Ethan Clarke
Plastic surgery is an umbrella term for procedures designed to alter the shape and appearance of the body. While the number of procedures performed is increasing, so are the complications. Complications from plastic surgery can include hematoma, seroma, blood loss, infection, nerve damage, organ damage, and scarring. Abdominoplasty procedures have a slightly higher rate of deep vein thrombosis (DVT) and pulmonary embolism (PE), affecting just under 1% of patients. The risk of clots is five times higher for people having multiple procedures. General anesthesia can also lead to complications, including lung infections, stroke, heart attacks, and death. While rare, complications from plastic surgery can be fatal and require extensive treatment.
| Characteristics | Values |
|---|---|
| Hematoma | A pocket of blood that resembles a large, painful bruise |
| Bruises | |
| Seroma formation | |
| Nerve damage | Leading to neuropathy or sensory/motor loss |
| Infection | Skin infections like cellulitis, or internal infections |
| Scarring | Abnormal or hypertrophic scarring |
| Blood loss | |
| Complications of anesthesia | Lung infections, stroke, heart attacks, death |
| Blood clots | Deep vein thrombosis (DVT) |
| Pulmonary embolism | |
| Thromboembolic shower | Caused by fat particles being dislodged during liposuction |
| Slow-healing wounds | |
| Persistent granulomas | |
| Pain | |
| Vomiting | |
| Disappointment with results |
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Blood loss and infections
Blood Loss
Plastic and reconstructive surgeries are often complex, involving significant changes to otherwise healthy areas of the body. Blood loss is a potential complication of these surgeries, particularly in advanced procedures such as facial feminization surgery. Blood-soaked dressings can be a sign of excessive bleeding. Other factors that may increase the risk of blood loss include the type of surgery, the patient's health history, and lifestyle factors such as smoking.
Infections
Infections are another common complication of plastic surgery. While postoperative care includes steps to reduce the risk, infections can still occur. These can be either internal or external, such as skin infections like cellulitis. In some cases, severe infections may require intravenous (IV) antibiotics. The risk of infection may depend on various factors, including the type of surgery, the patient's health history, and lifestyle choices.
Preventative Measures and Treatment
Receiving services from an experienced surgeon and following post-operative care instructions can help reduce the risk of complications. It is important to keep incisions clean, take all prescribed medications, and monitor the surgical site for any signs of infection. In the event of blood loss or infection, additional medical treatments or procedures may be necessary.
Other Considerations
It is worth noting that plastic surgery complications can vary depending on the specific procedure and the patient's characteristics. Smokers, older adults, and obese individuals are generally more prone to complications. Additionally, certain procedures, such as tummy tucks, liposuction, and facial reconstruction, carry higher risks than others.
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Nerve damage
- Blepharoplasty (eyelid surgery): Supraorbital nerve or supratrochlear nerve (4.0%), infraorbital nerve (2.8%)
- Rhinoplasty (nose surgery): Olfactory dysfunction (31.8%)
- Rhytidectomy (face-lift): Facial nerve injury (1.0%), permanent nerve injury (0.03%)
- Breast surgery: Intercostal cutaneous nerve (8.86-10.01%), long thoracic nerve (0.01%), permanent nerve injury (1.66%)
- Abdominoplasty ("tummy tuck"): Lateral femoral cutaneous nerve (1.36%), iliohypogastric nerve (0.1%), permanent nerve injury (1.02%)
To minimize the risk of nerve damage, practitioners should carefully assess the patient's anatomy and consider any potential variations or anomalies. During surgery, gentle tissue handling and a thorough understanding of the nerves' pathways are important to avoid inadvertently damaging nerves. Working with a highly experienced surgeon will also help reduce the risk of nerve damage.
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Anaesthesia complications
Although anaesthesia-related complications in plastic surgery are rare, they can be catastrophic. To ensure patient safety, it is crucial to understand the key aspects of anaesthesia administration, including patient positioning, airway management, and specific condition-related issues.
One of the main concerns with anaesthesia is respiratory issues, which can be life-threatening. Deep vein thrombosis and pulmonary embolism, which are among the most frequent complications, can lead to death. Elderly patients are at a higher risk of perioperative complications due to reduced organ function and age-related health conditions. Their risk can be minimised by understanding the physiological changes that occur with ageing.
Additionally, post-operative nausea and vomiting (PONV) are common complications, especially after general anaesthesia. Narcotics and nitrous oxide can exacerbate this issue. Furthermore, patients with obstructive sleep apnoea (OSA) may require more focused postoperative monitoring and, in some cases, conversion to a hospital stay.
Another complication is emergence delirium (ED), which occurs in 20-80% of children anaesthetised with sevoflurane. ED can lead to behavioural changes, and techniques using propofol, ketamine, and lidocaine have been described to reduce its occurrence.
To enhance patient safety, anaesthesiologists must be well-prepared and knowledgeable about the various techniques and potential side effects. They should work closely with surgeons to determine the best anaesthesia method for each patient, ensuring minimal postoperative side effects and a comfortable discharge.
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Organ damage
Plastic surgery is a complex procedure that can alter sensitive structures near major organs and delicate tissue. While complications are rare, they can occur during surgery or after recovery. One potential complication is organ damage, which can be caused by visceral perforations or punctures when the surgical probe comes into contact with internal organs. These injuries may require additional surgery and can even be fatal in some cases.
Liposuction, a type of cosmetic surgery, can be particularly risky when it comes to organ damage. The procedure involves the insertion of a surgical probe, which can inadvertently puncture internal organs. These perforations can lead to severe and life-threatening complications, requiring immediate medical attention and additional surgeries for repair.
Abdominoplasty, another surgical procedure, carries a slightly higher risk of deep vein thrombosis (DVT) and pulmonary embolism (PE). DVT occurs when blood clots form in deep veins, typically in the legs, and PE arises when these clots travel to the lungs. These conditions can have serious health consequences and require urgent medical intervention.
Furthermore, breast augmentation surgery can result in changes in sensitivity and, in some cases, permanent alterations in nipple sensation. About 15% of women experience these long-lasting effects, underscoring the potential for nerve damage following plastic surgery.
In addition to physical complications, plastic surgery can also lead to psychological impacts. Some individuals may experience disappointment with their surgical results, affecting their body image and self-esteem. This highlights the importance of thoroughly researching the procedure, understanding the risks, and selecting a qualified and experienced surgeon to mitigate the chances of undesirable outcomes.
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Scarring
Scars can be particularly troubling after cosmetic surgery, as the procedure seeks to improve one's appearance. The development of a scar can be unpredictable, and even a wound that heals well can result in a scar. They may be noticeable due to their size, shape, location, colour, texture, or other surface irregularities. Certain scars, such as hypertrophic scarring, may appear as abnormally red and thick raised scars.
Plastic surgery scars typically continue to diminish in appearance for up to two years. However, scar tissue can take up to a year to fully mature. Silicone gels or sheets and scar massages have been shown to decrease scarring by reducing inflammation and redness. Other methods to minimise scarring include microneedling or Morpheus8 RF microneedling, which help remodel collagen fibres, making scars flatter and less visible.
In more severe cases of scarring, scar revision surgery can be performed to minimise the appearance of the scar. While this procedure cannot create a scar-free result, it can improve the scar's appearance by removing scar tissue and suturing the new incision with techniques that help create a finer scar.
It is important to note that plastic and reconstructive surgeries are complex procedures that carry risks of complications. These surgeries may alter sensitive structures near major organs or delicate tissue. The likelihood of complications depends on factors such as the type of surgery, the patient's health history, and lifestyle factors.
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Frequently asked questions
Plastic surgery is an umbrella term for procedures designed to alter the body's shape and appearance. Complications are rare, but they can include:
- Blood loss
- Infection
- Nerve damage
- Organ damage
- Blood clots
Surgeons will take precautions to prevent infections, but they can still occur during the healing process. Infections can be mild or severe and may require intravenous antibiotics. Rigorous incision care is vital for infection prevention.
Numbness and tingling are common after plastic surgery and can indicate nerve damage. Usually, this damage is temporary, but it can be permanent. Most women experience a change in sensitivity after breast augmentation surgery, and 15% experience permanent changes in nipple sensation.
Deep vein thrombosis (DVT) is a condition where blood clots form in deep veins, usually in the legs. Abdominoplasty procedures have a slightly higher rate of DVT, affecting under 1% of patients. The risk of clots is five times higher for people having multiple procedures.
General anaesthesia can lead to lung infections, strokes, heart attacks, and death. Anaesthesia awareness, or waking up during surgery, is rare but possible. Confusion, disorientation, shaking, and vomiting are also common after waking up from surgery.
