Risks of Surgery
What Is Plastic Surgery?
Just because the name includes the word “plastic” doesn’t mean patients who have this surgery end up with a face full of fake stuff. The name isn’t taken from the synthetic substance but from the Greek word plastikos, which means to form or mold (and which gives the material plastic its name as well).
Plastic surgery is a special type of surgery that can change a person’s appearance and ability to function.
- Reconstructive procedures correct defects on the face or body. These include physical birth defects like cleft lips and palates and ear deformities, traumatic injuries like those from dog bites or burns, or the aftermath of disease treatments like rebuilding a woman’s breast after surgery for breast cancer.
- Cosmetic (also called aesthetic) procedures alter a part of the body that the person is not satisfied with. Common cosmetic procedures include making the breasts larger (augmentation mammoplasty) or smaller (reduction mammoplasty), reshaping the nose (rhinoplasty), and removing pockets of fat from specific spots on the body (liposuction). Some cosmetic procedures aren’t even surgical in the way that most people think of surgery — that is, cutting and stitching. For example, the use of special lasers to remove unwanted hair and sanding skin to improve severe scarring are two such treatments.
What are the risks of surgery?
The surgery involves the same level of risk for the donor as any other major surgery. The majority of complications following surgery are minor and may cause a longer hospitalization. The risks associated with surgery and donation should be discussed with your transplant team, and include:
- Pain. You will receive medication for pain after the surgery.
- Infection. An infection can delay the healing process or cause scarring or other problems. If the wound from the surgical incision becomes infected, it will be treated with antibiotics. Antibiotics are powerful medicines that fight bacterial infections.
- Pneumonia. Surgery increases the risk for pneumonia (an inflammation of the lungs caused by bacteria or a virus). You will be asked to cough and breathe deeply during your recovery period. Taking a deep breath and coughing forces air to the bottom of your lungs, which helps to expand them and lessens your risk for pneumonia.
- Damage to the kidney. There is a possibility that the kidney could become damaged during the surgical procedure. Every attempt will be made to minimize this risk.
- Blood Clotting. You will be encouraged to move around as soon as you can after surgery. This will stimulate blood circulation to help prevent blood clots.
- Collapsed lung. The kidney is close to the lung, and the pleura (the space around the lung) may be inadvertently opened during surgery. If this happens, the lung may collapse. The doctors would then insert a tube into the chest to expand the lung.
- Urinary tract infection. This is an infection of the bladder or kidneys. It can be treated with antibiotics.
- Allergic reaction to anesthesia. Anesthetics are drugs that prevent pain. During the evaluation process, the transplant team will try to identify any allergies you might have. If you have an allergic reaction to anesthesia, the doctor will take immediate action to correct the problem.
- Death. There is always a risk of death with any major operation. However, the risk of death from surgery for living kidney donors is very low. Living donors undergo careful pre-operative testing and evaluation to make sure they are healthy enough for surgery. In one study of over 80,000 living kidney donors, death from surgery was 3.1 per 10,000 donors. This rate has not changed for the last 15 years.
10 of the Most Common Plastic Surgery Complications
For many people, the thought of undergoing surgery is very scary. If you’re considering plastic surgery, it’s important that you’re aware of both the benefits and the risks. Here are some of the most common and most talked about cosmetic surgery complications.
Hematoma is a pocket of blood that resembles a large, painful bruise. It occurs in 1 percent of breast augmentation procedures. It’s also the most common complication after a facelift, occurring in an average of 1 percent of patients. It occurs more commonly in males than females.Hematoma is a risk in nearly all surgeries. Treatment sometimes includes additional operations to drain the blood if the collection of blood is large or growing rapidly. This may require another procedure in the operating room and sometimes additional anesthetic.
Seroma is a condition that occurs when serum, or sterile body fluid, pools beneath the surface of the skin, resulting in swelling and sometimes pain. This can occur after any surgery, and it’s the most common complication following a tummy tuck, occurring in 15 to 30 percent of patients.
Because seromas can become infected, they’re often drained with a needle. This effectively removes them, although there’s a chance of recurrence.
- Blood loss
As with any surgery, some blood loss is expected. However, uncontrolled blood loss can lead to a drop in blood pressure with potentially deadly outcomes.Blood loss can happen while on the operating table, but also internally, after surgery.
Though postoperative care includes steps to reduce the risk of infection, it remains one of the more common complications of plastic surgery.
The skin infection cellulitis may occur after surgery. In some cases, infections can be internal and severe, requiring intravenous (IV) antibiotics.
- Nerve damage
The potential for nerve damage is present in many different types of surgical procedures. Numbness and tingling are common after plastic surgery and can be signs of nerve damage. Most often the nerve damage is temporary, but in some cases it can be permanent.
Most women experience a change in sensitivity after breast augmentation surgery, and 15 percent experience permanent changes in nipple sensation.
- Deep vein thrombosis and pulmonary embolism
Deep vein thrombosis (DVT) is a condition where blood clots form in deep veins, usually in the leg. When these clots break off and travel to the lungs, it’s known as pulmonary embolism (PE).
These complications are relatively uncommon, affecting only 0.09 percent of all patients undergoing plastic surgery. However, these clots can be fatal.
Abdominoplasty procedures have a slightly higher rate of DVT and PE, affecting just under 1 percent of patients. The risk of clots is 5 times higher for people having multiple procedures than it is for people having only one procedure.
- Organ damage
Liposuction can be traumatic for the internal organs.
Visceral perforations or punctures can occur when the surgical probe comes into contact with internal organs. Repairing these injuries can require additional surgery.
The perforations may also be fatal.
Surgery typically results in some scarring. Since cosmetic surgery seeks to improve the way you look, scars can be particularly troubling.
Hypertrophic scarring, for instance, is an abnormally red and thick raised scar. Along with smooth, hard keloid scars, it occurs in 1.0 to 3.7 percent of tummy tucks.
- General appearance dissatisfaction
Most people are satisfied with their postoperative outcomes, and research suggests most women are satisfied with breast augmentation surgery. But disappointment with the results is a real possibility. People who undergo breast surgery may experience contouring or asymmetry problems, while those undergoing facial surgeries could simply not like the result.
- Complications of anesthesia
Anesthesia is the use of medication to make you unconscious. It allows patients to undergo surgery without feeling the procedure.
General anesthesia can sometimes lead to complications. These include lung infections, stroke, heart attacks, and death. Anesthesia awareness, or waking up in the middle of surgery, is very rare but also possible.
More common anesthesia risks include:
- nausea and vomiting
- waking up confused and disoriented
Cosmetic Surgery, Plastic Surgery—What’s the Difference?
If you’ve always thought cosmetic surgery and plastic surgery were one in the same, you’re not alone. A significant number of plastic surgeons choose to focus their practice on cosmetic surgery, and as such, the terms are often used interchangeably. But this is not technically correct. Cosmetic surgery and plastic surgery are closely related specialties, but they are not the same.
Cosmetic Surgery & Plastic Surgery Have Different Goals
While both cosmetic surgery and plastic surgery deal with improving a patient’s body, the overarching philosophies guiding the training, research, and goals for patient outcomes are different.
What is cosmetic surgery?
Cosmetic Surgery: Focused on Enhancing Appearance
The procedures, techniques, and principles of cosmetic surgery are entirely focused on enhancing a patient’s appearance. Improving aesthetic appeal, symmetry, and proportion are the key goals. An aesthetic surgery can be performed on all areas of the head, neck, and body. Since cosmetic procedures treat areas that function properly, cosmetic surgery is designated as elective. Cosmetic elective procedures are performed by doctors from a variety of medical fields, including plastic surgeons.
Types of Cosmetic Surgery Procedures:
- Breast Enhancement: Breast Augmentation, Breast Lift, Breast Reduction
- Facial Contouring: Rhinoplasty, Chin, or Cheek Enhancement
- Facial Rejuvenation: Facelift, Eyelid Lift, Neck Lift, Brow Lift
- Body Contouring: Tummy Tuck, Liposuction, Gynecomastia Treatment
- Skin Rejuvenation: Laser Resurfacing, Botox®, Filler Treatments
What is plastic surgery?
Plastic Surgery: Focused on Repairing Defects to Reconstruct a Normal Function & Appearance
Plastic surgery is defined as a surgical specialty dedicated to reconstruction of facial and body defects due to birth disorders, trauma, burns, and disease. Plastic surgery is intended to correct dysfunctional areas of the body and is, by definition, reconstructive in nature. While many plastic surgeons choose to complete additional training and perform cosmetic surgery as well, the basis of their surgical training remains reconstructive plastic surgery. In fact, in 1999, the American Society of Plastic and Reconstructive Surgeons changed its name to the American Society of Plastic Surgeons to more strongly communicate the message that “plastic and reconstructive surgeons are one in the same.”¹
Types Plastic Surgery Procedures:
- Breast Reconstruction
- Burn Repair Surgery
- Congenital Defect Repair: Cleft Palate, Extremity Defect Repair
- Lower Extremity Reconstruction
- Hand Surgery
- Scar Revision Surgery
How to ensure your plastic surgery is safe
Not all physicians are created equally: this is an essential consideration when looking for a plastic surgeon. How do you choose a plastic surgeon? Ensuring safety throughout your plastic surgery journey is just as important as the procedure you want and the desired result. To ensure a safe surgery with an expert in the field, I have outlined a 10-point checklist below to help you in selecting a plastic surgeon, what to ask, and qualities for which to look.
- Your prospective surgeon should be board certified by the appropriate specialty group for the procedure you are contemplating. With a multitude of medical practices throughout the country, you can immediately narrow your search down to physicians who are certified by the American Board of Plastic Surgery (ABPS). Do you want an occasional plastic surgeon or someone who has gone the extra mile to attain and maintain credentialing? The ABPS has a rigorous qualification, examination, and recertification process that ensures your plastic surgeon is qualified and an expert in their field.
- Find references you can trust. Ask people you trust, i.e. your personal physician, friends, and people you know in healthcare to give you recommendations on plastic surgeons they may know or of whom they have heard. Also, reach out to people you know who have had plastic surgery, ask about their experience, and if they are happy with the results. Lastly, go online: review sites can be great places to see what people are talking about with a plastic surgeon. Remember, though, online reviews are not vetted so they might not be as authentic as they appear. A good guide for truth vs fiction is a rating that has as many good and some not so good ratings. This is more realistic and truthful than someone who has a thousand great ratings and no negative ones. That is a red flag for fake reviews.
- Examine your prospective surgeon’s website. First look at the biography section of the plastic surgeon, this will give you information about their experience as well as certification. If there is no biography listed, ask yourself why. A great plastic surgeon will have nothing to hide. A well-organized website, with great design, and detailed information can tell you a lot about a prospective surgeon. Remember, also, that everyone can be famous on their own website, so, when referencing credentials, make sure also to research what each certification means, how is it obtained, how is it maintained, and what qualifications one must have to get that certification.
- Verify that your prospective surgeon has hospital privileges. “Hospital privileges” refers to the right of a physician to use the equipment and facilities at a given hospital. Even though you might have your procedure at a surgical center rather than a hospital, hospital privileges indicate that your surgeon has been vetted by their peers and by a hospital committee. It should be a red flag if your prospective plastic surgeon does not have hospital operating privileges.
- Inquire about your surgeon’s specific experience. You have the right to make sure the surgeon is right for you, possessing the experience and expertise they claim. A qualified plastic surgeon will be more than happy to explain his experience and expertise. If not, that should be a red flag. Make sure to ask if the procedure you are seeking is something they do at least once a week and is it in their top three procedures performed.
- Ask your prospective surgeon to clarify all potential benefits, risks, and complications. If your prospective surgeon answers questions with “everything will be fine,” or “you will not feel a thing,” this should be a red flag that your surgeon is not being honest with you. Plastic surgery, as relatively safe as it is, can have complications and each patient’s medical history can present different risks. Your plastic surgeon should be readily forthcoming with information about risks and potential complications.
- When it comes time for surgery, it should be performed in an accredited ambulatory facility. Accredited ambulatory facilities are subject to internal and external inspection by credentialing agencies, thus must maintain a facility that operates in such a manner. This type of facility will also have the emergency equipment and training necessary to respond to an emergency if the need arises. A board-certified plastic surgeon is required to operate in an accredited ambulatory facility.
- A great surgeon will employ a carefully selected and certified anesthetist or anesthesiologist. The person administering your anesthesia is pivotal to ensuring a relaxing and pain-free procedure. A reputable plastic surgeon will only employ staff that delivers the same quality of care that they deliver.
- Discuss your recovery period with your prospective surgeon. Understanding the recovery process and what to expect especially in the first 24-48 hours is crucial to maintaining safety. Every surgical recovery is unique, and your surgeon should explain in detail what to expect and how to get in touch with his or her staff if necessary.
- Get additional opinions from appropriate professionals, if needed or desired. Remember: This is your body, and you are the boss. Choosing a plastic surgeon is a very personal decision. Selecting a plastic surgeon is an interview process, and sometimes 2 or 3 consultations with different surgeons are necessary to find one that meets your criteria and makes you feel comfortable.
Ultimately when deciding on a board-certified plastic surgeon, you must find someone who has experience, who is an expert in the desired field, and who can show you proof of exceptional results. Deciding to undergo surgery to alter your appearance is a big decision and should not be taken lightly. As an educated consumer, you must do your part to determine what you want, do your homework, and seek expert consultation. By following the above steps, you can rest assured that you are making a well-informed decision.