What are the main complications that can occur after aesthetic surgery? Introduction Plastic surgery is commonly performed nowadays in all parts of the world, especially in the United States where the development of modern plastic surgery has been impressive and unapparelled in the last decade. Plastic surgery represents a solution for many people, both men and women of different ages, as it allows for an enhancement of the body with minimal risks and complications. However, keep in mind that all procedures come associated with a host of potential complications that can occur during or after the procedure. There are different factors that can increase the risks of developing a complication such as pre-existing health or emotional conditions, contraindications to the procedure, and even something as simple as not following the recommendations of the plastic surgeon for pre- and post-operative care. In this article, we will discuss the main complications that can occur after aesthetic surgery and how to prevent them. Be informed My strong opinion is that a patient who is informed is a patient ready to undergo surgery. Before your surgery, it is important to meet with the plastic surgeon and discuss all the details associated with the procedure, how to prepare, what will occur during the operation, and how to behave during recovery. Keeping you informed of the risks and possible complications have become an obligation for a responsible plastic surgeon. We are convinced that this can also be progress because responsibility and trust are based on good information. When the plastic surgeon gives you all the info you need, it will be easier for you to monitor your progress and even form a stronger bond with the plastic surgeon. Moreover, knowing what to expect can help lower the pre-operative anxiety and the post-operative stress that can occur. It is therefore normal for you to be informed of possible complications, even if every precaution is taken to avoid them. We choose to mention even exceptional complications, but particularly serious ones. An operation, however small, always entails risk. Despite all the precautions and safety measures taken before a surgical procedure and even while trying to control the smallest details, there is always a risk associated with the surgery. In other words, no procedure is 100% risk-free. Above all, it is important to inform you of the risks that may occur during a particular procedure and that it is unfortunately not always possible to prevent. The frequency and severity of these complications are variable. The age of the patient, health condition, and many other factors can increase these risks. Knowing what these risks and complications are can help you plan better and notice immediately if one of them occurs. Main complications after plastic surgery – Infection The presence of bacteria in the wound or on certain areas of your body or a decrease in your natural defenses can promote a local infection. In case of implants being used for the procedure, infections are rare but can be more severe, because it may require the removal of the implant. Any sign of infection is therefore and should be treated as an emergency. This means that you must schedule a consult your surgeon as soon as possible or to get medical assistance at a hospital. There are certain signs of infection that you should be aware of. The increase in pain or fever after the second day should make you fear infection and lead you to contact your surgeon immediately. Infections are often easier to treat if diagnosed early. In some cases, a surgical procedure might be needed, such as during deep tissue infection when implants are used. If the infection is not solved by antibiotic treatment alone, it requires surgical revision for drainage and removal of the implant for a few months, as this is the time needed before a new prosthesis can be repositioned without risk. To minimize the risk of developing an infection after plastic surgery, the plastic surgeon should perform with the patient receiving antibiotics through the IV. Antibiotics treatment is prescribed for preventive purpose for five days post-op. The patient should take the medication prescribed according to the recommendations of the plastic surgeon. Moreover, proper hygiene is mandatory to avoid infections. This means that the area operated on and the incision site should be kept clean and dry at all times after the procedure. The risk of infection is higher during the first few days post-op and decreases with time. – Seroma and hematoma Seroma is an accumulation of fluids on the incision site. A hematoma is an accumulation of blood on the wound that can occur during the first hours postoperatively. Most of the time the hematoma resolves on its own. However, when we are dealing with a large seroma or hematoma, it can compress some structures deep inside or distend the skin and compromise its vascularity or bring very significant pain. This is the reason why in some cases, large seromas and hematomas might require treatment and medical attention. The plastic surgeon can remove the liquid inside with a syringe to drain them or even remove them surgically, depending on the size and their position. In some cases, drain tubes are inserted close to the incision site with the aim of avoiding the accumulation of blood and fluids in the area. The patient will be discharged from the medical facility with the drain tubes still on. The drains are removed when there is no longer anything draining through them, usually about one to two days post-op. The plastic surgeon is the one to remove the drains, so make sure not to try getting rid of them at home. -Skin and fat tissue necrosis Necrosis of the tissue occurs as a result of a lack of oxygenation of the tissues caused by a lack of blood supply in the area. There are different reasons why skin and fat tissue necrosis might occur; however, the incidence rate to develop this complication is higher in patients who smoke. The plastic surgeon will advise patients to stop smoking at least three weeks before and after the procedure, preferably more. Smoking can interfere with the healing process and trigger other unwanted complications. If skin necrosis occurs, surgical revision is often required. A real inconvenience will be the fact that scars that will develop after taking care of this complication might not be negligible. – Abnormal scars Scars occur naturally after any type of surgical procedure, performed for aesthetic purposes or not. There is no procedure that is scar-free. However, in a vast majority of cases, the scars left behind after plastic surgery are rather small and carefully hidden away in the natural folds of the body if the area permits it. After the cicatrization process is completed and the scars are fully matured about a year post-op, the scar should look like fine white lines similar to the surrounding tissues. In some cases, patients will develop abnormal scars such as keloid or hypertrophic scars. These scars have an irregular pattern, take longer to heal, and look much more visible. Abnormal scarring is a complication that can occur after aesthetic surgery. During the follow-up consultations, the plastic surgeon will monitor the cicatrization process, and if abnormal scarring occurs, he will suggest suitable treatment. Keep in mind that abnormal scarring has little to do with the plastic surgeon’s skills and experience and more to do with the patient’s predisposition towards this type of scarring. In other words, if you had surgery before and developed a keloid or hypertrophic scar, chances are you have a natural tendency towards this and you should discuss the issue with the plastic surgeon. Also, keep in mind that the scars left behind surgery never disappear completely. They are permanent, even if in some cases barely visible. Conclusion Undergoing plastic surgery is a popular choice these days; however, the procedures are not completely risk-free as no surgical procedure is. When choosing to resort to plastic surgery, it is important to know what to expect in terms of the potential complications that could develop after the procedure. Informed patients are patients ready to undergo the procedure. Among the main complications that can occur after aesthetic surgery are infection, seroma and hematoma, skin and fat tissue necrosis, and abnormal scars. Talk to your plastic surgeon about these complications to find out if you are more at risk of developing one or more of them. Also, make sure to follow the recommendations of the surgeon to minimize the risks post-op.