Factors Associated with Court Outcomes of Medical Malpractice Litigations Involving Breast Reductions: 1990 to 2020

Up to 7.4% of physicians in the United States face the risk of undergoing medical malpractice litigation each year. Breast reduction operations are performed often, but specific factors of breast reduction malpractice litigation associated with the outcome and indemnity payments to plaintiffs are unknown.

Using the Westlaw legal database, the authors analyzed plaintiff and defendant characteristics, alleged reasons for malpractice, case outcomes, and payments to plaintiffs among medical malpractice lawsuits involving breast reductions with final jury verdicts or settlements, using logistic regressions.

Ninety-six malpractice litigations with jury verdicts or settlements involving breast reduction operations between 1990 and 2020 met the authors' inclusion/exclusion criteria. The average reported plaintiff age was 39 ± 15 years. A total of 28% ± 29.2%, 48% ± 50.0%, and 20% ± 20.8% cases occurred in the 1990 to 1999, 2000 to 2009, and 2010 to 2020 periods, respectively; 15% ± 15.6% of cases were held in New York. Most cases were in favor of defendants [ n = 65 (67.7%)]. Among 14 cases (14.6%) with nipple malpositioning as a sustained injury, eight of them (57.1%) were ruled in favor of plaintiffs. Nipple malpositioning had increased odds of plaintiff verdict or settlement versus defendant verdict (OR, 1.33; 95% CI, 1.03 to 1.74; P = 0.03). Median payments to plaintiffs were $221,348 (range, $4375 to $3,500,000) for plaintiff verdicts and $650,000 (range, $250,000 to $750,000) for settlements.

Most breast reduction malpractice litigations were ruled in favor of defendants. Nipple positioning should be taken into high consideration by plastic surgeons performing breast reductions to avoid malpractice litigation and indemnity payments.