What are the Risks and Potential Complications associated with Plastic Surgery?
Undergoing any type of surgery carries certain risks and potential complications. For most patients, plastic surgery complications are rare, however they are possible and do happen. They are more likely to happen to high BMI (obese/overweight), smokers, diabetics or patients with other medical issues.
Here at the Plastic Surgery Hub we constantly remind you to do your homework and reduce your chances of a bad outcome by choosing a plastic surgeon and/or clinic with a quality reputation and experience in your procedure/s. However, no matter how well-prepared you are, you should be aware of the unlikely but present risks and potential for complications.
Risks and Potential Complications of Anaesthesia
Hand-in-hand with any surgical procedure is the need to undergo anaesthesia or sedation and this in itself has risks and potential complications such as:
- Vomiting and nausea
- Allergic reaction
- Cardiovascular collapse
- Respiratory failure
- Aspiration pneumonia
- Brain damage
- Nerve damage
- Awareness during anaesthesia
- Damage to Teeth
Whilst this is a very daunting list, the chances of any of these happening are low. It is important to discuss with your surgeon if you have any concerns, medical history or family background that may put you at higher risk. It is also a good reason to check that the anaesthetist your surgeon uses has plenty of experience and quality training. Your life is not just in your surgeon’s hand, but your anaesthetist as well!
Other Risks associated with any surgical procedures can include:
- Seroma (fluid build-up/retention)
- Necrosis (tissue damage)
- Hematoma (bleeding)
- Infection, particularly at the site of the incision/s
- Loss of feeling
- Sepsis (blood poisoning)
- Blood clots
- Problems with the wound healing properly (often a problem more often found in smokers)
These risks are generally attached to any surgery, not just plastic or cosmetic surgery. Too often we hear of stories where plastic surgeries have gone bad, mostly due to the patient trying to save money or waiting time in order to get their procedures done overseas or in “backyard” in-rooms clinics. Plastic and cosmetic procedures are serious surgeries, so the doctor and clinic you choose could have serious consequences.
Whilst the risks listed above are definitely possible they are minimised by using an experienced and qualified surgeon for your procedure, see our list of quality Australian Plastic Surgeons.
When choosing your surgeon ask them what post-operative care and support they provide so you are able to reduce that risk even further. Every plastic/cosmetic surgery procedure comes with its own unique risks/side effects.
Always Do Your Research & Ask Lots of Questions
Look up the name or MED number of your surgeon on the AHPRA Practitioner Register to find out about their training, qualifications and registration.
Ask these questions during your patient consultation with your Doctor or Surgeon
1. What are your surgical qualifications and your AHPRA registration number & type? – Are you a Surgeon?
2. How long have you been a Surgeon?
3. How many procedures have you done similar to the one I’m considering?
4. What other healthcare professionals will be involved in my care?
5. What side effects can I expect?
6. What results can I expect?
7. What are the possible complications of the surgery I am considering?
8. What kind of help will I need at home following surgery?
9. How long before I see the final results of my surgery?
10. How long before I can go back to work and/or resume exercise?
11. Are there any complications related to my health history?
12. Will I have any scars and if yes, what will they look like?
13. If my procedure requires stitches, when will they be removed?
14. What is your surgical revision policy and who pays the costs for any complications or hospital readmission?
Post-Op Complications of Plastic Surgery
Understanding and Treating Post Op Complications
MINOR COMPLICATIONS AFTER PLASTIC SURGERY
- Pain – Mild to Mid-level
- Skin Rash
- Erythema – a type of skin rash caused by injured or inflamed blood capillaries.
- Allergy to Wound Dressing – micropore, bandaid, tapes etc
- Drain output High Volume
- Asthyma – a condition in which your airways narrow and swell and may produce extra mucus
- Abscess – a painful collection of pus, usually caused by a bacterial infection
- Wound Infection
- Wound Dehiscence – a partial or total separation of wound edges, due to a failure of healing
- Spitting Sutures
- Skin Injury caused by Hot Water Bottle / Ice Pack
SEVERE COMPLICATIONS AFTER PLASTIC SURGERY
- Skin Necrosis – Dark necrotic tissue is formed when healthy tissue dies and becomes dehydrated, typically as a result of local ischemia.
- Seroma – a build-up of clear fluid inside the body causing pain or discomfort
- Hematoma – a collection (or pooling) of blood outside the blood vessel. (deep bruise)
- Wound NOT Healing
- DVT – Deep Vein Thrombosis
- PE – Pulmonary Embolism
- NAC Necrosis (Nipple Areola Complex)
- Nipple Loss
- Umbi Loss – loss of umbilicus
MOST LIKELY LOCATION OF THE WOUND CONCERN OR COMPLICATION
- Abdominal incision in the centre (under belly button)
- T Junction on Breast – where the incisions join
- IMF – Inframammary Fold incision under the breast
- Umbilicus incision
- Backlift Surgery incision in the centre
- Arm lift or Thigh Lift incision
- Face / Nose / Ear / Eye incision
Symptoms to Watch for if you Suspect a Surgical Complication
- High Body Temperature
- Rising Pain Levels
- Redness & Swelling
- Malodour (It Smells)
- Wound Breakdown
- Nerve Damage or Numbness
- Breathing Issues
- Anxiety & Distress
Treating and Preventing Complications Related to Plastic Surgery
WOUND DRESSINGS COMMONLY USED IN PLASTIC SURGERY
The following wound dressings are used for sealing your incision
- Osmocel ® Hydroporous Foam is an ideal dressing to manage wounds with different needs and moisture levels.
- Aquacel Ag – anti-microbial dressings combining the infection-fighting power of ionic silver with the unique capabilities of Hydrofiber™.
- Tegaderm – Waterproof Transparent Dressings are flexible, breathable, waterproof and seal out dirt water and germs.
- Sorbact –Sorbact® dressings remove bacteria, irreversibly binding them to its surface to reduce bioburden and support wound healing.
- Zorflex® – a wound contact layer dressing for chronic, non-healing wounds. By cleaning the wound of microorganisms and creating favourable conditions for healing, Zorflex can significantly reduce signs of infection within 4 weeks1,2.
- Micropore Tape – White & Brown
- Strataderm – Silicone Gel
- Gauze Dressing
- NPWT – Negative Pressure Wound Therapy – Vac Dressings – PICO Dressing – 3M KCI Prevena Dressings
- Wound Packing – Daily, every few days
PRESCRIPTION TREATMENTS COMMONLY USED IN PLASTIC SURGERY
These prescription treatments may be used when treating patients in Plastic Surgery
- OABS – Oral Antibiotics (can’t have IV antibiotics at home)
- Clexane – Blood Thinner
- Prednisolone – a corticosteroid medication used to treat certain types of allergies, inflammatory conditions, autoimmune disorders, and cancers.
- Hydrocortisone – is a steroid (corticosteroid) medicine. It works by calming down your body’s immune response to reduce pain, itching and swelling (inflammation)
- Keflex – treat a wide variety of bacterial infections. This medication is known as a cephalosporin antibiotic. It works by stopping the growth of gram +ve and some gram -ve bacteria.
- Fluclox – Flucloxacillin is used to treat bacterial infections. It works by killing the bacteria causing the infection. Flucloxacillin is also used before some surgical operations to prevent an infection from developing
POST-OP TREATMENTS PERFORMED IN ROOMS TO AID HEALING
The following treatments may be performed during post op
- Wound Dressing
- Remove Drains
- Wound Debridement of Necrotic Skin
- Packing Wound and Re-dressing
- Scar Revision
- LED low level light treatment
PROCEDURES FOR TREATING ADVANCED COMPLICATIONS OF PLASTIC SURGERY
Some plastic surgery patients may need further treatment such as
- Take back to theatre & fix the key problem (e.g.bleeding internally, high volume drainage)
- Drain Seroma – Aspiration
- Drain Hematoma – Aspiration
- Hyperbaric Chamber – to increase oxygen levels
- Medical Leeches may be applied – can be used for nose surgery or skin cancer flaps to assist blood flow
PATIENT COMORBIDITIES ISSUES THAT HAVE A HIGHER RISK OF SURGICAL COMPLICATIONS
- Recreational Drugs
- Thalassemia – a group of inherited conditions that affect a substance in the blood called haemoglobin.
- Clotting Disorder
- MTFI Gene
BACTERIAL INFECTIONS RELATED TO SURGICAL COMPLICATIONS (RESULTS OF MICROFLORA SWABS)
- Staph Aureus
- Serratia Marcescens
- Mixed Flora
- Gram +ve and -ve bacillus
INFECTIONS / SWABS IN DETAIL
- Staphylococcus aureus is a Gram-positive round-shaped bacterium, a member of the Bacillota, and is a usual member of the microbiota of the body, frequently found in the upper respiratory tract and on the skin – Golden Staph
- Pseudomonas is a type of bacteria (germ) that is found commonly in the environment, like in soil and in water
- Serratia marcescens (/səˈreɪʃiə mɑːrˈsɛsɪnz/) is a species of rod-shaped, Gram-negative bacteria in the family Yersiniaceae. It is a facultative anaerobe and an opportunistic pathogen. The bacteria will grow in any moist location where phosphorous containing materials or fatty substances accumulate. Sources of these substances include soap residues in bathing areas, faeces in toilets, and soap and food residues in pet water dishes.
- Mycobacterium abscessus, Mycobacterium chelonae, and Mycobacterium fortuitum are three species frequently associated with cosmetic surgery infections (Zhang, 2015). RGM, particularly M. abscessus, can form biofilms and they tend to be resistant to disinfectants.
- Leukocytes are part of the body’s immune system. They help the body fight infection and other diseases. Types of leukocytes are granulocytes (neutrophils, eosinophils, and basophils), monocytes, and lymphocytes (T cells and B cells).
MANAGING YOUR SURGICAL INFECTION RISKS
- Overall, the risk of infection after plastic surgery for most people is very low—about 1 percent.
- Some patients are more susceptible than others, including those who have diabetes, smoke, take steroids, or have certain vascular conditions. The longer a procedure takes in theatre the higher the risk of infection as well.
Further Reading about Surgical Risks and Complications
- What is Skin Necrosis?
- What is a Seroma?
- What is a Haematoma?
- What are Hypertrophic Scars or Keloid Scars?
- What is Fat Necrosis? – risk of fat transfer or fat injections
- What is a Fat Embolism? – risk of fat transfer or fat injections
- Wound Breakdown or Wound Dehiscence
Read about Potential Complications Associated with Breast Implants
- What is Capsular Contracture?
- What is Double Bubble Deformity?
- What is Symmastia or Uniboob?
- What is the Waterfall Effect?
- What is Animation Deformity?
- What is a Pneumothorax? (risk of Breast Implant Removal surgery)
- Bottoming Out
USEFUL MEDICAL REFERENCES
Further Reading Related to Plastic Surgery
- Dr Carmen Munteanu – Melbourne Plastic Surgeon for Cosmetic Plastic Surgery
- Dr Bish Soliman – Soliman Plastic Surgery Sydney
- Dr Anh Plastic Surgery Perth | Cosmetic Surgery | Medispa
- Plastic Surgery Risks and Complications
Plastic Surgery Hub lists the individual risks and complications for each procedure on that procedure’s page. To read more on these go here.