Plastic surgery complications
Natural Standard Monograph, Copyright © 2013 (www.naturalstandard.com). Commercial distribution prohibited. This monograph is intended for informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.
Blood clots, blood loss, bruising, disfiguration, excessive scars, infection, numbness, pigmentation, plastic surgery adverse effects, plastic surgery side effects, scar tissue, seroma, skin death, skin discoloration, tissue death.
Plastic surgery is defined as a medical procedure that is performed to change the appearance of the body. As with any medical procedure, such as plastic surgery, there is a chance that undesired side effects or complications may occur.
Some individuals are more likely to experience side effects from plastic surgery than others. Factors influencing a person's likelihood of experiencing side effects from plastic surgery include genetic factors as well as lifestyle factors. A negative reaction by the immune system to a plastic surgery implant is an example of a genetic factor. Smoking is an example of a lifestyle factor. To varying degrees, these factors may impact the likelihood of developing undesired side effects.
To reduce the chances of undesired side effects of plastic surgery, it is important that patients only allow doctors that have received certification by the American Board of Plastic Surgery (ABPS) to perform the procedures. The ABPS provides a list of certified doctors to individuals who complete a free registration on the website. In addition, the doctor should have the patient sign a form that documents informed consent. By signing an informed consent form, the patient documents that they have discussed the benefits as well as risks of the plastic surgery procedure with the plastic surgeon. Patients should never sign an informed consent form until all of their questions have been answered, and they completely understand the possible risks and benefits of the procedure.
The patient should also openly and honestly discuss all aspects of their lifestyle and medical history. The doctor may ask about habits of smoking, drinking, and use of illegal drugs. Doctors usually want to know all of the prescription medications, over the counter drugs, herbs, diet pills, and supplements a person is taking, including those that are used without a prescription, as these products may interact with the drugs and materials used in plastic surgery and may increase the patient's likelihood of experiencing undesired complications or side effects. Because doctors do not always ask about the herbs, diet pills, and supplements a person is taking, patients should communicate this information if not asked. In most cases, patients should make absolutely sure that they are not pregnant before undergoing plastic surgery because some of the drugs that are safe for the mother may seriously harm the fetus.
Patients should follow the doctor's directions before, during, and after the procedure. Certain medications and levels of exercise may need to be changed before and after the procedure.
Patients should always keep in touch with their doctors after the procedure. Generally, patients have at least one follow up appointment after their plastic surgery. Patients should try to not miss any follow up appointments. If an appointment has to be missed, then patients should always reschedule rather than cancel.
Patients should understand that there is always a possibility that their bodies will not respond well to plastic surgery. Short-term side effects, such as swelling of the area, may occur. Some patients may experience long-term or permanent side effects, such as scarring or discoloration of the area. Also, patients should have reasonable expectations of how their appearance may change in desired and undesired ways after the procedure. Many plastic surgery complications are unavoidable and may occur even under ideal circumstances.
General unwanted side effects during surgery:
Airway obstruction: Drugs used to reduce pain and that cause a person to lose consciousness during surgery are called anesthetics. Sometimes, these drugs may irritate the throat and lungs. Also, the airway may be blocked. Serious brain damage and death may result if this condition is not treated immediately. The doctor who administers the anesthesia, called an anesthesiologist, may have to insert a tube down into the throat or cut into the windpipe to allow the patient to continue breathing.
Aspiration: Aspiration occurs when the patient vomits or has excessive mucous secretions during the surgery. These fluids may go into the lungs. Inhaling vomit or mucous may be uncomfortable and may lead to infections such as pneumonia. If not treated immediately, then a person may suffocate from inhaling vomit.
Blood clots: During anesthesia or following surgery, a blood clot may become loose and enter a vein. The medical term for this complication is called deep vein thrombosis or DVT. The loose blood clot may block the flow of blood, and a stroke, heart attack, or even death may result. In general, patients who receive more anesthesia and who undergo longer medical procedures are at an increased risk. Following surgery, patients should flex their feet often and try to change positions because movement helps to lower the risk of DVT. Patients may also receive medications to reduce the likelihood of experiencing DVT.
Blood loss: Some bleeding is normal during medical procedures. However, if a large amount of bleeding occurs, the patient's blood pressure may drop and serious side effects may result. Blood may accumulate underneath the skin during or after surgery, and removal of this blood may require another medical procedure. Patients may be able to see excessive bruising, but in some cases, a doctor may detect blood accumulation at a follow up appointment.
Brain damage: A patient may experience brain damage if the brain does not receive enough oxygen or blood during the procedure. For instance, if a patient experiences trouble breathing due to anesthesia, then the blood may not be able to carry enough oxygen to the brain.
Drop in blood pressure: Some decrease in blood pressure is normal during surgery. However, a sudden drop in blood pressure due to blood loss could lead to an irregular heart beat and possibly a heart attack.
Malignant hyperthermia: In a very small number of patients, body temperature, heart rate, and blood pressure may increase to levels that are much higher than normal. This condition may lead to death if it is not treated immediately.
General unwanted side effects after surgery: In general, the likelihood of undesired side effects occurring after surgery is decreased if a patient follows the doctor's directions following surgery. Many of the side effects that occur after surgery may require an additional surgical procedure to correct the problem.
Infection: The wounds created by plastic surgery may become infected. The risk of infection is decreased if the patient follows all written and spoken directions for after-surgery care from health care professionals. For instance, a patient's wound could become infected if they do not change the dressings as frequently as instructed. If patients are given a prescription after the surgery, then they should be sure to carefully read, understand, and follow all of the instructions. For instance, a patient could become seriously ill if they do not finish all of the antibiotics after the surgery.
Irregularities, dimples, puckers, divots, and scars: Undesired changes in the texture, tightness, and smoothness of the skin may occur after surgery. These usually occur at or around the site where the surgery was performed. Changes in the skin may be temporary, or they may never resolve. Patients should contact their doctor if they think the skin is showing abnormal or undesired changes after surgery.
Loose stitches: The doctor may use a special type of thread or glue to hold together wounds created during the surgery. If the stitches become loose or gape, then the patient may experience a hernia, bleeding, or pain.
Numbness / tingling: There is a chance that the degree of sensation a person feels may be reduced in the area where the surgical procedure was performed. This is especially true if the procedure is being performed on the breasts or genital region.
Seroma: A condition called seroma occurs when clear fluid pools underneath the skin. This type of swelling may require an additional surgery to drain the fluid. Some individuals may need to have a tube inserted into their skin to allow the fluid to leave the body.
Skin death: Skin tissue on or around the area where the procedure was performed may die. This skin may need to be surgically removed for the safety of the patient. Dead skin around the site of the procedure and its removal may change the appearance of the skin.
Slow healing: Some patients may take much longer than others to heal. In some cases, slow healing times may increase the likelihood that the area may become infected.
Temporary paralysis: Some patients may find it difficult to move or speak immediately after cosmetic surgery. This condition may occur when the effects of painkillers used during the procedure have not yet subsided. This condition usually improves within several hours.
Side effects after specific plastic surgery procedures:
Breast augmentation (augmentation mammaplasty): Side effects of breast augmentation may include temporary soreness, swelling, change in nipple sensation, and bruising. The breast may be sensitive to stimulation for a few weeks. Risks of breast augmentation procedures include the possibility of the need for implant removal or replacement to treat complications, including deflation, formation of scar tissue around the implant (capsular contracture), which may cause the breast to feel tight or hard, bleeding, or infection. An increase or decrease in the sensitivity of nipples or breast skin to breastfeeding and/or sexual stimulation may occur, which occasionally may be permanent. Women with breast implants may need to undergo a special type of mammogram. Some women have reported symptoms similar to those of immune disorders. Plastic surgeons and the U.S. Food and Drug Administration (FDA) website have information available on these possible complications.
Breast lift (mastopexy): Side effects of a breast lift may include temporary bruising, swelling, discomfort, numbness, or dry breast skin. Permanent scars may also occur. Risks include skin loss, infection, and thick wide scars. The nipples may also appear unevenly positioned. Some individuals experience a permanent loss of sensation in their nipples or breast.
Chemical peel (phenol and trichloroacetic acid): Temporary side effects of chemical peels may include throbbing, tingling, swelling, redness, and an acute sensitivity to sun. Patients may also develop tiny whiteheads at the procedure site, as well as infection, scarring, fever blisters, and cold sores. Permanent side effects may include a lightening of the skin tone, an inability to tan, and scarring. Some patients may have an allergic reaction to some of the materials used in a chemical peel.
Ear surgery (otoplasty): There are different types of ear plastic surgery. However, the side effects that may result from these procedures are the same and may include temporary throbbing, aching, swelling, redness, and numbness. The cartilage may become infected. Blood clots near the ear may form, and the patient may need a second procedure to drain the clot. The ears may assume their old shape after the initial procedure, and some patients may desire to repeat the surgery. Patients may also experience excessive scarring, and the ears may look mismatched or artificial.
Eyelid surgery (blepharoplasty): Temporary side effects of eyelid surgery may include temporary discomfort, swelling, bruising, bleeding, whiteheads around the eyes, tightness of the eyelids, and a sensation of burning or itching around the eyes. For the first few weeks after surgery, the patient may experience excessive tearing, light sensitivity, swelling at the corners of the eyelids, infection, blurred vision, or double vision. Long-term side effects may include a slight asymmetry in the eyes after healing or some scarring around the eyes. The lids may be pulled down more than what is desired. There is a very small risk of blindness as a result of having this procedure.
Facelift (rhytidectomy): Temporary side effects of a facelift may include swelling, bruising, skin numbness, bleeding, skin tenderness, tight skin, and dry skin. Men may need to shave behind their ears because beard-growing skin may be repositioned in that area. More serious risks include infection, a loss of feeling in facial muscles or loss of ability to control facial muscles, nerve damage, and excessive scarring. The hairline may appear asymmetrical or may change. Patients must avoid sun exposure for the first several months after a facelift.
Facial Implants: Facial implants may be composed of a variety of materials. However, the side effects that may result from this procedure are generally the same. Temporary side effects include swelling, bruising, discomfort, numbness, and stiffness. Individuals who have areas near or on their jaws altered with facial implants may be unable to completely open their jaw several weeks after the surgery. More serious risks include a shift in or incorrect positioning of the facial implant. The scar tissue around the implant may excessively tighten or harden and may cause unnatural distortions in the appearance of the face.
Forehead lift (browlift): Temporary side effects of a forehead lift may include swelling, numbness, infection, bruising, and headaches. Itching and hair loss may also occur. Injury to the facial nerve may occur and may result in a loss of facial motion, facial muscle weakness, or an asymmetrical appearance in the face. The scars may appear broad or seem very noticeable. Patients should limit their exposure to the sun for several months after the procedure.
Hair replacement surgery: Temporary side effects of hair replacement surgery include an achy tight scalp. The hair may look unnatural in the early stages of recovery, and the area where the surgery was performed may become infected. The hair may not respond well to transplantation or replacement, and a loss of hair may result.
Laser facial resurfacing: Short-term side effects from laser facial resurfacing may include swelling, discomfort, and infection. Side effects such as a pinkness or redness of the skin, acute sun sensitivity, and increased sensitivity to makeup may persist for up to six months after the procedure. Risks include scarring, abnormal changes in skin color, a flare up of the viral infection that causes cold sores, and burns from the laser. Recovery in the form of a return to normal skin pigmentation may take up to one year.
Liposuction (suction-assisted lipectomy): Side effects of liposuction may include bruising, swelling, numbness, soreness, and a burning sensation. Fluid may drain from the incision sites, which is more likely when a larger cannula is used. Risks include asymmetry, an appearance of bagginess of the skin, ripping of the skin, changes in pigmentation, skin injury, fluid retention, or excessive fluid loss.
Breast reduction (gynecomastia): Temporary side effects of breast reduction include bruising, swelling, numbness, soreness, or a burning sensation. Risks include fluid accumulation, injury to the skin, an appearance of bagginess of the skin, ripping of the skin, asymmetry of the chest area, excessive scarring, and pigmentation changes. Patients should avoid sun exposure for the first several months after the procedure.
Nose surgery (rhinoplasty): Side effects of nose surgery may include a temporary swelling or bruising around the eyes and nose. Headaches, bleeding, and stiffness may also occur. Risks include infection and an incomplete change in the appearance of the nose. Small blood vessels in the nose may burst, resulting in permanent red spots.
Tummy tuck (abdominoplasty): Temporary side effects of a tummy tuck may include pain, swelling, soreness, numbness, and bruising. Patients may feel tired for several weeks or months after the procedure. Risks include blood clots, infection, and bleeding under the skin. Poor healing may result in skin loss or scarring, and patients may require a second operation. The fading and flattening of scars may take up to two years.
It is impossible to predict who will have undesired complications from plastic surgery. There is some degree of risk for each patient when undergoing any surgical procedure.
A 1997 survey by Morello et al. found that very serious complications as a result of plastic surgery occurred rarely (less than one half of one percent, or less than one in every 200 patients). Further, the risk of having a serious complication of plastic surgery performed at an accredited surgical office was the same as having a procedure performed at a hospital.
Additional clinical study is needed in this area before any conclusions can be made.
Patients at increased risk for side effects from plastic surgery include those who are overweight, have had a recent injury, or have ever had a disorder of the heart, lungs, or central nervous system. Individuals who have ever had cancer, genetic blood clotting disorders, or an ongoing severe infection are also at risk. Women who are taking hormone replacement therapy or who are taking or recently stopped taking birth control pills are also at risk.
Prior to undergoing plastic surgery, patients should understand the worst possible complications or side effects they may experience and consult with their healthcare provider on how they might handle these side effects.
Some medical professionals recommend consulting with a mental health professional prior to undergoing plastic surgery in order to prepare as much as possible for adverse effects that may occur.
Patients should be sure to follow the doctor's instructions for recovery after surgery because following these directions may decrease the likelihood of undesired side effects.
This information has been edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).
Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.
Copyright © 2013 Natural Standard (www.naturalstandard.com)
The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.
March 22, 2017