Educating patients about the risks and complications of plastic surgery Introduction Plastic surgery is a hot conversation topic nowadays. Many people believe they know a lot about plastic surgery, but when consulting with an experienced plastic surgeon, most of the time it turns out many of the facts they considered true were actually just myths and legends. This is the reasons why many patients still show up for the pre-operative consultation for liposuction with the idea that the procedure will help them lose weight, and many others have the same expectations from the tummy tuck. Some of these myths have origins in some real facts that certain plastic surgeons have exploited and advertised for them to attract more patients. This is the reason why there are still plenty of doctors telling patients that liposuction can be used for weight loss purposes. At the same time, there are plastic surgeons committed to educating patients about what plastic surgery really entails and the risks and complications associated with it. It is essential for a patient seeking help from plastic surgery to understand exactly how the procedure works, what are the risks associated, how these risks can be minimized, and what are its limitations. The ideal candidate for plastic surgery Before anything else, you should know that good communication with the plastic surgeon is essential. The patient should be able to talk openly and honestly about his medical history, medication, and allergies to help the plastic surgeon form an idea about his eligibility for the procedure. Plastic surgery is not a one size fits all, and all procedures can and are often customized to fit the needs of the patient. Patients undergoing plastic surgery should be in a good emotional and physical condition; however, nowadays an experienced plastic surgeon can also operate on patients with certain conditions, including diabetes. Generally speaking, you should know that plastic surgery poses a risk, but the presence of preexisting chronic or severe conditions can increase the risk exponentially. People who suffer from pulmonary, heart and blood afflictions should avoid undergoing plastic surgery, and the same is valid for people who suffer from depression or other emotional conditions or who are not able to stop smoking at for at least a few weeks before and after the procedure. People who take drugs or drink alcohol in excess are also not suitable to undergo plastic surgery. It is recommended to share your habits with the plastic surgeon during the initial consultation, as well as the medical history, medication that you might be taking or potential allergies. Smoking can trigger severe complications after plastic surgery that include (but are not limited to) delayed wound healing and skin necrosis. To have a fast and smooth recovery period and to minimize the risks and complications associated with plastic surgery, it is preferable to quit smoking weeks before the procedure and stay non-smoking for the same amount of time afterwards. There are clinical studies associating smoking with an increased rate of developing an infection and also anesthetic complications. A good candidate for plastic surgery is a patient who doesn’t smoke, is emotionally stable, and lives a balanced and healthy life. The expectations from the procedure need to be realistic. It is not the plastic surgeon’s responsibility to change your life, and this is something you can do after the procedure. Moreover, it is essential for e patients of plastic surgery to understand and accept the benefits but also the disadvantages of undergoing plastic surgery. If this sounds like you, then you are probably eligible to undergo plastic surgery. Otherwise (and it doesn’t necessarily mean that you can’t have plastic surgery), the risk of developing a complication is increased. Risks and complications of plastic surgery Each procedure is different, and each patient is different. When considering the risks of plastic surgery, you should know that in a vast majority of cases they rarely occur if the patient is eligible for the procedure and he follows the recommendations of the plastic surgeon for pre-operative preparation and post-operative care. Among the risks with undergoing general anesthesia are cardiac arrhythmia, embolism, and obstruction of the respiratory ways, among others. The obstruction of the respiratory ways during anesthesia can occur due to the irritation that causes a spasm in the larynges. Cerebral lesions can be caused by the lack of oxygenation to the cerebrum. Malignant hyperthermia is a rare complication in which the temperature, arterial tension, and the cardiac frequency have increased levels. If undetected and untreated, it can cause the death of the patient. Patients with cardiac or respiratory conditions, as well as patients who are obese, have an increased risk of developing complications during anesthesia, and this is why it is important to tell the doctor if you are suffering from any condition before scheduling your procedure. If the patient eats or drinks in the 6 to 8 hours before the procedure when fasting is recommended, another complication can be triggered. Aspiration is caused when the patient vomits and it ends up in the lungs. This could cause infections, chronic cough, and pneumonia. It is important not to drink or eat anything for a minimum of five hours pre-operatively. Excessive blood loss is another complication that can occur after any type of surgery. There will be a certain amount of blood loss and this is natural, but if it is excessive, it could cause other severe complications. When blood loss happens during the operation, the plastic surgeon can take care of it, but when it occurs after the procedure, the patient should seek medical assistance as soon as possible. Arterial hypotension represents a remarkable decrease in the arterial tension that can lead to cardiac arrhythmias or myocardial infarction. A common complication after any type of surgery is infection. The incidence of developing an infection is very small (under 1%) if the patient is prescribed antibiotics to be taken for five days after the surgery. Keep in mind that the procedure should also be performed with the patient getting antibiotics through the IV to minimize the risks of developing an infection. Post-operative infections are dangerous, and they can present symptoms such as high fever, intense pain, and pus coming from the incision site. It is important to seek medical assistance or get in contact with the plastic surgeon as soon as you notice the first signs of infection. Delayed wound healing can occur in different circumstances such as in patients who smoke, who don’t wear the compressive garments or girdle, or patients who have chosen implants that are too big for their anatomy to be inserted into the breasts or buttocks. Aside from the complications that occur in rare conditions, there are other side effects that can be encountered by patients after undergoing plastic surgery. Among these are seroma and hematoma (accumulation of blood or fluids on the surgical area), swelling and bruising. There are also risks that are not related to the health of the patient, such as getting unsatisfactory results. This can happen when the patient has chosen an inexperienced plastic surgeon, when the patient didn’t have good communication with the plastic surgeon, or when the patient didn’t manage to follow the post-operative recommendations. In case of unsatisfactory results, the recommendation is to wait at least six to eight months after the procedure to make sure the results are final and only after this to get a second opinion and maybe revision surgery to correct the initial results of the surgery. Conclusion Educating the patients about the risks and complications of plastic surgery is important. A patient who knows what to expect is better equipped to manage the recovery period and understands why the plastic surgeon’s recommendations for post-operative care are so strict. Generally speaking, the risks of plastic surgery are reduced for patients who are good candidates for the procedure and able to follow the pre and post-operative instructions from the plastic surgeon. Make sure to discuss all the details about your health condition and medical history with the plastic surgeon before the procedure is scheduled. While plastic surgery is generally associated with a low incidence of developing a complication post-op, patients need to be aware that this might happen and to know when to contact the plastic surgeon or seek medical assistance.