Understand the Risks of Plastic Surgery

from plastic surgery

Complications may follow any operation but are most poorly accepted when they occur after cosmetic surgery. With medically necessary procedures, most complications are outweighed by the necessity to have surgery to solve an existing or potential problem. With cosmetic surgery, no existing or potential medical problems have been remedied. Thus when a complication occurs, a patient is likely to think, "I wish I had never had this procedure."

But for the best outcome, you must fully acknowledge the risk of complications and be willing to accept any that occur. In addition, if your surgeon is well qualified and experienced, you will have the best chance of having a reasonable outcome following any complication.

Less Improvement than Expected

One of the most common problems is getting less improvement than you expected. All patients should think of this as a potential risk. Although it might be due to inadequate surgery, it is more often due to unrealistic expectations.

Infection

Infection can occur following any operation and is often treated with antibiotics alone. Occasionally, it is necessary to remove stitches to allow the infection to drain. Sometimes the wound is left open, which can result in a more visible scar that can often be revised at a later date. For severe infections, additional surgery and admission to the hospital for intravenous antibiotics might be necessary.

Hematoma

A hematoma is the accumulation of blood within the surgical site after the skin incision has been closed. A small hematoma usually causes minor bruising and swelling, which often resolves on its own. A large hematoma is more serious. It can threaten the overlying skin, lead to infection, and compromise the final cosmetic result. Surgical exploration and removal of the hematoma is usually required if it is large.

Seroma

A seroma is a collection of clear fluid that weeps into the wound several days following surgery. Your surgeon can remove most seromas in the office with a needle. Surgeons may prevent some seromas by placing plastic drainage tubes at the time of surgery and removing them during a postoperative office visit.

Skin Death or Skin Breakdown

Skin death may occur where skin is under tension or where circulation has been compromised. This is often seen following infection or hematoma and is most common in smokers. Treatment involves waiting for the dying skin to separate from the surviving skin. The dead skin is then surgically removed, and the remaining tissue is allowed to heal or is closed surgically. As you might imagine, this can potentially alter the cosmetic outcome.

Asymmetry

A natural and symmetric appearance is the universal goal of both patient and surgeon. Surgery might, however, fail to correct preexisting asymmetry or might create new asymmetry. Mild degrees of asymmetry are normal. Moderate or severe asymmetries might require surgical revision.

Numbness or Tingling

Sensory changes may occur following many operations. Sometimes these changes are expected, such as temporary cheek numbness after a facelift, persistent abdominal numbness after a tummy tuck, or temporary tingling after liposuction. Other times they are unexpected, such as permanent nipple numbness after breast augmentation. In the majority of instances, sensory changes eventually return to normal. Until that time, they can cause significant distress.

General Anesthesia

Because general anesthesia involves greater stress to the body than sedation or local anesthesia does, it carries greater risk. Patients who have a history of cardiovascular disease, lung disease, or obesity are at higher risk for complications. Problems can include pneumonia, stroke, heart attack, and blood clots in the legs or lungs. Fortunately these complications are less likely in healthy individuals.

Insurance Coverage for Complications

If you experience a complication from cosmetic surgery, such as infection, pneumonia, or blood clots, you might require hospitalization and further surgery. Most plastic surgeons will not charge you directly, but some may bill your insurance company if you need further surgery. Be certain to clarify this with your surgeon as soon as possible if complications arise. Other doctors, the hospital, and the operating room will definitely charge you.

Your insurance company might not pay for treatment of these medical problems if sustained following cosmetic surgery. One could argue that this is equivalent to your insurance company denying coverage for treatment of lung cancer because you chose to smoke or for treatment of injuries sustained in an automobile accident because you chose to travel by car. In each scenario, a serious medical problem results from a personal choice. As hospital-based management of complications can cost tens of thousands of dollars, you should know your company's policy in advance. When you contact your insurance company, ask for a response in writing.