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Risks and Complications

Every surgical procedure, no matter how minor, carries some level of risk. Plastic surgery is no exception, and understanding potential complications is an essential step in making an informed decision. While the vast majority of procedures are performed safely and successfully, complications can arise, varying in severity and occurrence based on individual health factors, surgical techniques, and adherence to post-operative care guidelines. Below is an in-depth look at the risks associated with plastic surgery, along with strategies to minimise them.

Scarring

Scarring is an inevitable part of the healing process following any surgical incision. The extent and appearance of scars depend on multiple factors, including the surgical technique, the patient’s skin type, genetic predisposition, and adherence to post-operative care instructions. Key types of scarring include:
  • Hypertrophic Scars: Raised and red scars that may diminish over time but remain prominent.
  • Keloid Scars: Overgrown scars that extend beyond the original incision site and can be challenging to treat.
Preventative measures, such as proper wound care, avoiding tension on the incision site, and using scar treatments (e.g., silicone sheets or gels), can help improve outcomes. For persistent or severe scarring, advanced treatments such as laser therapy, steroid injections, or surgical revision may be necessary. It’s crucial to discuss any history of abnormal scarring with your surgeon during consultations.

Infection

Infections occur when bacteria infiltrate the surgical site, potentially leading to redness, swelling, fever, and discharge of pus. While rare, infections can range from superficial (affecting only the skin) to deep infections involving tissues or implants.

Preventative Steps

  • Surgeons adhere to strict sterilisation protocols during procedures.
  • Prophylactic antibiotics are often administered before and after surgery.
  • Patients should follow detailed wound care instructions to minimise risk.

If an infection does develop, early detection is critical. Symptoms should be reported immediately so that treatment, such as antibiotics or drainage of infected fluid, can begin without delay.

Pain

Post-surgical pain is a natural and expected response to tissue manipulation and healing. Pain levels can vary based on factors such as the type of procedure performed, the individual’s pain tolerance, and adherence to recovery protocols.

  • Acute Pain: Typically occurs within the first few days post-surgery and gradually decreases with time.
  • Chronic Pain: Rare, but can develop if nerves are affected during surgery or if healing complications arise.

Your surgeon will provide a tailored pain management plan that may include prescription medications, over-the-counter analgesics, and non-pharmacologic methods such as cold compresses and rest. If pain persists or worsens, it may signal complications such as infection, haematoma, or nerve irritation.

Bleeding

Both internal and external bleeding are possible complications. Minor bleeding at the incision site is common and usually stops with proper wound care. However, excessive or uncontrolled bleeding can occur, particularly in the form of:

  • Haematomas: Collections of blood beneath the skin that may appear as bruising, swelling, or localised pain.
  • Active Bleeding: Requires immediate attention if it cannot be controlled by applying gentle pressure.

Patients are advised to avoid blood-thinning medications and supplements, such as aspirin or fish oil, before surgery and to follow activity restrictions during recovery to minimise the risk of bleeding.

Seroma

A seroma forms when clear lymphatic fluid accumulates beneath the skin after surgery. This fluid build-up is common after procedures involving significant tissue disruption, such as abdominoplasty or breast surgery.

Signs of Seroma

  • Swelling or a soft, fluid-filled lump near the surgical site.
  • Clear fluid leaking from the incision.

While small seromas often resolve on their own, larger ones may require drainage or further intervention. Wearing compression garments and avoiding excessive activity can reduce the likelihood of seroma formation.

Anaesthetic Complications

Anaesthesia is a critical component of surgical procedures, ensuring patient comfort and safety. However, adverse reactions to anaesthesia can occur, including:

  • Allergic reactions.
  • Respiratory or cardiovascular issues.
  • Rare but severe conditions, such as malignant hyperthermia.

To mitigate these risks, patients undergo thorough pre-operative evaluations, including a review of their medical history and prior anaesthetic experiences. Intraoperative monitoring by an experienced anaesthesiologist ensures prompt management of any complications.

Undesirable Cosmetic Outcome

Despite careful planning and execution, some patients may experience results that fall short of their expectations. Common concerns include:

  • Asymmetry or uneven results.
  • Skin irregularities, such as puckering or dimpling.
  • Residual deformities that require revision surgery.

Realistic expectations, detailed pre-surgical consultations, and clear communication with your surgeon are key to minimising dissatisfaction. In cases where revision surgery is necessary, your surgeon will discuss options to address specific concerns.

Nerve Damage

Nerve damage, though uncommon, is a potential risk of plastic surgery. It can result in temporary or permanent changes to sensation, including:

  • Numbness or tingling near the incision site.
  • Loss of sensitivity in affected areas.
  • Rarely, persistent pain due to nerve irritation.

In most cases, nerve function improves as the tissues heal. Your surgeon will discuss the likelihood of nerve-related complications based on the specifics of your procedure.

Bruising and Swelling

Temporary bruising and swelling are expected after surgery as part of the natural healing process. However, excessive or prolonged symptoms may indicate complications such as haematomas or infection.

Management Tips

  • Elevate the surgical site when possible.
  • Apply cold compresses during the first 48 hours.
  • Avoid strenuous activities and follow all aftercare instructions.

Persistent swelling or deep, dark bruising should be evaluated promptly to rule out underlying issues.

Death

While extremely rare, all surgical procedures carry a small risk of mortality. Contributing factors may include severe complications such as blood clots (deep vein thrombosis or pulmonary embolism), adverse reactions to anaesthesia, or undiagnosed medical conditions. Pre-operative screenings and consultations are vital for identifying and mitigating these risks. Patients are encouraged to disclose their full medical history, including medications and lifestyle factors, to ensure the safest surgical experience.

Your Role in Minimising Risks

Patient education and collaboration with your surgical team are key to minimising complications. By selecting a board-certified and experienced surgeon, following pre-operative and post-operative instructions, and maintaining open communication throughout your recovery, you can significantly reduce the likelihood of complications and enhance your overall experience.

If you have additional questions or concerns, we encourage you to contact our team for further guidance and support.

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