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Plastic Surgery Risks

Complications of Cosmetic Surgery
Cosmetic surgery has a low rate of complications among board certified plastic surgeons. However, every surgery carries risk. Be sure to discuss the possible risks and complications with your plastic surgeon so you feel fully informed before surgery.

Risks with any surgery
Anesthesia/Sedation Complications
Some patients have serious reactions to the anesthesia or sedation used during surgery. Most anesthetic complications occur with general anesthesia.

Possible complications:

  • abnormal heart rhythm
  • airway obstruction
  • blood clots
  • brain damage
  • death
  • heart attack
  • malignant hyperthermia
  • nerve damage
  • stroke
  • temporary paralysis

Airway obstruction: Anesthesia can sometimes irritate air passages, causing the vocal cords to spasm and this can block the airway. The anesthesiologist may need to insert a tube down the throat or cut into the windpipe.

Temporary paralysis: This occurs if muscle relaxants have not fully worn off after surgery. It is easy to detect and easily treatable.

Patients who have heart trouble, lung disease or are obese are at greater risk of complications due to anesthesia. To reduce your risk, tell your doctor about any medications you are on and let her know your complete medical history.

Aspiration occurs if you vomit (aspirate) during surgery and the vomit is forced into the lungs. Aspiration can cause mild discomfort, and can also lead to infections, chronic cough, an obstruction in the lungs or pneumonia.

Blood Loss
Bleeding is normal with any procedure. However, if there is excessive bleeding, it can create major complications. If this occurs during surgery, your plastic surgeon and anesthesiologist will be aware of by pooling blood or by a blood pressure drop. If bleeding occur after surgery, it can accumulate under the skin and require an additional surgery. Discuss with your physician what you can expect as far as bleeding and bruising.

Blood Clots (DVT)
A blood clot in the veins can be fatal. Longer operating time and general anesthesia increase the risk of a DVT. They can occur as a result of a medical condition or from immobilization (which allows the blood to pool) such as pregnancy, international airplane flights, and recovery from surgery. They are difficult to predict. To help prevent them, during recovery do not stay in one position for too long and flex your feet often. Patients who have liposuction in their legs are at higher risk. Compression garments worn reduce the risk of DVT.

Drop in Blood Pressure
Some decrease in blood pressure is normal during surgery. However, a sudden drop due to blood loss could lead to irregular heart beat and possibly a heart attack.

The risk of infection is less than 1% and antibiotics reduce this risk dramatically. However, if infection does occur, it is very serious. People who smoke, take steroids or have certain vascular conditions are at greater risk. The longer your surgery lasts and the more blood you lose, the more likely you are to have an infection.

Loose Sutures
If the sutures come loose this can lead to internal bleeding or a hernia. Such problems would require additional surgery.

Source: The Surgery Handbook.

General Risks for Cosmetic Surgery
Skin Death or Necrosis: usually follows an infection or hematoma and is much more likely among smokers. The skin is excised (surgically removed) and this may affect the cosmetic outcome.

Asymmetry: moderate or severe asymmetries may require a second surgery. Mild asymmetry is normal.

Slow Healing: due to age, skin type, failure to follow doctor’s advice or factors beyond anyone’s control.

Numbness/Tingling: often temporary, sometimes permanent loss of sensation. This results from injury to sensory or motor nerves.

Irregularities, dimples, puckers, and divots: can be due to surgeon error, healing irregularities or body make-up.

Seroma: fluid can collect under the skin and can occur after breast augmentation, liposuction or a tummy tuck.

See specific procedures for more information.

The American Society for Aesthetic Plastic Surgery (ASAPS) has a very informative article about outpatient surgery:

What You Should Know About the Safety of Outpatient Plastic Surgery

Plastic surgery procedures performed in accredited surgical facilities by board-certified plastic surgeons have an excellent safety record. A survey based on more than 400,000 operations performed in accredited facilities found that:

  • The rate of serious complications was less than half of 1 percent
  • The mortality rate was extremely low – only one in 57,000 cases
  • The overall risk of serious complications in an accredited office surgical facility is comparable with the risk in a freestanding surgical center or hospital ambulatory surgical facility

You will also be evaluated for other factors that may increase the risk of blood clots. These include:

  • being extremely overweight
  • having recent traumatic injury
  • any disorder of the heart, lungs or central nervous system
  • a history of cancer, recurrent severe infection or genetic problems that affect blood clotting

For women, additional risk factors include:

  • taking oral contraceptives or having recently ceased taking them
  • undergoing hormone-replacement therapy

If you are considered low risk, your doctor may simply ensure that you are positioned on the operating table in a way that allows for adequate blood circulation to the legs. If you are of moderate or high risk for developing blood clots, you may also be advised to wear elastic stockings before, during and after your procedure, or to take special anti-clotting medications. Compression devices on the legs may be used during surgery to support your normal circulation.

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