General Risks and Complications of Plastic Surgery
1. Wound Infection
Wound infection is a possible complication of any plastic surgery procedure. It occurs when bacteria manage to get into the wound and can damage your skin and tissues.
Symptoms that of a wound infection after plastic surgery can include:
- Redness around your wound(s)
- Increased pain
- Non-healing wounds
- Pus formation and leakage – yellow-white fluid drainage
To reduce the risk of wound infection, Dr Hunt and Dr Maryam follow strict sterility techniques in all surgeries they perform. Wound infection should be promptly treated with antibiotics. Sometimes, surgical debridement might be necessary to remove any dead (necrotic) tissue and promote wound healing. If you suspect that you might have a wound infection after any cosmetic procedure, don’t delay letting your surgeon know.
2. Seroma Formation – Internal Fluid Collection & Pooling
A seroma is a collection of fluid or lymph that occurs in the wound; under the skin. Lymph is a protein-rich fluid that runs in our tissue to nourish cells. Surgery can damage the lymph vessels in the target body area, so lymph leaks and collects in a closed area, causing a seroma. Symptoms of seroma include:
- Increased pain
- Feeling of pressure
- A bump under the surgical site
- Clear fluid drainage from the wound
A Seroma is a minor plastic surgery complication that can usually be easily handled. Your surgeon might use a syringe to drain the fluid out. This may require another visit back to theatre.
3. Hematoma – Internal Blood Collection & Pooling
Haematoma is another complication of plastic surgery. It’s when a collection of blood forms inside the wound. The symptoms resemble those of seroma, however, blood might drain out. Most of the time, a haematoma is easily handled and is not considered a serious complication of cosmetic procedures. Dr Hunt might also use a syringe to drain the blood out. This may require another visit back to theatre.
The source of bleeding usually heals alone without needing further intervention.
Other Potential Risks and Complications
4. Wound Dehiscence or Wound Breakdown
This is when a suture breaks and the wound fails to close. It’s an uncommon plastic surgery complication, but it needs rapid evaluation and management. Wound dehiscence can sometimes be associated with wound infection. If not managed quickly, it might ruin the results of your plastic surgery. Treatment of wound dehiscence after a cosmetic procedure includes wound debridement, antibiotics, and re-suturing the wound.
You can help avoid a wound breakdown by taking time for the wound to close and internal tissues to heal before over-exerting yourself at work or the gym.
5. Risks of Anaesthesia
General anaesthesia is mostly safe but has some risk of complications. Complications of anaesthesia can include:
- Allergic reaction to anaesthetic medications
- Trauma to the teeth, mouth, and throat (due to intubation)
- Malignant hyperthermia
- Problems with blood pressure and respiration
- Problems with the cardiovascular system
Today, anaesthetists follow well-studied protocols, and general anaesthesia is considered very safe. Your anaesthetist will be next to you during the whole procedure and will be monitoring your vital signs to keep everything under control. If complications occur, they are usually quickly handled in the operation room.
6. Blood Clot Formation
Blood clot formation is a risk after any plastic surgery procedure. It most commonly occurs with more invasive procedures that require extended bed rest. When you’re not moving enough after surgery, blood stagnates in the circulation, and clots inside the vessels. This occurs most commonly in the legs due to the effect of gravity. It’s called “deep vein thrombosis” or DVT.
Symptoms of deep vein thrombosis include:
- Leg pain
- Leg swelling
- Feeling of warmth in the affected leg
- The affected leg looks more red compared to the other leg
It is essential to treat blood clots without delay after plastic surgery. Otherwise, the clot might migrate to the lungs and cause an infarction. Treatment usually involves prescribing blood-thinning medications. To prevent blood clots, we usually encourage patients to move as quickly as possible after surgery. Sometimes, compression stockings for blood-thinning medications are recommended for a short time post-op.
7. Excessive Scarring or Keloid Scars
Wound healing abnormalities can rarely occur as a long-term complication of plastic surgery. They can ruin the aesthetics of the wound, and lead to a flagrant scar. Keloid and Hypertrophic Scarring are two wound healing abnormalities that pose such a threat. The scar overgrows, extending above and beyond the wound edges. Sometimes, it might be noticeably more or less pigmented than your normal skin colour. Keloid and hypertrophic scars rarely take place. The cause is thought to be related to the patient’s genetics. Treatment involves scar removal surgery and, sometimes, steroid injections.
Specific Risks and Complications – associated with Plastic Surgery Procedures
In addition to the general complications of anaesthesia and surgery, specific types of plastic surgery procedures are associated with their own risks.
Risks of Body Lift Procedures
Body lift procedures include major surgeries such as back lift, thigh lift (thighplasty), tummy tuck (abdominoplasty) and arm lift (brachioplasty). They involve removing a lot of subcutaneous tissue and skin and tightening the rest of the tissue with sutures.
The only specific complication of body lift procedures is the loss of sensation. You might lose touch sensation in a patch of skin near the area that was lifted. This can be temporary or permanent.
Risks of Liposuction Procedures
Liposuction involves the use of a thin metallic catheter to suck the fat from under the skin. The metallic rod is moved in and out under the skin in different directions to target the fat.
One specific complication of liposuction is internal organ injury. While thrusting the metallic catheter under the skin, it might brush against an internal organ (e.g. the liver). This is an extremely rare complication, however, it can lead to serious outcomes unless quickly managed.
Risks of Breast Surgery
Complications can occur with breast augmentation mammoplasty, breast lifting mastopexy, reduction mammaplasty, and implants. Most of the complications of breast surgery are long-term and happen after years of your procedure (if ever). Complications of cosmetic breast procedures include:
- Capsular contracture: It’s the most common complication of breast implants. It’s when a tough scar capsule forms around the implants which can cause breast deformity, pain, and asymmetry.
- Breast implant malrotation or malposition: This is when the implant rotates or migrates from its original position. It can cause breast deformity and unevenness.
- Breast implant rupture: Breast implants might rupture, causing asymmetric breasts and deflation on the affected side.
- Loss of sensation: Nerve injury is a side effect of breast surgery. It might lead to temporary or permanent loss of sensation in the nipple or a patch of breast skin.
- Inability to breastfeed: If the milk ducts are damaged with breast surgery, you might lose the ability to breastfeed. You should always discuss this risk with your surgeon to know which type of procedure is best for you.
- Risk of BIA-ALCL: Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is an extremely rare complication of breast implants. It’s a type of cancer that arises from immune cells around the implant, and usually manifests as a seroma. BIA-ALCL is thought to be exclusively associated with textured implants. Treatment involves explantation and c- sometimes an Enbloc Capsulectomy.
- Risk of BII – Breast implant illness: This is a fairly new and rare condition thought to be linked to breast implants. It’s a vague syndrome that includes non-specific symptoms like fatigue, sleep troubles, joint pain, and clouded thinking. Some authors suggest that it might occur in susceptible people due to a chronic low-grade inflammation around the implant. The only treatment for BII is breast implant removal.
- Pneumothorax: Unlike the others, pneumothorax is an intraoperative complication of breast surgery. It occurs during the procedure. It’s when the lung is injured during surgery, causing an air leak inside the chest cavity. This is may during an en-bloc capsulectomy or less likely, during breast surgery.
Longer-term complications of breast plastic surgery that lead to breast deformity can usually be managed by breast revision surgery or breast implant revision surgery.
If you suspect that there’s something wrong with your breasts or breast implants, please consult your surgeon urgently.
Risks of Facial Surgery
Risks of Eyelid Surgery (Blepharoplasty)
Specific complications can rarely occur with cosmetic eyelid surgery procedures such as upper blepharoplasty (eyelid lift), lower blepharoplasty (eye bag removal), and canthoplasty. These complications include:
- Inability to fully close the eyes: If the eyelid is lifted or tightened too much, then the eye might not be able to fully close. This can lead to eye irritation and dryness.
- Overexposure of conjunctiva: If the eyelid is tightened too much, then the inner red part (conjunctiva) might be exposed.
- Asymmetric eyes: The eyes might look different if the eyelids are not lifted and reshaped in a similar way.
- Problems with eye movement: Sometimes, the eye muscles might be damaged during blepharoplasty, leading to eye movement problems.
- Problems with vision: direct eye trauma and nerve damage are rare blepharoplasty complications that might cause vision problems.
These complications are very rare, especially if an experienced plastic surgeon is performing the surgery.
Risks of Facial Cosmetic Surgery
Aside from the general surgical risks, facial nerve injury is a specific risk of facelift (rhytidectomy) procedure.The facial nerve is an important nerve that supplies the muscles of facial expression and part of the tongue. During a facelift, a branch of the facial nerve might be damaged. This can rarely lead to facial muscle weakness in the affected muscle group. It can also lead to facial asymmetry.
Risks of Nose Surgery
Rhinoplasty is one of the most commonly performed plastic surgeries at our clinic. Rhinoplasty, like other cosmetic procedures, is generally safe. However, some rare complications might occur after getting your nose done:
- Difficulty breathing: Rarely, the nasal passage might become narrow after a nose job. This complication can cause difficulty breathing.
- Nasal septal perforation: The nasal septum is the wall separating the two nasal cavities on the inside. It can rarely become perforated as a complication of rhinoplasty. This can manifest as wheezing, recurrent nosebleeds, dryness, and a feeling of nasal obstruction.
- Problems with skin sensation: If a branch of the sensory nerves supplying the skin around the nose is damaged, it can lead to altered sensation in the area.
- Unsatisfactory results: The nose is very delicate. As such, rarely, the new nose might not look the way you want it to. Sometimes a second (revision) rhinoplasty to correct the shape of the nose.
How you can Reduce the Risks of Plastic Surgery Complications
Although the risks and complications of plastic surgery are not common, there are several things you can do to reduce your risks :
1. Always Choose an experienced Plastic Surgeon
This is the most important factor when it comes to preventing plastic surgery complications. Experienced plastic surgeons have performed thousands of surgeries and pay attention to details that might be missed by others. They usually have their own special techniques to reduce complications, and know how to effectively deal with them should they arise.
2. Rest & Relax – Respect your recovery timeline
The recovery period after plastic surgery is critical. Depending on your procedure, your surgeon will recommend 1-6 weeks of rest, with a gradual increase in physical activity. Don’t perform sports or demanding activities ahead of the recommended time. Otherwise, you’re just risking a complication.
3. Do Not Smoke, Vape or do Recreational Drugs
Smoking is the enemy of wound healing. It significantly reduces the ability of your tissues to heal and can ruin your results. Lack of oxygen to your tissues, can cause wound breakdown, death of skin & surrounding tissue (Necrosis) and even loss of a Breast Nipple. Please don’t smoke or be near other smokers.
It is recommended that you stop smoking for as long as possible – a minimum of 4 weeks before and after your plastic surgery procedure.
4. Follow your surgeon’s aftercare instructions closely
After your plastic surgery, your surgeon and the team will explain how you should sleep, how to clean the wound, what you should eat, and what medications you should take. You should follow these instructions closely to reduce the chances of a complication of plastic surgery.
5. Wear your compression garment
Early on, wear your garment night and day or for as long as possible (or as instructed). You will need to wear some form of compression garment after some surgeries. These include procedures like the tummy tuck, breast lift, breast augmentation, arm lift, and others. Compression garments can prevent seroma, hematoma, bleeding, and swelling. The support they provide can also speed tissue healing and improve results.
6. Move Gently and start walking
You should start walking after a plastic surgery procedure as soon as you are allowed. This prevents blood clot formation and improves blood circulation to nourish the wound. Do not spend hours in bed or a chair. Get up and walk at least for a few minutes every half an hour.
7. Don’t overdo it – Avoid Stress and Strain too early
Give yourself time to heal. The quality of your surgical result can really be impacted if you put too much pressure and stress on your incision and internal wound. Please avoid overdoing things at home, at work or going back to exercise too early. You might feel good, but you may not be quite healed just yet and you’ll do damage.
8. Avoid Alcohol
Alcohol can slow healing. Please go easy.
Real Patient Results for Plastic Surgery
The outcomes shown are only relevant for this patient and do not necessarily reflect the results other patients may experience, as results may vary due to many factors including the individual’s genetics, diet and exercise.
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FAQs about Risks of Plastic Surgery
How long is the recovery period after plastic surgery?
The length of your recovery period is dependent on many factors, such as:
- the type of procedure you had
- your health condition before the intervention
- how committed you are to following the indications of the plastic surgeon
- your own healing pace
In plastic surgery there is no one-size-fits-all and this is valid for the recovery period too.
Further Reasing about BII and BIA-ALCL - risks of breast implant plastic surgery
Here are some good articles on the special risks of breast implant surgery
Further Reading & Medical Sources about Risks of Plastic Surgery
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