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Home » Consumer Information » Medical Malpractice » Surgical Error » Plastic Surgery

Cosmetic Surgery Risks

No surgical procedure is completely foolproof, but it is safe to say that under the care of well-versed surgeons, complications are seldom and usually repairable. If you have sought out a reputable surgeon, they should do everything in their power to reduce the likelihood of getting unwanted results; your doctor should screen you to be certain you're physically and emotionally fit for cosmetic surgery.

You'll be prompted to discontinue all medication prior to surgery that contributes to bleeding. In some instances, your doctor may require you to be cleared by your primary care physician to verify that it is completely safe to go through with it. Your surgeon should also provide pre/postoperative directions that are formatted to lessen the risk of side effects. Although serious complications occur infrequently, they will happen to the best plastic surgeons under the most stringent conditions. Those patients in excellent health, who follow the medication instructions from the surgeon, and who abide by pre/postoperative guidelines are least likely to develop a problem.

Bleeding and Hematomas

Various everyday medicines, herbal supplements, vitamin E, alcohol consumption, and high blood pressure have an effect on the probability of bleeding. In reality, anything that boosts your blood pressure and heart rate like exercise, strenuous activity, vomiting, and leaning forward increases the odds of bleeding.

Postoperative bleeding is most likely to occur during the first 24 hours and can develop into a hematoma (collection of blood), infection, separation of an incision, and even dead tissue in some instances. A hematoma starts out as a sore dense area beneath the skin. It may feel hard or cause the skin above it to turn blue or purple. Generally, the bleeding is not very intense, and it will subside and reabsorb into the body as the blood begins to clot on its own.

If the hematoma grows large enough, it will compress the tissues, impede oxygen from reaching the skin, and cause the skin to deteriorate and eventually die. In a case like this, the patient must return to the operating room to stop the bleeding, remove excess blood, and have a drain put in place to reduce the risk of blood collecting under the skin again. A hematoma spread across a large area could very well lead to additional complications like infection, wound separation, and necrosis (tissue death).

Infections

Infections are most likely to develop within the first 72 hours following surgery. Bacteria can enter the body during or after surgery. If it does so following surgery, it can enter through areas that have been stitched or drained or are open. A patient who's had surgery in close proximity to the mouth could require antibiotics prior to surgery to protect against a viral infection that could cause a herpes outbreak.

Anti-viral medication is often administered during surgery through an IV. Antibiotics in the form of a pill are exceptional when it comes to treating systemic infections (in the bloodstream) or ointment for skin or eye infections. Even if you don't have an infection, the doctor will normally prescribe an antibiotic in some capacity for the purpose of prevention. Patients with mitral valve prolapse or implants such as pacemakers, breast or facial implants, or artificial joints should be on antibiotics whenever skin or mucous membranes are cut open.

If you experience any of the following symptoms, chances are you have an infection:

  • Warmth
  • Tenderness
  • Increased redness
  • Foul odor
  • Thick, yellow or white discharge
  • Fever of 101°F or higher

If the infection worsens, a change in antibiotics is imminent; the patient will either require a stronger pill or will need an alternative such as IV or IM antibiotics. In the worst case scenario, they may need another surgical procedure to drain and clean the infected area.

Seroma

A seroma, or fluid collection, is another potential side effect of procedures in which tissue has been separated (i.e. tummy tuck). It is your body's natural reaction to fill the void with liquid created amidst the separated tissue or as the layers of tissue rub together. When a seroma is present, it greatly increases the chances of infection. If the patient has implants near a seroma, they could need to be taken out for the body to heal healthily.

The possibility of developing a seroma can be lowered by wearing compression clothing and keeping activity to a minimum. If a seroma occurs, the patient may be aware of the area becoming fuller, heavier, and enlarged. They also may notice the movement of liquid or even weight gain.

The typical treatment of a seroma includes compression or drainage with a syringe. An antibiotic or a solution that encourages the tissue to stick together may be injected into the cavity of the seroma if neither of the first two treatments work. Seromas can take weeks or even months to evacuate the body after being drained.

Suture reactions

Since a suture is a foreign object, it is not unusual for your body to reject it. This is made apparent in the form of a spitting suture, suture granuloma, or suture abscess.

A spitting suture happens weeks to months following surgery when your body attempt to rid itself of the suture by pushing it to the skin's surface.

A suture granuloma shows up as a bump under the skin that is caused by a wall of scar tissue created to separate the suture from the rest of the body.

A suture abscess is caused by bacteria that invades the area surrounding the suture and creates a minor infection. It will cause redness, tenderness, and pus around the suture. If not treated, the infection can spread throughout the skin.

If you've had previous procedures done in which you've had difficulty with sutures (e.g., sutures that don't dissolve as quickly as advertised), notify your doctor well before the surgery. The surgeon may have the ability to alter the technique of how the suture is imbedded or use a different material that may not trigger such a negative response.

Skin reactions

Medication used during or after surgery or topical products applied to the skin can cause irritating effects. The most frequent side effects are prompted by adhesive bandages or tape that cause redness, itchiness, and tiny blisters underneath the adhesive. Neomycin, Neosporin, and other triple antibiotic ointments tend to cause an allergic response in approximately five percent of users. As a result, doctors suggest using Polysporin, Bacitracin, or a generic double antibiotic ointment that is lacking Neomycin.

If you experience a rash, hives, or itching all over your body, contact a physician right away. This type of reaction, known as a systemic reaction, is usually spurred on by the use of medication and can initiate breathing problems if not tended to. Hydrocortisone cream, Benadryl, or antihistamine pills are able to cure most skin irritations. However, more severe cases may call for oral steroid treatment or a hospital visit.

Wound separation

Whenever the skin is sliced open during surgery, there is always a slight possibility that it will not close and heal appropriately. The following complications all contribute to delayed and improper healing of wounds:

  • Bleeding
  • Swelling
  • Smoking
  • Jerky or extreme movement
  • Shearing forces
  • Oral steroid intake
  • Unmonitored blood sugar levels
  • Hematoma
  • Infection

Other factors that the surgeon has semi-control over are:

  • Surgical technique
  • Amount of strain on the wound
  • Time of suture removal

If a patient's wound splits open, a plastic surgeon may decide to allow it to heal naturally without stitching it back up. Once the area has completed the healing process, the surgeon could decide to suture it again. Sometimes, it may not be necessary to wait so long if the wound separates within the first 24 hours following surgery, and the doctor could decide to re-suture the region in question.

Necrosis

In order to remain healthy, tissue must have a sufficient supply of oxygen and nutrients. If the oxygen does not saturate the tissue to the point where they reach a high enough concentration, the tissue could turn a bluish or purplish color. Once the tissue is ischemic, or lacking oxygen, for an extended amount of time, necrosis may set in.

Oftentimes, necrosis is negligible, but in procedures where the blood supply is halted, the threat of circulation problems increases. Some higher risk operations supporting this theory include facelifts, tummy tucks, and breast reductions. During these procedures, flaps are made to separate the skin and its blood supply from other bodily structures.

Most of the time, the alternate circulation that provides the tissue with nutrients is plentiful. But, the chances of necrosis setting in rise when considerable swelling occurs, during procedures where large flaps are created, and when the patient is a smoker. Smokers are more susceptible to necrosis because they typically have constricted blood vessels and a depleted oxygen supply.

One telltale sign of necrosis is that the skin turns a blue, purple, or grey hue. However, it looks nothing like a "black and blue" bruise. Pain can also be associated with the onset of necrosis and could be the sole sign if the tissue death is deep beneath the surface of the skin. In advanced stages, the tissue will turn grey or black with a distinct odor and may become infected.

To prevent significant damage, it is important to treat ischemia and necrosis in its earliest stages. Treatment possibilities include liberating sutures to ease compression caused by swelling or hyperbaric oxygen therapy. If the harm inflicted is minor, allow the tissue to slough, after which it will heal without any assistance.

Nerve damage

Nerve damage can be the result of something as simple as an anesthesia injection, or it can be caused by the surgery itself. In the event of nerve damage, the patient may be aware of numbness, prickling, or fluctuations in feel or sensation.

Damage to nerves responsible for muscular actions could weaken or even paralyze the associated muscle. In general, nerve damage is short-term, and feeling will be normal in as little as six months. In the worst cases, total rehabilitation can last two to three years.

As the nerve grows back, the patient may realize tickling sensations, shooting pain, or feelings of electric shock. These are normal side effects to nerve re-growth, and they can be minimized with aspirin or specific nerve medication.

If the nerve is completely severed, there is a chance it may never be what it once was. You may be affected by eternal numbness or paralysis of that particular muscle. Reconstructive surgery may be the only option to restore some function to the muscle in worst case scenarios.

If you or someone you know has experienced a plastic surgery injury like any of those mentioned above, there is a possibility that it occurred as a result of the doctor's negligence. Contact a medical malpractice attorney today.

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