Maya Ellison
Plastic surgery is a group of procedures that alter certain areas of the body, including the face, neck, breasts, stomach, arms, and legs. While most people are satisfied with the results of their surgery, there are risks and complications that can occur. These include blood loss, infection, nerve damage, deep vein thrombosis (DVT), scarring, and in rare cases, complications from anaesthesia. It is important to select a qualified and experienced surgeon to perform your procedure and to follow postoperative care instructions to reduce the risk of complications.
| Characteristics | Values |
|---|---|
| Disappointment with results | Contouring or asymmetry problems |
| Anesthesia complications | Lung infections, stroke, heart attacks, death, anesthesia awareness |
| Hematoma | Occurs in 1% of breast augmentation procedures and facelifts |
| Blood loss | Internal bleeding |
| Infection | Skin infection, cellulitis, internal infection |
| Nerve damage | Temporary or permanent numbness and tingling |
| Deep vein thrombosis (DVT) | Blood clots in the legs |
| Visceral perforations | Fatal punctures to internal organs |
| Scarring | Hypertrophic scarring |
| Excessive bleeding | Blood-soaked dressings |
| Pain | Pain that doesn't respond to medication |
| Vomiting | Inability to keep fluids down |
| Recovery | Physical therapy, speech therapy, occupational therapy |
| Surgeon issues | Surgeon qualification, experience, and realistic expectations |
| Revision surgery | Additional costs and surgeon reluctance |
| Legal action | Lawsuit as a last resort |
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What You'll Learn
Complications from anaesthesia
Firstly, it is important to ensure your surgeon and anaesthesiologist are experienced and certified to carry out the procedure. You should also ensure that your doctor is aware of your full medical history, including any medications, drug use, and previous surgeries.
General anaesthesia is the most common type of anaesthesia used in plastic surgery. It involves a combination of intravenous drugs and inhaled gases to ensure the patient remains asleep and free from pain. Under general anaesthesia, bodily functions slow down, and the patient may experience side effects such as nausea, vomiting, and short-term memory loss after the operation.
Some medications, herbal supplements, and recreational drugs may negatively interact with general anaesthesia, so it is important to disclose any drug use to your doctor. For example, blood thinners will cause increased bleeding during the operation, so you may be asked to stop taking certain medications like aspirin or ibuprofen.
Another potential complication is emergence delirium (ED), which occurs in 20-80% of children, especially when sevoflurane is used for anaesthesia. ED can cause behavioural changes in children, and techniques such as the administration of propofol, ketamine, and lidocaine can reduce its occurrence. Elderly patients are also at greater risk of complications due to reduced organ function and age-related diseases.
Finally, proper assessment of the patient's airway is crucial before administering general anaesthesia, especially for head and neck surgeries. A history of previous airway difficulty, limited mandibular protrusion, abnormal neck anatomy, sleep apnoea, snoring, and obesity can indicate potential difficulties with mask ventilation.
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Blood loss and infections
Blood loss and infection are two of the most common complications that can occur during plastic surgery. While postoperative care includes measures to reduce the risk of infection, it remains one of the more common complications of plastic surgery. In some cases, infections can be internal and severe, requiring intravenous (IV) antibiotics. Signs of infection include fever or yellowish discharge from the incision.
Blood loss can occur while on the operating table, but it can also happen internally after surgery. Blood-soaked dressings are a sign of excessive bleeding. Hematoma, a pocket of blood that resembles a large, painful bruise, is the most common complication after a facelift and occurs in an average of 1% of patients. It is also common after breast augmentation procedures, occurring in 1% of patients, and is more common in male patients than female. Hematoma treatment sometimes includes additional operations to drain the blood if the collection of blood is large or growing rapidly. This may require another procedure in the operating room and sometimes additional anesthetic.
Deep vein thrombosis (DVT) is another condition that can occur after plastic surgery, where blood clots form in deep veins, usually in the leg. DVT can be fatal and the risk of clots is five times higher for people having multiple procedures than for those having just one. Signs of blood clots include abnormal swelling in the groin or lower leg.
To reduce the risk of complications, it is important to follow postoperative care instructions closely. This includes getting lots of rest, not lifting anything heavy, and spending limited time on your feet. Changing surgical dressings regularly and elevating the surgical area to reduce swelling are also important steps in postoperative care.
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Nerve damage
Plastic surgery involves intricate procedures where surgeons work near delicate nerves. Nerve damage can occur during any type of surgery, but the risk depends on the specific procedure. For example, facelift surgeries carry a higher risk of nerve damage, which may result in permanent numbness, loss of motion in the jaw, or drooping features. Rhinoplasty may lead to olfactory dysfunction, and breast surgery may damage the intercostal cutaneous nerve or the long thoracic nerve.
It is important to distinguish between known risks of surgery and harm caused by negligence. Surgeons are expected to meet a standard of care, and failing to do so may result in a medical malpractice claim. Recognising the symptoms of nerve damage early is crucial, as it can guide treatment plans to relieve nerve pain and address other symptoms.
If you suspect nerve damage after plastic surgery, consulting a medical professional is essential. They can help diagnose nerve damage and determine the appropriate treatment. Various diagnostic tests can identify nerve compression, inflammation, or other nerve problems resulting from surgery. While minor nerve injuries may heal on their own, severe nerve damage can be catastrophic and require specialised treatment.
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Blood clots
Plastic surgery, like any other surgery, can increase the risk of developing blood clots. Blood clots are semi-solid clumps of platelets, proteins, and blood cells that form to stop bleeding when you get an injury. However, sometimes, blood clots form in places they shouldn't, and they can be life-threatening.
Deep vein thrombosis (DVT) is a common complication of surgery, where blood clots form in deep veins, usually in the leg or thigh. This happens when blood thickens, settles, and pools in the veins during long surgeries, especially when the patient is lying down for an extended period. Inactivity during recovery can also cause blood to pool and clot in the veins. DVT can lead to a pulmonary embolism (PE), a life-threatening condition where the clot breaks free and travels to the lungs, blocking blood flow. Abdominoplasty procedures have a slightly higher rate of DVT and PE, affecting just under 1% of patients. The risk of clots is five times higher for people having multiple procedures.
Some surgeries carry a higher risk of blood clots than others. For example, orthopedic and spine surgery have a high risk of postoperative venous thromboembolism, and heart bypass surgery increases the risk of blood clots because the heart is stopped during the procedure. Surgeries that involve cutting into bones, such as hip replacements, may release substances called antigens that increase clotting.
There are measures that can be taken to prevent blood clots during and after surgery. Doctors may prescribe blood thinners or anticoagulants to prevent blood clotting, but these must be carefully considered as they can also cause excessive bleeding. Patients can also take simple measures such as moving around and doing gentle exercises to improve blood flow and prevent blood from pooling in the veins. Compression devices can also be used to improve circulation.
Signs and symptoms of blood clots after surgery include abnormal swelling in the groin or lower leg, pain, and swelling. If you experience any of these symptoms, seek medical attention immediately as blood clots can be life-threatening.
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Dissatisfaction with results
Dissatisfaction with the results of plastic surgery is a real possibility. While most people are satisfied with their postoperative outcomes, some people may experience contouring or asymmetry problems, or they may simply not like the result. For example, people who undergo breast surgery may experience contouring or asymmetry issues, while those who undergo facial surgery may dislike the aesthetic outcome.
In some cases, dissatisfaction with plastic surgery results may be due to complications that arise during or after the procedure. These can include hematoma (a pocket of blood that resembles a large, painful bruise), infection, nerve damage, scarring, and blood loss. Hematoma occurs in 1% of breast augmentation procedures and facelift patients, and it is more common in males than females. Infections can be external, like cellulitis, or internal and severe, requiring intravenous (IV) antibiotics. Nerve damage can result in numbness and tingling, which is usually temporary but can be permanent in some cases, such as the 15% of women who experience permanent changes in nipple sensation after breast augmentation surgery.
To manage expectations and increase the likelihood of satisfaction with plastic surgery results, it is important to select a qualified and experienced surgeon. Patients should ensure their surgeon is registered with a specialist association, has specific training, and has experience in the desired procedure. Board-certified surgeons, for example, must pass rigorous training and examinations, demonstrating their knowledge of safety and quality practices. During consultations, patients should be open and honest about their desired outcomes and ensure they are on the same page as their surgeon.
If a patient is dissatisfied with the results of their plastic surgery, there are a few steps they can take. Firstly, they should talk with their surgeon to discuss their concerns and explore possible solutions. It is important to be honest and open during these conversations without assigning blame. If the patient has already healed and is still unhappy with the results, they can consider a second cosmetic procedure. However, a new surgeon will likely charge for any revision surgery.
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Frequently asked questions
Some common complications of plastic surgery include blood loss, infection, nerve damage, deep vein thrombosis (DVT), scarring, and hematoma (a pocket of blood resembling a large, painful bruise). Complications from plastic surgery are relatively uncommon, with a 2018 review of 25,000 cases showing that fewer than 1% of outpatient surgeries had complications.
Signs of an infection include fever or yellowish discharge from the incision site.
Signs of blood clots include abnormal swelling in the groin or lower leg area.
It is important to manage your expectations before undergoing plastic surgery and ensure that you and your surgeon are on the same page. If you are unhappy with the results, you should first talk openly and honestly with your surgeon to understand what happened and explore possible solutions. You may also need to give yourself time to heal as many problems will resolve with time. If you are still unsatisfied after the healing process, you can consider a second cosmetic procedure.
To lower your risk of complications, it is important to closely follow any home-care instructions provided by your healthcare provider. These may include getting lots of rest, not lifting heavy objects, limiting time on your feet, regularly changing surgical dressings, and elevating the surgical area to reduce swelling.
