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 are informed
before surgery.
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.
Brain Damage: Brain damage can occur if blood circulation
is depressed at dangerous levels.
Malignant Hyperthermia: This is a rare complication where
body temperature, blood pressure and heart rate all rise to hyperactive
levels. If not recognized and treated quickly, can lead to death.
This may be inherited.
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: 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.
Infection: Antibiotics reduce infection 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.
General risks for cosmetic surgery
See specific procedures for more information.
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.
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 1997 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 1 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, severe infection or 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.
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.
