Dr Jeremy Rawlins

Whilst every effort is made to provide safe and successful surgery, all surgical procedures do carry some degree of risk.  Before proceeding with surgery you need to understand the risks.  Despite a thorough surgical plan and meticulous tissue handling, complications may occur that are beyond the surgeons’ control.  Understanding these risks makes it easier for both surgeon (and patient) to do everything they can to minimise them.

Each surgical procedure has a unique set of potential risks (and complications), and these will be specific to the patient and the procedure.  These complications will be discussed in detail as part of your bespoke treatment plan, however the following are applicable for all plastic surgery procedures.

Scars

Every surgical procedure will leave a scar, and the degree to which the scar ‘fades’ will depend on many factors including skin type, genetics, where on the body the scar is, and the general health of the patient.  Occasionally scars can be thick, hypertrophic or even keloid.

Infection

All surgical wounds have the potential for infection.  We reduce the risk of infection by ensuring an aseptic technique during your procedure and using appropriate dressings and wound coverings post-operatively.  In many cases antibiotics are used prophylactically to reduce the incidence of infection.  If an infection does occur after surgery it may require antibiotics to treat the infection or further surgery.  There may also be a delay in the wound healing

Bleeding

All surgical wounds have the potential to bleed afterwards.  Usually this is very minor and settles with pressure.  Occasionally bleeding may not settle and requires further surgery to control the bleeding.

Nerve Damage / Numbness

In the process of performing plastic surgery it is not uncommon for small nerves in the skin to be cut, and for larger nerves to be bruised or irritated.  This may cause some areas of numbness that may take a few days / weeks to settle.  Occasionally if larger nerves are cut then the numbness can be permanent

Pain and Discomfort

Mild to moderate pain should be expected after any surgical procedure (and can easily be managed with Paracetamol and Ibuprofen (or other ‘over the counter’ medications).  Post operative pain is minimised by the use of local anaesthetic blocks during the surgical procedure.  Stronger pain killers are indicated for larger procedures.  Very occasionally patients can develop longer term pain, when it may be necessary to involve pain specialists.

Swelling / Bruising / Skin Discolouration

It is not uncommon to have some degree of tissue swelling and bruising after surgery.  This is the body’s normal response to surgery and will generally settle with time.

Seroma

This is a collection of fluid under the skin that can occur following body contouring procedures (eg abdominoplasty).  We reduce the risk of seroma formation with the use of drains, compression garments, negative-pressure dressings, and binders.  If a seroma occurs it may require aspiration in the clinic or placement of a drain in the radiology department to drain the fluid away.  Rarely further surgery is indicated to excise the seroma cavity and re-close the wound.

Unfavourable Outcome

In some cases the surgical procedure may not achieve the desired cosmetic (or functional) result.  In these cases a thorough discussion about what is / isn’t possible (with respect to further surgery) is had before revision surgeries are performed.

Anaesthesia and General Complications of Surgery

Whilst modern day anaesthetics are extremely safe, there are risks associated with general, regional, and local anaesthetic procedures.  Complications can range from bruising, shivering, nausea and vomiting, sore throat, and feeling generally ‘groggy’ following a general anaesthetic.  Other rare complications can include respiratory distress, deep venous thrombosis, pulmonary embolism, stroke, cardiac arrhythmia, and in very rare cases death.

There are certain patient related factors that increase the risk of complications.  Patients are advised to do everything they can to optimise themselves for surgery by considering the following.

• Elevated BMI (Body Mass Index):

  • Increases the risk of general/anaesthetic complications

  • Associated with wound healing issues, wound breakdown, and infection

• Diabetes and cardiorespiratory conditions:

  • Increase the risk of general complications for all types of surgery

• Smoking and use of illicit drugs:

  • Linked to poor wound healing

  • Higher risk of flap and graft failure

  • May lead to poor aesthetic outcomes

• Alcohol consumption:

  • Not advised during the peri-operative period

  • Increases the risk of post-operative complications

• Certain medications:

  • May impair healing or increase bleeding risk

  • It’s important to inform the medical team of all medications being taken

• Good nutrition:

  • Essential for proper surgical healing

  • Patients are encouraged to eat well before and after surgery