Background Malpractice litigation has a significant impact on healthcare costs and important professional implications for healthcare providers. Objectives The authors sought to comprehensively characterize the litigation landscape in plastic surgery across its different subspecialties. Methods The authors utilized the Westlaw legal database to conduct a comprehensive search of malpractice cases in the United States in the following categories: cosmetic, reconstructive, hand, craniofacial, and gender affirmation surgery. They conducted both a Boolean and a natural language search to identify cases in which a plastic surgeon was the defendant. Data were analyzed employing descriptive statistics, logistic regression, and relative risk calculations. Results In total, 165 cases were included. Most surgeons accused of malpractice worked in a private setting (148 [90%]). Among the 22 (13%) cases that contained information on board certification status, most surgeons were board certified (17 [77%]). Resident involvement was mentioned in only 5 (3%) cases. The majority of cases were successfully defended by surgeons (98 [60%] vs 65 [40%]), particularly in craniofacial surgery (risk ratio: 1.54; P = 0.03; 95% CI: 1.03-2.3). Surgeons who successfully defended a case were more likely to benefit from summary judgment (P = 0.005). Conclusions Malpractice litigation is commonplace in medical practice, and no specialty is spared. Legal outcomes were in favor of plastic surgeons in the majority of cases, particularly those that proceeded to summary judgment. Surgeons can avoid litigation by maintaining detailed office and surgical notes, always obtaining informed consent, adequately following and monitoring patients after surgery, and ensuring compliance by communicating frequently and effectively.

stablished in 1966 under the Social Security Administration, Medicare is the primary health insurance for many Americans older than 65 years. 1 In 2018, Medicare represented more than 61.5 million individuals, and its budget was approximately $750 billion. 2 Medicare reimburses physicians based on a national fee schedule. 1 To establish this fee schedule, each medical procedure or service is represented by a CPT code and linked to an International Classification of Diseases, Tenth Revision, diagnosis. This represents the relative resources required to provide a particular service and forms the basis for physician and hospital reimbursement. 3 These relative value units are updated annually by the Centers for Medicare and Medicaid Services and effectively set the standard by which hospitals and/or physicians are reimbursed. Relative value units consider expenses related to physician work, practice expenses, and malpractice insurance. The final fee schedule for each procedure/service is then determined by applying the conversion factor to the relative value units. The conversion factor is a number selected by Centers for Medicare and Medicaid Services every year based on complex formulas that take into consideration the Medicare charges the year prior, the number of Medicare enrollees, the overall status of the U.S. economy, and any expected regulations that may affect Medicare services. The goal of the conversion factor is to limit potential increases in the Medicare budget higher than 20 percent from the last year's budget. 4 Growth in the aging population, steadily rising health care costs, and increased demand for health care services combined with fluctuations in the national political and financial landscape lead to financial unpredictability in the health