Risks & Complications

• General complications
  • 
    These complications can occur with any type of surgery and are not specific to just plastic surgery.  Essentially any one that undergoes any type of procedure is subject to these complications and it can be under general anaesthetic, local anaesthetic and sedation or local anaesthetic only.

    These include:

    Anaesthetic complications like breathing difficulties, heart problems or allergic reactions to medications given in the anaesthetic

    Pain

    Bleeding

    Infection

    Wound breakdown

    Scar

    Deep Vein Thrombosis or pulmonary embolism

    Heart attack

Breast surgery

• Breast Augmentation

  • Scar usually under the breast – about 5cm

    Seroma around the implant

    Capsular contraction

    Implant leakage or deflation

    Rupture of the implant

    Auto immune disorders

    Palpable implant

    Secondary ptosis or dropping of the implant on the chest wall or muscle

    Loss of sensation of the nipple and breast

    Asymmetry of the breasts

    Silicoma around the breast or arm pit if there is leaking of silicon

    Deformation of the implant when placed under the breast muscle

    Recent associations with Anaplastic Large Cell Lymphoma – this is very rare



• Breast lift or reconstruction

  • Bleeding

    Haematoma – blood clot in the area of surgery

    Wound breakdown

    Inflammation and swelling in the surgical sites

    Infection

    Pain

    Seroma

    Numbness in the area where flaps are taken

    Scar in donor sites and on the breast reconstruction site

    Capsular contraction when implants are used

    Asymmetry – uneven sides

    Skin and fat necrosis – skin and fat death in the area of surgery due to deficient blood supply



• Breast Reduction

  • Scarring: this will be discussed in detail in the consultation with diagrams and photos

    Scar hypertrophy or keloids – thick obvious presence of the scar and can sometimes be very painful;

    Decreased nipple-areolar sensation

    Necrosis of nipple, skin and fat.  Necrosis means death of tissue due to a poor blood supply and this may be evident a the time of surgery or a couple of days later.  If the nipple or areolar dies then this will be replaced with a skin graft or if allowed to heal of its own accord it will be replaced with white to pick scar tissue and the colour of the nipple-areola will be lost.

    Asymmetry

    Seroma

    Pain

    Decreases ability to breast feed

    Recurrent ptosis or droopiness of the breast with time

    Reaction to sutures and stitch abscess

    Cyst formation

    Mondors Disease: a rare condition of inflammation along scar associated with surgery



• Gynaecomastia

  • Pain

    Numbness of the skin and nipple areolar area

    Seroma collection of fluid underneath the skin.

    Haematoma which is a collection of blood in the area where the tissue has been removed from

    Drains depending on the extent of the removal of tissue

    Skin necrosis (death) when too much skin and fat is removed

    Fat necrosis (death) again f too much fat is removed and the blood supply significantly reduced

    Scar.  If liposuction then several small sub centimetre incisions and scars on the chest wall on each side and if done with open incision then usually a scar around the lower half of the nipple to remove the breast tissue from.

    Asymmetry

    If extensive liposuction then can have cannula tunnels visible and tethering of the skin to the chest wall

Body surgery

• Tummy tuck / abdominoplasty

  • Pain

    Numbness of the skin especially around the belly button

    Seroma: collection of fluid underneath the skin flaps of the tummy.  This is the most common complication

    Skin necrosis (skin death) when too much skin and fat is removed

    Fat necrosis (fat death) again f too much fat is removed and the blood supply significantly reduced

    Scar mostly transverse across the lower pubic area, around the belly button and also occasionally a small vertical up going scar.

    Asymmetry

    Malposition of the umbilicus as can be a little off centre

    Elevation of the pubic hair line, which if needed, can be treated with IPL laser following surgery.

    Nerve injury around the flanks and lower abdomen

    Drains will be placed, usually 2, and can be in place for several days to 7-10 days.

    Dog ears which are excess skin at the edges of the scar around the hips, which can be modified at a revision procedure if needed.



• Liposuction

  • Pain

    Scar from small incisions where the liposuction cannulae are inserted

    Contour irregularities from the liposuction cannulae

    Swelling post operative – can be prolonged

    Bruising

    Asymmetry or unevenness in the skin and fat content from certain areas of liposuction

    Skin discolouration

    Numbness in the skin overlying the liposuction areas

    Seromas – collection of fluid underneath the liposuction areas

    Skin necrosis and fat necrosis- essentially skin death and fat death in liposuction areas if too  much liposuction is done

    Skin redundancy – post liposuction from much fat removed and failure of skin to retract, especially when large volumes of liposuction is performed



• Body Contouring

  • Pain

    Numbness of the skin especially around the areas that have been operated on.  For example with an arm reduction the inside of the arms can feel numb and with a thigh reduction the inside and front of the thigh can feel numb.

    Seroma collection of fluid underneath the skin flaps.  This is the most common complication.

    Skin necrosis (death) when too much skin and fat is removed

    Fat necrosis (death) again of too much fat is removed and the blood supply significantly reduced

    Scar will be discussed in detail and shown on diagrams.  Most scars settle well however can sometimes be enlarged or stretched and hypertrophied.  Rarely they can keloid and also become painful

    Asymmetry.  Uneven flaps of skin and fat on the sites operated.

    Nerve injury around the flanks and lower abdomen, arms and thighs

    Drains will be placed, usually 2, and can be in place for several days to 7-10 days.

    Dog ears which are excess skin at the edges of the scar around the hips, which can be modified at a revision procedure if needed.

    With lower limb and upper limb contouring surgery, when operating in deeper planes of tissue lymphoedema can occur which is permanent swelling in the tissues.  A more rare complication

Face surgery

• Facelift / Rhytidectomy

  • Pain

    Bruising

    Seroma: fluid under the facial skin flaps

    Asymmetry

    Swelling

    Numbness on the skin of the face

    Nerve damage particularly the facial nerve which supply the facial expression muscles of the face

    Permanent change to the hairline around the temple area, side-burn area and behind the ears and neck area

    Skin and fat necrosis.  This is death of the skin or fat on the fat due to excess skin or fat removal and affecting the blood supply to the skin flaps of the face.

    Abnormal facial contour if the skin is pulled too tightly

    Tightness in the face and neck area

    Submandibular gland prominence. These are the glands under the jaw line.

    Broken capillaries and pigmentation on the face of the skin

    Scars which are detailed in the consultation, these vary depending on the type and extent of the facelift performed

    Scar hypertrophy or keloid scarring. This is prominent and painful scars.

    Lumpiness in the skin flaps on the face.



• Eyelid / Blepharoplasty

  • Post operative pain

    Scarring

    Blindness – very rare

    Difficulty in closure of eyes usually because too much skin has been excised

    Dry eyes, most common post-operative and usually settles after several weeks

    Watery eyes – less common that dry eyes and more associated with lower eyelid surgery

    Ectropion which is lower eyelid tethering which shows the sclerea or whites of the eye a little more.

    Blurring of vision

    Ptosis of the lower eyelid which is drooping of the eyelid applies to both upper and lower

    Lagopthalmos which is inability to fully close the eyelids and can lead to dry eyes and corneal ulceration or keratopathy

    Prolonged swelling of the upper eyelids is very common and most swelling settles after 2-4 weeks however takes a total of about 3 months to really settle down

    Pigmentation of the lower eyelid

    Asymmetry or uneven eyelids

    In time excess skin will recur

    Chemosis – swelling of the conjunctiva of the eye

    Sub-conjunctival haematoma which is bruising of the white part of the eyeball

    Visual changes

    Inclusion cysts on the scar line

    Corneal abrasions which occur if any trauma to the eyeball during surgery

    Loss of eye lashes, especially in the lower eyelid when lower eyelid surgery is conducted

    Residual fat pad herniation especially in the inner pockets of the upper eyelids



• Ear pinning / Otoplasty

  • Tenderness of the ear and scar on the back of the ear

    Asymmetry

    Pain

    Numbness of the ear and skin around the ear

    Swelling of the ears

    Scar and especially hypertrophy or keloid formation of the ear

    Exposure of sutures

    Bruising

    Cauliflower ear- usually if a large degree of bleeding post operative

    Skin complications like necrosis (death of skin)