Plastic Surgery Risks

Risks and Complications of Plastic Surgery and Cosmetic Surgery

While plastic surgery can provide transformative results, it is important to acknowledge that all surgical procedures carry certain risks. Understanding these risks and taking appropriate measures to minimise or prevent them is an integral part of a successful recovery. However, it is crucial to recognise that despite choosing a plastic surgeon, being in a reputable hospital, and following best practices for procedure and wound care, some complications and risks may still occur.

Plastic surgery involves invasive techniques requiring both surgical incisions and manipulation of tissues. The associated risks can range from minor to severe, depending on the type of surgery performed. Therefore, it is essential to have a thorough discussion with your surgeon about the specific risks that pertain to your procedure.

Please note that the information provided on this page is of a general nature and should not substitute a consultation with a qualified plastic surgeon. For personalised advice regarding your individual condition and surgical options, you will need to attend a consultation with a medical professional. They will be able to provide you with specific guidance based on your unique circumstances.

Risks of General Surgery

There are general risks associated with surgery, as well as, plastic surgery risks. Read on to find out more.

General Anesthesia Risks

• Prior to surgery, you will be provided with the details of your anesthetist.
• This will allow you to discuss any specific concerns you may have.
• Although most healthy patients respond well to general anesthesia, the General Anaesthesia risks can include;
  • Negative reaction to the medications used during general anesthesia, leading to complications.
  • In rare cases, patients may have an allergic reaction to the anesthesia drugs, which can range from mild to severe.
  • Anesthesia can temporarily affect the function of the lungs and respiratory system, potentially leading to breathing difficulties.
• Many patients experience nausea and vomiting after general anesthesia, although medications can be administered to help manage these symptoms.
• The breathing tube inserted during anesthesia can cause a sore throat in some patients, which typically resolves within a few days.

It’s important to note that healthcare professionals take multiple precautions to ensure patient safety. Your anesthesiologist will discuss these risks with you before the surgery and closely monitor your condition throughout the procedure.

Bleeding (Hematoma)

A hematoma refers to a collection of blood outside the blood vessels, often occurring at the surgical site. It can cause swelling, pain, and discomfort. This is a potential risk both during and after surgery.

• The risk of hematoma can be influenced by the surgical technique used. Careful handling of tissues and meticulous surgical skills can help minimise the risk.
• Individuals with certain blood clotting disorders or those taking blood-thinning medications may have a higher risk of bleeding and hematoma formation. It’s crucial to inform your surgeon about any pre-existing conditions or medications you are taking.
• During surgery, the surgical team closely monitors for any signs of excessive bleeding. Techniques such as proper cauterization, suturing, and the use of hemostatic agents may be employed to control bleeding and reduce the risk of hematoma formation.
• After surgery, following your surgeon’s instructions is essential to minimize the risk of bleeding. This may involve avoiding strenuous activities, taking prescribed medications, and applying cold compresses as recommended.
• If you notice either increasing pain, swelling, or signs of excessive bleeding at the surgical site, it is important to contact your surgeon promptly. They will assess the situation and provide appropriate medical care, which may include draining the hematoma if necessary.

It’s important to have a thorough discussion with your surgeon about the potential risks of bleeding and hematoma formation specific to your procedure. They can provide personalised advice and guidance to help minimise these risks and ensure a safe and successful surgery.

Fluid Build-Up (Seroma)

A seroma is an accumulation of fluid that gathers under the skin at the surgical site. It can occur when the normal drainage of fluid is disrupted, leading to fluid buildup.

• Seromas can develop due to various factors, including:
  • Surgical trauma
  • Tissue manipulation
  • Disruption of lymphatic vessels
  • Or, inadequate drainage of fluid during surgery.
• Common signs of a seroma include:
  • Swelling
  • Pain
  • Tenderness
  • A feeling of fluid movement under the skin.
  • In some cases, the skin above the seroma may appear stretched or puffy.
• Certain factors can increase the likelihood of developing a seroma, such as:
  • Extensive surgical dissection
  • Large tissue removal
  • Obesity
  • Poor wound healing
  • And infection.
• Surgeons employ various techniques to minimise the risk of seroma formation, such as the use of drains to facilitate fluid drainage from the surgical site. Compression garments or dressings may also be recommended to reduce the risk of seroma development.
• If a seroma occurs, it may resolve on its own over time as the body reabsorbs the fluid. However, in some cases, intervention may be necessary. This can involve aspiration, where a needle is used to drain the fluid, or surgical removal of the seroma if it persists or becomes problematic.
• It’s essential to closely follow your surgeon’s post-operative instructions, which may include regular follow-up appointments to monitor the healing process.
  • Inform your surgeon if you notice any signs of seroma formation or other complications.

Remember to consult with your surgeon regarding the specific risks and management strategies related to seroma formation for your particular surgery. They can provide guidance tailored to your individual circumstances to minimize the risk and ensure a successful recovery.

Infection

• Certain factors can increase the likelihood of developing an infection after surgery. These include poor overall health, smoking, obesity, diabetes, immunodeficiency disorders, prolonged surgery duration, and contaminated surgical instruments or environments.
• Surgeons take several precautions to minimize the risk of infection. These may include strict adherence to sterile techniques, proper sterilization of instruments, preoperative antibiotics administration, thorough skin preparation, and maintaining a sterile surgical environment.
• Common signs of infection after surgery include:
  • Redness
  • Swelling
  • Warmth
  • Increased pain or tenderness at the surgical site
  • Pus or discharge from the incision
  • Fever
  • General malaise. (A feeling of overall discomfort, unease, or fatigue that is not specific to any particular symptom or condition. It is a nonspecific symptom that may be accompanied by other signs such as fever, body aches, weakness, or a sense of unwellness.)
• If you experience any of these symptoms, it is important to notify your surgeon promptly.
• If an infection occurs, early detection and appropriate treatment are crucial.
  • This typically involves antibiotics tailored to the specific bacteria causing the infection.
  • In some cases, additional interventions such as drainage of abscesses or debridement of infected tissue may be necessary.
• Following your surgeon’s postoperative instructions is essential to minimize the risk of infection. This may include;
  • Proper wound care
  • Keeping the surgical site clean and dry
  • Taking prescribed antibiotics as directed
  • Avoiding swimming pools or hot tubs
  • And attending follow-up appointments.
• Maintaining good personal hygiene, such as regular handwashing, can help reduce the risk of infection.
  • It is important to keep the surgical site clean and follow any specific hygiene recommendations provided by your surgeon.
• If you have any concerns about infection or notice any signs of infection, it is important to communicate with your surgeon promptly. They can evaluate your condition, provide appropriate guidance, and initiate treatment if necessary.

Remember, the specific risks and management of infection can vary depending on the type of plastic surgery procedure you undergo. It is important to have open and honest discussions with your surgeon to fully understand the potential risks and how they can be minimized in your case.

Delayed Wound Healing

Delayed wound healing is a potential risk associated with plastic surgery. It refers to a slower or impaired healing process of surgical incisions or wounds. Several factors can contribute to delayed wound healing, including:

• Poor blood circulation
  • Inadequate blood flow to the surgical site can impair the delivery of oxygen and nutrients necessary for proper healing.
• Infection
  • Infection at the surgical site can disrupt the healing process and lead to delayed wound healing.
• Chronic medical conditions
  • Underlying health conditions such as; diabetes, immune disorders, or certain medications can affect the body’s ability to heal wounds efficiently.
• Smoking
  • Smoking can impair blood circulation and decrease oxygen supply, increasing the risk of delayed wound healing.
• Poor nutrition
  • Inadequate nutrition, particularly a deficiency in protein, vitamins, and minerals essential for wound healing, can hinder the healing process.

If delayed wound healing occurs, it is important to notify your surgeon. They will assess the wound, provide appropriate wound care instructions, and may recommend additional treatments such as wound dressings, medications, or close monitoring of the healing progress. Following post-operative instructions, maintaining good nutrition, and avoiding activities that strain the surgical site can help minimise the risk of delayed wound healing.

Scarring

Scarring is a common concern and potential risk associated with plastic surgery. Whenever an incision is made during a surgical procedure, scarring is a natural part of the healing process. The extent and visibility of scarring can vary depending on several factors, including:

• Genetics
  • Some individuals are more prone to developing noticeable scars due to their genetic makeup.
• Wound care
  • Proper wound care and following post-operative instructions provided by the surgeon can help promote optimal healing and minimize the risk of excessive scarring.
• Tension on the incision
  • Excessive tension or stress on the incision site can lead to widened or raised scars.
  • Surgeons take precautions to minimize tension during the procedure, but individual healing responses can vary.
• Infection
  • Infections can increase the risk of poor wound healing and potentially result in more noticeable scarring.
• Keloid or hypertrophic scarring
  • Some individuals may be predisposed to developing keloid or hypertrophic scars, which are raised and thicker than typical scars.

It’s important to note that while scars are an inevitable part of surgery, they can fade and improve in appearance over time. There are also various treatments and techniques available to help minimize the appearance of scars, such as silicone sheets, topical creams, laser treatments, or steroid injections. Your surgeon can provide guidance on scar management options specific to your procedure and individual healing process.

More Serious and Life Threatening Risks

Deep Vein Thrombosis

Deep Vein Thrombosis (DVT) is a potential risk following plastic surgery, particularly when procedures involve prolonged immobilization or significant tissue trauma.

DVT is a condition where blood clots form in deep veins, typically in the legs. These clots can obstruct blood flow and may lead to serious complications if they break free and travel to the lungs, causing a pulmonary embolism.

Factors that can contribute to the development of DVT after plastic surgery include:

• Immobility
  • After surgery, limited mobility and prolonged periods of bed rest can increase the risk of blood clot formation.
• Trauma and tissue manipulation
  • Surgical procedures can cause tissue trauma, leading to inflammation and activation of the clotting cascade.
• Not wearing Compression garments
  • Wearing compression garments or bandages as part of post-operative care can help reduce the risk of DVT by promoting blood circulation.
• Personal risk factors
  • Certain individuals may have an increased predisposition to blood clot formation, such as those with a history of DVT, obesity, smoking, advanced age, or underlying medical conditions like cancer or clotting disorders.
    

Preventive Measures – Minimising the risk of DVT

Preventive measures are usually taken to minimise the risk of DVT after Plastic Surgery. This may include:

• Early mobilisation: Encouraging patients to move and walk as soon as possible after surgery to improve blood circulation.
• Compression stockings: Wearing compression stockings or pneumatic compression devices that help prevent blood pooling and promote venous blood flow.
• Medications: In some cases, the use of blood-thinning medications like anticoagulants may be prescribed to reduce the risk of blood clot formation.

It is essential to discuss your individual risk factors and the preventive measures with your plastic surgeon, who will take appropriate steps to minimize the risk of DVT and ensure your safety during the recovery process.

Additional Surgical Risks

In addition to the specific risks mentioned earlier, there are some general surgical risks that apply to various plastic surgery procedures. These risks can include:

• Nerve damage
  • During surgery, there is a possibility of nerve damage, which can result in temporary or permanent numbness, tingling, or changes in sensation in the surgical area.
  • This risk is typically discussed with the surgeon prior to the procedure.
• Poor wound healing
  • In some cases, the incision site may heal poorly, leading to delayed wound healing, infection, or the formation of hypertrophic or keloid scars.
  • Proper wound care and adherence to post-operative instructions can help reduce these risks.
• Skin discoloration or pigmentation changes
  • In certain procedures, there is a risk of temporary or permanent changes in skin color or pigmentation around the surgical site.
  • This can include hyperpigmentation (darkening) or hypopigmentation (lightening) of the skin.
• Allergic reactions or complications from implants or materials
  • For procedures involving the use of implants or other materials, there is a potential risk of allergic reactions, implant rupture, capsular contracture (scar tissue formation around implants), or other complications specific to the implanted material.

It is important to have a thorough discussion with your plastic surgeon before undergoing any procedure to understand the potential risks and complications that may be associated with your specific surgery. Your surgeon will provide you with detailed information, guidance, and post-operative care instructions to minimize these risks and ensure a safe and successful outcome.

Risks and potential complications can be influenced by various factors

Certain patients may face additional risks when undergoing surgery. These risks and potential complications can be influenced by various factors:

• Genetics
  • Each individual has a unique genetic makeup, which can impact their body’s response to surgery and healing process.
  • Certain genetic factors may increase the risk of complications or affect the overall outcome.
• Obesity or overweight/high BMI
  • Excess weight or a high body mass index (BMI) can pose additional risks during surgery.
  • It can increase the strain on the cardiovascular system, impair wound healing, and increase the likelihood of post-operative complications.
• Underlying health conditions, allergies, or sensitivities
  • Patients with pre-existing health conditions such as diabetes, heart disease, or autoimmune disorders may have a higher risk of complications.
  • Allergies or sensitivities to medications, anesthesia, or surgical materials can also increase the risk of adverse reactions.
• Substance use or lifestyle factors
  • Factors such as smoking, alcohol or drug use, and living in bacteria-laden environments can impact the body’s ability to heal and fight off infections.
  • These factors can increase the risk of complications during and after surgery.
• Improper wound care
  • Inadequate post-operative wound care, such as not following the surgeon’s instructions for cleaning, dressing, and protecting the incision sites, can lead to an increased risk of infection and delayed wound healing.

Smoking and Surgical Risks

Smoking is strongly associated with increased surgical risks and complications. It can have detrimental effects on the body’s ability to heal and recover after surgery. Here are some key points regarding smoking and surgical risks:

• Impaired Wound Healing
  • Smoking restricts blood flow and oxygen delivery to tissues, which can significantly impair wound healing.
  • This increases the risk of wound infections, delayed wound closure, and poor scar formation.
• Increased Risk of Infection
  • Smoking weakens the immune system, making smokers more susceptible to infections.
  • Surgical incisions in smokers have a higher risk of developing surgical site infections, which can lead to prolonged hospital stays, additional treatments, and compromised surgical outcomes.
• Poor Circulation and Blood Clot Formation
  • Smoking constricts blood vessels and promotes the formation of blood clots.
  • This can lead to complications such as deep vein thrombosis (DVT), a potentially life-threatening condition where blood clots form in deep veins, most commonly in the legs.
• Respiratory Complications
  • Smokers are more prone to respiratory issues such as coughing, chest infections, and pneumonia after surgery.
  • These complications can impair lung function and slow down the recovery process.
• Anesthesia Risks
  • Smoking can affect the body’s response to anesthesia, increasing the risk of complications during the surgical procedure.
  • It can lead to breathing difficulties, decreased oxygen levels, and an increased need for respiratory support during anesthesia.
• Poor Cosmetic Outcomes
  • Smoking can negatively impact the final aesthetic results of plastic surgery procedures.
  • It can impair skin healing, cause excessive scarring, and lead to poor tissue quality and texture.

Given these risks, it is strongly recommended that individuals who smoke quit smoking well before surgery. Ideally, a minimum of four to six weeks of smoking cessation before surgery and another 6 weeks after surgery is advised to allow the body to recover and improve its ability to heal. Quitting smoking not only reduces the risks associated with surgery but also has numerous long-term health benefits.

It is important to be open and honest with your plastic surgeon about your smoking history and any tobacco or nicotine product use. They can provide guidance, support, and resources to help you quit smoking and optimize your surgical outcomes.

Breast Surgery Risks

Risks and potential complications associated with breast surgery should be thoroughly understood before undergoing the procedure. Common side effects of breast surgery include discomfort, skin sensation changes, bruising and swelling. While most side effects are temporary and resolve over time, it is important to be aware of potential risks. Here are some key points elaborating on breast surgery risks:

Discomfort, Skin Sensation Changes, Bruising, and Swelling

These are common side effects following breast surgery and are typically temporary. However, skin sensation changes may persist for a longer period, as nerve endings gradually reconnect.

Nipple Sensitivity

There is a possibility of temporary or, rarely, permanent loss of nipple sensation. Most patients experience temporary loss, with sensations returning as the nerves heal.

Nipple Loss/Necrosis

This is a rare complication, more commonly seen in smokers. It involves the partial or complete loss of the nipple due to compromised blood supply. Quitting smoking prior to surgery significantly reduces this risk.

Effect on Breastfeeding

Breast surgery can potentially affect the ability to breastfeed. The extent of this impact varies depending on the specific procedure performed and individual factors. It is important to discuss this with your surgeon before the surgery.

Allergic Reactions

Some individuals may develop allergic reactions to various substances used during the surgical process, such as tapes, sutures, glues, blood products, topical preparations, or injected agents. Inform your surgeon about any known allergies beforehand.

Scarring

All surgical procedures result in scarring, including breast surgery. Poor scarring or keloid scarring (more common in individuals with higher skin pigmentation or darker skin) can occur. Your surgeon will take steps to minimize scarring and provide post-operative care instructions to promote optimal healing.

Breast Implant Risks

Breast procedures involving implants come with their own particular complications. Most resolve over a period of weeks but skin sensation changes can last longer. More serious risks can include:

Implant issues

If a breast lift is performed in conjunction with breast augmentation using implants, there is a risk of complications related to the implants, such as skin wrinkling or implant rupture. Your surgeon will discuss the specific risks associated with implants and provide guidance on implant selection and maintenance.

Capsular Contracture

When combining a breast lift with augmentation, there is a risk of capsular contracture. This involves the formation of excessive scar tissue around the implant, causing firmness, discomfort, and potential distortion of the breast shape. Your surgeon will closely monitor your healing process to detect and address this complication if it arises.

Asymmetry

There is a possibility of uneven breasts or nipples following breast surgery. Your surgeon will strive for symmetry, but natural anatomical variations and individual healing responses can contribute to slight asymmetry.

It is crucial to have a comprehensive consultation with your plastic surgeon to discuss these risks, evaluate your individual circumstances, and make an informed decision about proceeding with breast surgery. Your surgeon will provide personalized advice and recommendations to minimize potential risks and optimize your surgical outcomes.

Recommendations

It is important to do your research in order to understand the risks associated with your chosen surgery. Surgical risks will also be covered in your consultation with a qualified plastic surgeon and before you proceed with surgery. There will also be a list of risks on your consent form.

Be sure to ask your surgeon for a detailed list of potential plastic surgery risks or potential complications, including risks specific to certain procedures. It is also important to read all materials provided to you regarding your procedure. Furthermore, ensure you follow your surgeon’s advice carefully to help reduce risks where possible.

About Dr Craig Rubinstein
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Dr Craig Rubinstein FRACS (Fellow of the Royal Australasian College of Surgeons) is an experienced Melbourne Specialist Plastic Surgeon for breast and abdominoplasty surgery.

Dr Rubinstein offers women personalised abdominoplasty surgery and all forms of cosmetic breast surgery.

BOOK A CONSULTATION (03) 8849 1400

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• Please be aware you may need to undress for a physical exam so wear simple clothes.