In cosmetic surgery, is there an obligation of result or an obligation of means? In cosmetic surgery, there is no obligation of result. Why ? Cosmetic surgery is surgery and above all it is medicine. In medicine we have what is called a contract of means, and not of result. That is to say that we have the contract not to commit any error, whether it is at the level of the operative indication, the performance of the technical act or the information that we give to the patient, operative follow-up. “During an expertise, the magistrate asks the expert if there was a fault. If there was no fault and that is what is called a therapeutic hazard, because the The hazard exists, zero risk does not exist. If the patient has been really informed, in this case there will be no compensation. But it is not necessary for the patient to take out insurance. D ‘elsewhere, it does not exist. ” Obligation of means For a doctor, failure to comply with the obligation of means is a fault, liable to legal and / or ordinal sanctions. As we know, the Code of medical ethics obliges physicians to deliver care “attentive, conscientious and in accordance with the data acquired from science”. This is the official formulation, since the very famous “Mercier judgment” (Cour de cassation of May 20, 1936), which does not really take into account the fact that medicine is a human science, like anthropology, and not a exact science, like physics. The data acquired from science are therefore still questionable (and they were certainly more so in 1936 than in 2017!). This Mercier ruling is included in article L.1142-1 of the Public Health Code as it results from the law of March 4, 2002 relating to “the rights of patients and the quality of the health system” (c ‘ is the full name of this law, passed down to posterity as the “Kouchner law”). Obligation of result There is a medical specialty for which the question of the obligation of result has legally arisen: cosmetic surgery. Of course, the plastic surgeon cannot guarantee that the patient (of whatever sex) will be totally satisfied with the result of his intervention; on the other hand, this result must be in accordance with what was envisaged during the consultation: if the surgeon has made a commitment, supporting photos, that his patient has a “trumpet” nose, the result must be conforms to this type of nasal morphology. As the Senate website indicates, cosmetic surgeons are in fact not subject to the obligation of result, but to an “enhanced obligation of means”, in particular with regard to the information provided to the patient, particularly in matters of risks. In addition, the risk of the intervention must be proportionate to the extent of the disgrace observed; likewise, it is imperative that the operative sequelae (scars in particular) do not exceed the initial cosmetic defect. The obligation to provide information on the risks of a technical act, an intervention in particular, is in practice an obligation of result, even if it is not presented in this way. In other words, the doctor who delivers information to his patient must ensure that the latter has actually understood it, and that, consequently, the obligation to inform has been effective. In addition, he must be able to demonstrate it if necessary (see below). However, doctors find daily that information, no matter how they give it (orally, in writing, and even both), is rarely understood correctly, and not just because patients lack knowledge. medical. Statistics show that millions of women and men use cosmetic surgery every year. At the IRAQI CLINIC all medical and cosmetic surgery operations are carried out: lifting, nose, eyelids, lips, chin, ears, breasts, abdomen, liposuction, liposculpture, scalp micro-grafts, scar correction, wrinkle treatment , botox, laser, lipofilling, vaginoplasty, hymenoplasty, penoplasty, nymphoplasty … Dr. KAMAL IRAQI HOUSSAINI Specialist graduated from the Universities of Paris Specialist qualified in Reconstructive and Aesthetic Plastic Surgery by the National Order of Doctors Ex. President of the Moroccan Society of Reconstructive and Aesthetic Plastic Surgery Member of the French Society of Aesthetic Plastic Surgeons Sworn Expert by Courts in Reconstructive and Aesthetic Plastic Surgery Speaker at many national and international congresses Author of the book: PRACTICAL GUIDE OF LIPOSUCCION OR LIPOASPIRATION AND IRAQI CLINICAL SURGERY AESTHETIC MEDICINE 89 boulevard IBN SINA Casablanca – MOROCCO Tel: 00212 (0) 522360771/00212522360777 E-mail: ccecasa@gmail.com Web sites: http: // www.clinique-esthetique-maroc.com.

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