions.

Criminal exposure, where it arises, runs on a separate track through a permission filter and does not affect the civil claim. Supplementary art. 18 of Law No. 3359, added by Law No. 7406 of 12 May 2022 and amended by Law No. 7496 of 21 February 2024, applies Law No. 4483 to investigations of physicians, dentists and other health professionals working in public or private health institutions and foundation universities in respect of medical acts performed in the exercise of the profession; permission to investigate is given by the Professional Liability Board established within the Ministry of Health, a seven-member body chaired by a Deputy Minister; the time limits in art. 7 of Law No. 4483 apply doubled; and the Board’s decisions may be challenged before the Ankara Regional Administrative Court. It governs criminal investigation permission and public-sector recourse decisions only — it is not a gateway to, or a filter on, a compensation claim, and patients do not apply to it. Where the same facts also found a criminal complaint, that proceeds under general criminal law rules alongside the civil action.

The position of a foreign patient

A patient who travelled to Türkiye for an aesthetic procedure is in the same legal position as a patient resident here: the treatment was given in Türkiye, the claim is governed by Turkish law, and it is pursued before the Turkish courts. Four features of the framework bear on that situation specifically.

The consumer-law layer applies in the same way. Nothing in arts. 2 or 3 of Law No. 6502 conditions consumer status on nationality or residence; what matters is that the person acted for non-commercial and non-professional purposes and contracted with a supplier acting professionally. The fee exemption in art. 73(2), the mediation pre-condition in art. 73/A and the annual arbitration-committee threshold apply on the same terms.

The consent analysis is patient-specific, and that cuts both ways. Because adequacy is assessed against the individual patient’s education, age and cultural level, and because art. 18 of the Patient Rights Regulation requires the information to be given orally, by the professional who will perform the intervention, in language suited to the patient’s social and cultural level and with a reasonable period allowed before the procedure, an explanation given in a language the patient did not follow — or given minutes before theatre — is a recognisable issue rather than a rhetorical complaint. It is also, for the same reason, an issue that has to be established on the record rather than asserted.

The Biomedicine Convention applies. Because the Convention forms part of Turkish domestic law and the Yargıtay has held that it must be accepted as applying to aesthetic interventions of a works-contract character, its professional-standards requirement in art. 4 and its informed-consent requirement in art. 5 are available in a Turkish court without any need to invoke foreign law.

Promotion aimed at patients abroad is separately regulated. Art. 8 of the 12 November 2025 Regulation creates a narrow health-tourism carve-out: facilities and intermediaries holding a Ministry authorisation under the International Health Tourism Regulation (Official Gazette of 26 April 2025, No. 32882) may run sponsored promotion in official languages other than Turkish, on separate outward-facing channels, and may publish patient stories, comments or thank-you statements there with documented explicit consent. The carve-out is bounded: promotion aimed at creating demand among people living in Türkiye is prohibited, domestic audience targeting may not be selected, and automatic audience targeting must be disabled. A foreign patient is therefore likely to have seen material that is lawful for that audience and would not be lawful domestically — which makes what was promised, and in what terms, a matter to be preserved rather than assumed.

Physicians’ own professional rules point the same way. Art. 8 of the Medical Deontology Regulation provides that the professions of medicine and dentistry, and treatment institutions, may not be given a commercial character, and bars the physician from self-advertisement and from procuring thank-you notices of an advertising nature in newspapers and other publication media.

What this means in practice

Aesthetic-surgery litigation in Türkiye is decided on issues that are settled early and rarely revisited.

• The characterisation is the first contested question, not a formality. Whether the aesthetic aspect predominated determines what has to be proved, and it is the judge’s own duty under HMK art. 33 rather than something the paperwork can fix in advance.
• Under a works contract the case is about the promised result. A report confirming the intervention was technically lawful does not answer the question the court has to decide.
• The guarantee has limits. Complications do not automatically excuse, but the defence of a broken causal link, the patient’s own fault, and the owner-instruction rule in art. 476 all remain open to the defendant.
• Consent is proved by the physician, not disproved by the patient — and it is proved from records, which is why gaps in the file work against the provider.
• The defect-notification rules bite. Inspection and notification within a reasonable time under art. 474, and notification without delay of a later-appearing defect under art. 477, are conditions of the elective rights, not administrative detail.
• Do not assume a limitation period. Four rules compete, art. 148 forbids varying them by agreement, and the most recent judgment on the point declined to settle which governs.
• Check the year on every figure. The consumer arbitration threshold changes every 1 January; the insurance cover figures are revised periodically. A number without a date attached is not usable.

The texts of every law and regulation cited here, as consolidated and in force, are published on the Presidency’s official legislation database, Mevzuat Bilgi Sistemi; the judgments are published in the Court of Cassation’s own decision database at karararama.yargitay.gov.tr.