Risks and complications with cosmetic surgery

As with any surgery, cosmetic surgery is associated with an amount of risk. But there are certain differences between the risk one takes with plastic surgery and those surgeries that are performed due to purely medical reasons.

Primarily the difference is about choice. A surgery is performed either out of medical or aesthetical reasons. Surgeries performed due to medical reasons always have a health motive. Surgeries performed because of aesthetical reasons have more of a personal motive.

The above does not imply that aesthetical plastic surgery cannot affect the health positively because it can. Many patients experience increased self-esteem and a stronger self image following cosmetic surgery, as well as increased well-being. Thus it has a direct effect on our mental health which has a well known connection with our physical well-being.

The final decision should be the result of a conscious decision making process based on the risk one takes in proportion to the advantages one sees.

The choice aspect means that as a patient one needs to be aware of the risks and complications one is exposing oneself to when choosing to undergo a plastic surgery procedure. The final decision should be the result of a conscious decision making process based on the risk one takes in proportion to the advantages one sees.

Risk management is about being aware of what risks there are and the probability of them occurring. Therefore one should ask oneself and the plastic surgeon the following questions;

  • What risks are associated with the procedure?
  • How likely is it that I will be affected by them?
  • What are the consequences?

Dividing the risks of cosmetic surgery

One can divide risks of cosmetic surgery as general and procedure specific risks. On this page we will present the general risks – those that in some form or another are always a risk regardless of what type of surgery one undergoes. Further information about the procedure specific risks are found under each procedures information section.

Aesthetical risks and complications with cosmetic surgery

Dissatisfaction with the surgical result

Before we go through the health risks we can establish that the most common complication that appears following plastic cosmetic surgery is not physical. The most common reason for dissatisfaction is simply not being pleased with the results that have been achieved. Therefore the greatest risk one takes is not achieving the goals one has imagined.

In some cases it means that the patient is unhappy due to he/she not achieving as great a change as had been expected. But it can also be the opposite; that the changes are greater than what one had imagined and therefore one does not recognise oneself. This is very common after nose jobs whereby patients react to the big difference but later “grow into it” and find great satisfaction from the changes.

Asymmetries

Other aesthetical complications are so called asymmetries, differences between form/shape of a pair of organs, for instance with breast enlargement or on either side of the face after a facelift.

Scarring and skin unevenness

Other examples of aesthetical complications are that the patient experiences the surgical scars as more visible than he/she has expected or that there is a slight unevenness and/or colour variation of the skin.

You can read more about how you can affect your scar healing on the information page about surgical scars.

How to minimise the risk of dissatisfaction

Since aesthetical risks are greatly founded in the individuals’ personal experiences, clear communication between the plastic surgeon and patient is extremely important. In many cases photos that the patient brings along can be of great help. In others, computer simulation can be used which can be a very valuable tool.

Make sure that your plastic surgeon has completely understood what you want to change and what changes you are expecting.

It is also important that you as a patient have the attitude that the surgery is to improve something not to reach perfection. Do not expect that your surroundings will treat you any different and make the procedure for your own sake and not for someone else’s.

It is also important to know that no serious plastic surgeon, however competent he or she is, can in advance guarantee a result free from aesthetical complications. As long as the procedure is performed in a correct manner and in line with tried and tested techniques most dissatisfactions can be corrected afterwards.

Health related risks of cosmetic surgery

Bleeding

It is possible, but not unusual, that bleeding occurs during or after cosmetic surgery. During the plastic surgery the risk is normally minimised by staying far away from large blood vessels, using vasoconstrictor medications as well as quickly coagulating small bleeding vessels by using special instruments.

I those cases that after bleeding under the skin occurs, it generally does so within a few hours up to a day after surgery. It may then need to be emptied and a small drainage tube is inserted. In very rare cases one may need a blood transfusion.

To minimise the risk of bleeding you should not take blood thinning medications such as magnecyl or similar anti-inflammatory medication. Neither should you drink alcohol ten days before your surgery. There are also some herbs that are available without a prescription which can increase the tendency to bleed.

Infection

Infections are uncommon in conjunction with cosmetic surgery procedures but if one arises it should be treated with antibiotics. In rare cases it may need hospital treatment and additional surgery. Many surgeons prefer to limit the risk of infection by providing preventive antibiotic treatment with some procedures.

If an infection arises it will do so 3-7 days after surgery. The symptoms of infection are increasing aches, raising temperature and/or swelling in the area of surgery, redness and fever.

Poor wound healing

The wounds healing process may not go as it should. This can present itself as a slow healing, wound opening or delayed healing. If an infection arises in such a process the skin is at risk and can be damaged or in extreme cases necrosis can set in (tissue death). Poor wound healing will therefore need frequent re-dressing and in some cases also corrective surgery at a later date. Smokers are at a higher risk of healing problems.

Swelling

Swelling due to oedema, bruising or fat necrosis can arise in the area of surgery. Since swelling as a complication is difficult to predict it is important that the assessment of the final result first takes place 9-12 months after surgery.

Sensitivity changes

When placing the incisions during surgery one also severs nerve-paths, therefore following surgery one may experience changed or lost sensitivity in the area of surgery. As the nerve-paths rebuild sensitivity generally returns to normal within a few months. However, sensitivity does not always return completely and in some cases it can be lost completely.

Scarring

In all procedures that penetrate the skin there is some scarring. How the scars will finally look is hard to predict since it is greatly affected by the patient’s own healing process and treatment of the scars while healing is taking place.

Normally the scars are first red and firm to later become soft and faint. In exceptional cases the skins healing leaves thick, wide scars. In some cases these need to be corrected by treating the scars with cortisone. In other cases they may need to be treated with additional surgery, known as scar revision plasty.

You can read more about plastic surgery scars and how you should take care of them in order for achieve the best healing on the information page about scars ».

Allergic reactions

In rare occasion various allergic reactions can arise. These can appear locally or be caused by different things such as tape, suture materials or other solutions that have been applied to the skin.

Allergic reactions can also be caused by medication and can spread through the body. Such a central reaction can be serious. It is therefore important that you state any allergies or hypersensitivities in your health profile during your consultation. In some cases allergic reactions need further treatment.

Local anaesthesia and narcosis

Both local anaesthesia and narcosis implies risks. There is a possible risk of complications, damage and also in very rare cases death from all types of sedation and narcosis.

Additional information related to cosmetic surgery risks

There are, although very rare, other risks associated with plastic surgery then those presented here, for instance necrosis and thrombosis (blood clot). However, it is not possible to in detail describe all possible scenarios and risks without making this information too extensive.

As a patient it can feel frightening to be confronted with the different scenarios associated with the risks of plastic surgery procedures. It is however important to put these into perspective in terms of likelihood and consequence.

Several statistics have been put together regarding how common it is that patients are afflicted with a complication following plastic surgery. This material does however differ quite a lot. Although one can say that the likelihood of a patient being afflicted with any type of complication is only a few percent. Most of these are risks with very limited consequences.

The risk of being affected with a complication that is dangerous to the health or of a serious aesthetical nature can be estimated to one-tenth percent.

Just a little advice

The best way to minimise the risk of being affected by aesthetical as well as health related complications is to choose a competent clinic, to be well informed, be clear about ones expectations and have realistic expectations of the result.

You will find further information about finding a good clinic and surgeon on the page about choosing a plastic surgeon ».

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