What are the general risks of having cosmetic surgery?

No surgery is risk-free, but luckily complications are very rare if you're in the hands of a good and experienced surgeon. A surgeon will perform several examinations prior to the surgery, in order to minimise the risks of unwanted results.

Your surgeon will ensure that you're physically and mentally capable of going through an operation. You'll also be asked not to take any medicine that can cause bleeding. Additionally the surgeon will advice you on how to behave both before and after the surgery. All this is done in order to reduce the risk of complications.

Bleeding, blood accumulation, fluid build-up under the skin, along with infections are all possible complications which might occur during surgery. Luckily, all of these complications can easily be treated, if discovered in due time.

Skin rash and reactions to the sutures (the threads used for stitching) or the anaesthesia (sedation) are also some of the possible risks with surgery. If the complications aren't discovered in time, and therefore remain untreated, it can cause the wound to open, which again could mean wider and uglier scars. In the worst case, death of the skin and underlying tissue can occur. During the surgery there is a risk of damaging the nerves, which could result in loss of sensation in the skin, partly or completely. The movement function of the muscle might also be reduced.

With some cosmetic surgery procedures, there will be additional risks. You can read about these in the treatment information for the individual treatment, here on Mylooks. Find the treatment in the Treatment Index or use the step-by-step Patient Guide.

Aside from the risk of complications, there are often several unwanted side effects associated with cosmetic surgery. The most obvious one is a scar. Wherever a cut is made, there will be a scar. This is unavoidable. A scar can be corrected or moved, and it will fade with time, but it can never go away completely. Therefore, the fewer the cuts, the better!

The complications

Here's a detailed explanation of the individual complications:

Bleeding

Many common medicaments, herbal supplements, Vitamin E, and alcohol, as well as an uncontrolled, high blood pressure, can lead to bleeding tendencies. In fact, anything that increases your blood pressure and heart rate, such as exercise, strain, vomiting, and leaning forwards, all increase the risk of complications.

Bleeding after the surgery often occurs within 24 hours and can lead to further complications, such as blood accumulation, infection, the wound opening, and very rarely – tissue death. A blood accumulation will reveal itself by making the affected skin area very painful. The skin might feel tight and will maybe change to a bluish or purple colour. Normally the bleeding will be minor and stop by itself, with the help of the body’s own blood clotting mechanism.

If, however, the blood accumulation grows so large that it presses on the tissue in a such degree that the skin can't get enough oxygen, the skin will slowly start to die. In such cases, an additional operation will be necessary, in order to remove the excess blood. A drain will be inserted, to prevent further bleeding underneath the skin. A large blood accumulation can also increase the risks of additional complications, such as infection or the wound opening.

Infection

Infection is another possible complication. The likelihood of developing an infection is highest within the first 3 days after surgery. Bacteria can penetrate into the body during the surgery, after the surgery (through the sutures), when a drain was inserted, or through an open wound. If having a treatment in the mouth area, the surgeon may give you some medicine to prevent an outburst of herpes.

Typical signs of infection are intense heat, soreness, intense reddening, bad smell, thick, yellow or white flux, and fever above 38 degrees C (100 degrees F). If the infection develops, you will have to start taking a new antibiotic or have a second operation to drain and empty out the infection.

Blood accumulation

A blood accumulation is a possible complication in cases where tissue parts have been separated from each other (particularly with abdominoplasty/tummy tucks). A blood accumulation can occur, when the body attempts to fill out the empty space that was created, when the tissue was separated during surgery, or when the layers of tissue rub against each other. When blood accumulation occurs, the risk of infection will be increased. If a surgical implant has been inserted in the affected area, it will sometimes be necessary to remove this, so the wound is able to heal.

The risk of blood accumulation can be limited by wearing a tight bandage, and by limiting physical activity. If a blood accumulation develops, you might notice a swelling, heaviness, flux, and in rare cases an increase in weight.

Reaction to the sutures (the threads used for stitching)

The sutures aren't a natural part of the body, and so it's not uncommon for it to react against these. This can show in several ways.

After a couple of weeks or months the body might attempt to reject the sutures, by pushing them out of the skin. Another way for the body to react is to form a tiny wall of scar tissue around the sutures, to separate them from the body. This reaction may be seen as a bump underneath the skin. If bacteria has been able to penetrate into the area surrounding the stitching, there's a risk of infection. This can be seen as reddening, soreness, and pus (a yellow substance that emerges from the infected wound). If this isn't treated, the infection might spread to a larger area.

If you've previously experienced that your body reacts undesirably to sutures, it's advised that you notify the surgeon about this. This will make it possible for him or her to adapt the technique or the choice of suture material, in order to avoid problems.

The skin’s reaction

Your body can react to medicine, both during and after the surgery, or to products applied to the skin after the surgery. The most common case is that the skin reacts to the bandages, which are applied after the surgery. Complications may show as reddening, itching, and tiny blisters underneath the bandages.

Most mild cases can easily be treated with, for example, pills. If you experience skin rash and itching all over the body, it's important to contact your doctor immediately. This could be a systemic reaction, often to the medication, and in the worst cases, it can lead to breathing difficulty.

Poor wound healing

Every time an incision is made, there's a risk that the wound might not close properly. Poor wound healing can be caused by bleeding, swelling, smoking, intense physical activity, uncontrolled blood sugar, blood accumulation, or infection. The surgeon will of course do his or her best to prevent this from happening. He or she will use a suitable surgical technique, and make sure that the stitching is performed correctly. The surgeon will also make sure not to removes the sutures (threads) prematurely.

If the wound should open up anyway, the surgeon will be forced to leave it as it is, and not sew it back together. This will mean, that the scar will become larger and uglier, although this can be corrected later on. In some cases, it will be possible to sew the wound back together, despite it having opened up. Particularly within the first 24 hours after the surgery.

Necrosis (tissue death)

Tissue needs oxygen and nutrition. If the tissue receives to little oxygen, it will slowly turn to a purple or bluish colour. If the tissue is left without oxygen for a long time, it will slowly die. This is called necrosis.

With many operations, there's really no reason to fear necrosis. But with surgery, where the blood flow is temporarily cut off, the risk will increase. This is true of procedures such as facelift, abdominoplasty (tummy tuck), and breast lift. Additionally, smokers are generally more at risk of necrosis than non-smokers, as smoking makes the tiny blood vessels contract, thereby minimising the blood flow.

The signs of necrosis are a bluish, purple, or grey discolouration of the skin, although not to be confused with bruising, which will always occur after surgery. In worst cases, the skin will slowly die, which will cause pain and a bad smell, and the skin will change to a black or grey colour.

Damage to the nerves

Damage to a nerve can happen when an anaesthetic is injected, or during the actual surgery. If a nerve is damaged, you'll experience numbness or a sensation change in the affected area.

If damage is caused to a nerve that controls a muscle, it can cause this muscle to be weakened or even paralysed. Often the effects of nerve damage will be temporary, and the sensation will slowly return after 6 to 12 months. In some cases, however, it can take 2 or 3 years.

If the nerve is completely severed, it will never return to normal again. This could mean permanent numbness, and inability to move the muscle.

Repercussions from the anaesthesia

There will also be a risk associated with the anaesthesia itself. For further information about this, please read the article: What is anaesthesia, and is it dangerous?

Conclusion:

We've chosen to provide a detailed description of the risks of surgery. This is not to frighten, but to inform you, so you can make an educated decision on, whether or not to have the surgery. It's a good idea to discuss these issues with your surgeon in relation to the treatment in question. It's important that you ask about anything, that you don't understand.

Lastly, it's important to emphasise that serious complications are very rare, although they do occasionally occur. It can happen to the best surgeon. No form of surgery – not even cosmetic surgery – is risk-free. But if you're fit and healthy, and you follow the doctor’s advice, before and after the surgery, you will most likely have a beautiful result, and with no serious complications!

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Read more about what surgery really is, and whether or not it's dangerous, here!