14 Plastic Surgery Complications That You Need to Know
- 20 March 2017
- Dr. Nidal (Nick) Masri
Complications are always a possibility in plastic surgery – or any surgery, for that matter. Even something as simple as a blepharoplasty can lead to pain and swelling, or worse, an infection. You can try minimizing the risks by hiring a board-certified plastic surgeon, but you cannot eliminate your chances of getting a complication.
Though plastic surgery complication rates remain low, they can manifest at almost all times after your surgery. A retrospective study done by the University Hospital of Zurich revealed that complications could happen as early as immediately after surgery. But there are also patients who still get complications even after six months post-surgery.
The costs associated with treating these complications are no laughing matter either, as inpatient costs average $10,100, while outpatient costs are at $3,830 per patient.
No invasive surgery is ever painless. You may not feel anything during the surgery itself, but you would need some painkillers during the recovery period.
Your perception and experience of pain may differ from other plastic surgery patients depending on the procedure performed, the type of anesthesia used, gender, age, and pain tolerance.
Mild pain is expected for rhinoplasty, arm lift, and most breast procedures. Breast implants, tummy tuck, liposuction, and thigh lift cause moderate pain, while a butt lift and surprisingly, a blepharoplasty, can be more painful than others.
Though some level of discomfort is inevitable, your plastic surgeon will often make sure that you are as comfortable as possible during your recovery. He may prescribe painkillers to be taken around the clock right after the procedure, tapering it gradually as you heal.
He may also instruct you to avoid a certain position for maximum comfort, like lying on your back or sitting down after a Brazilian butt lift.
It is common to experience temporary numbness with facelifts and tummy tucks. They usually resolve within a year if no major nerve damage occurred.
However, numbness is most common after breast surgeries of any type, occurring 10% to 70% of the time, depending on the procedure. The most notorious would have to be breast reductions since they involve removal of the nipples and areola, which are reattached as skin grafts. Loss of sensation in the nipple area may be permanent in these types of procedures.
Consult your plastic surgeon when you experience numbness in a certain area of your body, as this might just be a symptom of nerve damage.
Hematomas and Seromas
Hematomas are small pockets of blood that look like a large, painful bruise. It may require follow-up surgery to drain the blood if it doesn’t resolve on its own.
It is also often seen among breast augmentation patients, as it happens at a rate of 1-6%. It is also rather common to around 1-2% of facelift patients and is more prevalent among men, as beard follicles result in increased blood supply in the capillaries of the face.
Another similar complication is a seroma, which is an internal collection of watery body fluids that results in swelling and pain. It can lead to infection if not treated promptly. It is so common among tummy tuck patients that it has become customary for plastic surgeons to automatically use drains post-surgery to take the fluid out, thus dramatically lessening the rate of seroma complications.
Almost every plastic surgery needs an incision to access to the underlying structures. After the procedure, the incision site is closed with sutures or staples, which might need to be removed after some time.
Wound breakdown or wound separation happens when the edges of the incision pull apart before the area has completely healed. It requires immediate medical attention because it can lead to evisceration – the protrusion of your internal organs through the incision.
Symptoms of wound breakdown include bleeding, open wound, broken sutures, pain, pus, and drainage at the incision site.
Fortunately, this is not something that happens frequently. It can also be prevented by refraining from heavy lifting, strenuous exercise, and aggressive coughing while recovering, as this can increase the strain on the incision site. Maintaining a healthy diet and staying hydrated can also hasten your healing process.
Some manageable degree of necrosis or tissue death is inevitable in any surgical procedure due to surgical manipulation. It happens when there is an insufficient supply of oxygen to the operated area.
However, the risks heighten dramatically for smokers since smoking causes blood vessels to constrict, thus lessening the supply of oxygen to your tissues. Since the surgeon is cutting the blood supply to those tissues with already compromised blood supply, just imagine how much more possible tissue necrosis is to occur. That is why smokers are advised to stop smoking for at least six weeks before any plastic surgery.
Surgeries like facelifts, breast reductions, and tummy tucks are more prone to necrosis than other procedures. To prevent this complication, make sure that you select a certified plastic surgeon with ample experience in your chosen surgery. His experience provides him enough knowledge about the blood supply in the area being operated on.
Small nerves are severed any time the skin is cut. That’s doesn’t really pose much of a problem. But when major nerves are affected, that’s when irreversible nerve damage occurs.
Approximately one in 1,000 facelift patients experience nerve injury, leading to permanent nerve damage. It is often characterized by facial numbness and a tingling sensation. In extreme cases, this may lead to weakness and paralysis of certain muscles if the affected nerves are related to muscle movement. It can only be repaired with reconstructive surgery.
However, the risk of nerve injury significantly decreases when you choose a certified and experienced plastic surgeon since he is knowledgeable about the location of the important nerves in your body.
Infections are quite rare in plastic surgery because the patient is usually healthy and does not have a compromised immune system. In fact, the risk is less than 1%. But when it happens, it can spread quickly to the rest of the body, causing shock and even death.
Those who smoke, take steroids, or have certain blood supply problems are at higher risk for infections during plastic surgery. Longer surgeries also increase the risk for infection as it exposes the body to bacteria and viruses in the atmosphere. It is also possible for the incision to become infected, especially when it is not properly cared for during the recovery period.
Though infections can be serious, it is not hard to prevent it. Make sure that you undergo your operation in a clean and sterile facility. Proper wound aftercare is also important to prevent late-onset infection.
Scarring is an inevitable aspect of every invasive surgery. But while scars naturally fade over time, there are times when they develop into abnormal hypertrophic scars, which are thick, red, and unsightly in appearance. These scars occur to about 2-5% of breast augmentation patients. Arm lift and thigh lift scars are also notorious for being nasty.
Some people may also be predisposed to scarring. A plastic surgeon can do the same incision on two patients but still yield different-looking scars. In general, those who have a darker complexion and high skin pigmentation are more at risk of developing hypertrophic scars.
But even if scars are unavoidable, experienced plastic surgeons can usually make them appear minimal and even imperceptible by hiding the incision in natural body creases or using a different surgical technique.
Blood loss is a possibility in any plastic surgery. It is normal for patients to lose blood during surgery, but it can become life-threatening if bleeding continues after surgery. This happens to about 1% of plastic surgery patients.
Even localized bleeding can be detrimental to a patient. For instance, bleeding because of an eyelid lift can threaten a patient’s eyesight. It can also lead to hematomas, which can compress surrounding tissues and disrupt oxygen flow in the area. Large hematomas can also lead to infection, wound breakdown, and necrosis.
Patients at risk for excessive blood loss are those with high blood pressure and are taking aspirin regularly. That is why plastic surgeons advise their patients to stop taking aspirin at least six weeks before their scheduled surgery. Men are also more at risk than women.
Deep Vein Thrombosis and Embolisms
Deep vein thrombosis is a condition wherein blood clots form in deep veins, usually in the veins of the legs. When these clots travel into the lungs, it becomes a pulmonary embolism, which can block blood supply to the lungs.
Pulmonary embolisms are a fatal complication of many plastic surgeries. It can happen all of a sudden without pretense, even in the presence of an experienced and board-certified plastic surgeon. In fact, many sensationalized plastic surgery patient deaths resulted from a pulmonary embolism. It requires prompt treatment using anticoagulants and thrombolytics. Large embolisms may even require immediate surgical intervention.
Sometimes, what clogs the pulmonary arteries are not blood clots, but fats and silicone lumps. Fat embolisms can develop in surgeries that involve fat transfer. Surgeries that require silicone, like buttocks and breast augmentation, can cause a similar incident.
Patient dissatisfaction is a rather common complication of plastic surgery, mostly because it is a subjective criterion. The results may look good, but if it does not meet your goals and expectations, you may end up dissatisfied with the results.
Patients who underwent breast augmentation may have asymmetrical breasts. Those who got a thigh lift may be unhappy with the lengthy scars. Botox patients may not like how rigid their face looks after the treatment.
But aside from unfavorable appearance, another source of patient dissatisfaction is the health complications associated with plastic surgery. Persistent pain, tissue damage, and localized paralysis due to nerve damage all contribute to disappointment.
Dissatisfied patients have the option to undergo revision surgery to correct any mistakes made during the initial plastic surgery. This can be done a few months after the original surgery.
Though uncommon, organ damage can happen when surgical instruments come in contact with your internal organs, causing visceral perforations or punctures. This is especially risky for liposuction, as it uses a surgical probe that might damage these internal organs. These perforations may also be fatal.
Adverse Anesthesia Reactions
Adverse anesthesia reactions rarely occur for surgeries only requiring local anesthesia. But the risk heightens considerably for patients under general anesthesia, as their exposure to these painkilling and sedating drugs are longer.
Nausea and vomiting are pretty common side effects of general anesthesia. You may also wake up confused and disoriented after getting general anesthesia. These symptoms usually subside after a few days and are not considered life-threatening.
A more serious complication is nerve damage, which may happen if your anesthesiologist injures one of your major nerves. Other potentially catastrophic adverse anesthesia reactions include allergic reactions, shock, respiratory failure, cardiac arrest, comatose, and even death.
Some people worry that they might wake up in the middle of surgery due to lack of anesthesia, but the probability of such an occurrence is slim to none.
According to the Plastic and Reconstructive Surgery journal, only two plastic surgery patients die out of 100,000 cosmetic procedures. The probability increases to one in every 11,000 procedures if you hire a non-certified plastic surgeon.
Death may be rare in plastic surgery, but the fact remains that it can happen due to different scenarios. Anesthesia overdose may cause respiratory failure in some patients. Even topical lidocaine overdose can lead to death.
Patients who receive imitation fillers for Botox, breast augmentation, and butt lift are risking their lives for something that’s not approved by the Food and Drug Administration. This can leave them comatose for years, and eventually, dead.
Choosing a board-certified plastic surgeon with hospital privileges can help lessen your risk of dying on the operating table, as it makes emergency equipment and staff accessible. It’s also important to make sure that the procedure you’re undergoing and the materials you’re using have been approved by the FDA.
There will always be risks when it comes to plastic surgery, but that doesn’t mean you can’t do anything to decrease their probability. The best thing you can do is to choose a reputable and board-certified plastic surgeon to do your desired procedure.
You may Schedule a Free Consultation with one of Face + Body Cosmetic Surgery’s double board-certified plastic surgeons to learn more about the risks and dangers of plastic surgery – and how you can avoid them.