Risks and Complications
Millions of Americans have cosmetic plastic surgery each year, and over a third of them are repeat patients who have had other procedures. The majority are pleased with the results and have no lasting complications. Still, as a surgical p ro cedure, these procedures are to be taken seriously, and it's important to understand potential complications.
Infection. Your doctor's expertise and your own self-care, including the antibiotics you'll take before and after surgery, should prevent infection. Let your doctor know right away if there is inflammation, pus, or unusual pain at the incision lines, or if your temperature rises more than one and a half degrees above normal.
Bleeding. If there's any bleeding at all after your procedure, it should be slight and short-lived. More than a li tt le bleeding is unusual and should be reported to your doctor immediately.
Hematoma. A hematoma - a blood-filled swelling under the skin - occurs less than three percent of the time in facial plastic surgery. A tender, raised area filled with fluid can indicate hematoma even if you can't see any blood. If necessary, the doctor can drain a small hematoma with a needle. Large, spreading hematomas require your doctor's immediate attention in order to prevent tissue damage.
Careful surgeons monitor bleeding during the surgery and use techniques that make hematoma formation very unlikely. Some surgeons use a closed-suction drain - a small tube under the skin behind the ear. Many doctors, however, are turning to other techniques, such as the use of platelet gel, that not only prevent hematomas but reduce bruising and speed healing.
Seroma. Similar to a hematoma, a seroma is a pool of fluid that forms under the skin; however, the fluid is not blood but a sterile body fluid. Seromas may dissolve on their own, or the doctor may need to drain them with a thin needle. Like hematomas, seromas are less likely to occur with the use of small surgical drains or platelet-rich plasma during surgery.
Incision complications. Rarely, incisions become crusty. In this case, your doctor will give you instructions on how to clean them. Follow the surgeon's advice carefully to promote incision healing. As mentioned earlier, scars may be more noticeable on thicker-skinned patients.
Excessive scarring, such as hypertrophic scars (overdeveloped scars) or keloids along the incision lines, and permanent scarring are rare among patients with no history of scarring problems.
Anesthesia reaction. An allergic reaction to the anesthesia or another medication is usually preventable; your doctor will learn of the possibility while reviewing your medical history and take preventive measures. Such a reaction is rare in any case, especially when sedation and local anesthesia are used. If it does occur, it will probably be observed and treated during recovery at the surgical center or doctor's office.
Other complications. Fewer than one percent of patients experience complications such as nerve or muscle damage leading to numbness and loss of movement. Discuss the risk of such complications with your doctor.
Although it's important to be aware of risks, note that a 2003 study reported that the rate of complications from plastic surgery, whether performed in a hospital or a doctor's accredited surgical suite, was below one percent - significantly lower than for a tonsillectomy. Other studies indicate that most patients are satisfied with their plastic surgery outcomes and enjoy significant improvement in quality of life. For study data, visit the Web sites of the organizations listed in the Resources section at the end of this book.
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