General Risks of Surgery

Preconditions of surgery

A certain degree of risk is inherent in any surgical procedure and although complications seldom occur, this should be considered in your decision to undergo surgery.

Prior to booking your treatment, you must disclose to your surgeon all medical conditions and your medical history. If you suffer from diabetes, poor circulation, heart, lung or liver disease, if you smoke or have a family history of blood clots you may be at increased risk of complications. It is the privilege of the surgeon to decide if you are physically and mentally fit for surgery, so it is important to discuss these issues thoroughly with the surgeon before going ahead with booking your surgery.

Make sure to inform the surgeon if you have had:

Aspirin and other types of aspirin-containing medicines or anti-inflammatory medicines should be stoped at least 10 days prior to surgery as they increase the risk of excessive bleeding.

Smoking should be stoped at least 2 weeks prior to surgery. Nicotine containing products such as patches or gum must also be stopped.

Nutritional and herbal supplements should be stopped 2 weeks prior to surgery as certain supplements may increase the risk of complications such as excessive bleeding, inability to breathe and increased pulse rate.

Risks of Surgery    

Kindly note that there are well-documented risks and universally accepted potential complications, associated with every surgery. While serious complications are rare, they do occur from time to time, even with the most careful plastic surgeons under the strictest conditions. Fortunately, complications are rare in healthy, carefully screened patients that follow pre- and post-operative guidelines.

Potential complications of all surgery includes:

Bleeding
Bleeding is most likely within the first 24 hours after surgery. Many common medications, vitamin E and some herbal supplements, and uncontrolled high blood pressure may increase the risk of bleeding. Factors which increase your blood pressure and heart rate such as leaning forward, straining, vomiting and exercise can increase your risk of bleeding. Bleeding can also develop into a haematoma.

Haematoma
A haematoma is collection of blood under the skin. The bleeding is usually minimal and will generally stop and reabsorb on its own. The area may feel tender to the touch and the skin may turn blue or purple as in a bruise. A large haematoma may need surgical intervention and drainage.

Infection
The highest risk of infection is about 72 hours after surgery. Signs of infection are warmth, tenderness, an increased area of redness, thick yellow or white discharge, unpleasant smell, or a fever above 38°C (37-38°C is normal after surgery). Bacteria can enter the body during surgery or after surgery through the wound, drains or sutures. Preventative antibiotics are often given during surgery through the IV and continued in pill form after surgery. Antibiotic ointment may also be prescribed for infections of the skin or eye.

Seroma
A seroma is an accumulation of clear serous fluid under the skin, around an implant or around the incision. A seroma is a possible complication in procedures where the tissues have been separated during surgery. Diligently wearing your compression garments will reduce the risk of developing a seroma. While the body absorbs small seromas, larger ones will require aspiration or surgical drainage. A small scar can result from surgical draining.

Wound Separation
Anytime an incision is made there is a risk it won’t heal accordingly. Several factors such as smoking, swelling, bleeding, infection, haematoma, oral steroids, diabetes, and too much movement may negatively influence wound healing. If wound separation occurs within the first 24 hours after surgery, it may be possible to re-suture the incision, or the surgeon may prefer to let the wound heal naturally and then correct the scar once it is healed.

Necrosis
Healthy tissues require a constant supply of oxygen and nutrients. However, if the tissues are deprived of oxygen over an extended period of time, necrosis or tissue death may occur. In surgeries where flaps are created by separating the skin and its blood supply from the underlying tissues, such as in facelifts, tummy tucks and breast reductions, there is an increased risk of circulatory problems. Usually there is adequate circulation to supply the tissue with oxygen and nutrients. Smokers have an increased risk of developing necrosis as nicotine constricts blood vessels and reduces oxygen supply. Signs of necrosis are a blue, purple or gray hue to the skin (not to be confused with the blue and purple discolouration of a bruise). Pain may be another sign of necrosis, and possibly the only sign if the necrosis is deep.

Nerve Damage
Signs of nerve damage are numbness, tingling or a change in sensation. Usually, any nerve damage is temporary and normal sensation will return within 6 month to a year, however it may take 2-3 years for full nerve regeneration. Itching, shooting pains or electric sensations may be felt as the nerve is regrowing and is considered normal. Occasionally, medication is used to control pain. Injury to nerves which control muscles can lead to weakness or paralysis of the affected muscle. If a nerve is completely severed, permanent numbness or loss of muscle function may occur.

General Anaesthesia
The most common side affects are nausea and vomiting, sore throat, shivering, disorientation, and a longer recovery period. Less common side affects are low blood pressure, kidney or liver damage, seizure or allergic reactions. There is also an increased risk of complications such as heart attack, stroke or death, which occurs in 1 out of 10,000 people. If you suffer from heart or lung disease, liver damage or obesity you may be at increased risk of complications.

Anti-nausea medication is often given prior to, during or after your surgery to prevent nausea and vomiting during your recovery period. 

Scar Formation
With any operation in which skin is cut, a scar will naturally form. In most cases the body will stop producing scar tissue when desirable tissue strength has developed/formed. However, in some cases the scar tissue formation continues to produce a thick raised scar called a hypertrophic scar. A keloid scar, is an irregularly, unsightly, raised scar that extends beyond the incision site. Keloids are more common in people with dark skin. Both types of scars can cause itching, burning, sharp shooting pains.

Deep Vein Thrombosis
Deep Vein Thrombosis (DVT) is the formation of a blood clot in a deep vein, usually the legs or pelvis. There is a significant risk of the blood clot embolising and travelling to the lungs causing a pulmonary embolism. In up to 25% of all hospitalised patients, there may be some form of DVT. The most common risk factors are prolonged surgery or hospitalization. Other risk factors include advanced age, obesity, infection, heart or circulatory problems, smoking, history of varicose veins and immobilisation.
If you experience chest pains or pains or swelling in your legs during your postoperative period, or if one leg feels tender to touch, contact your surgeon immediately, as these symptoms may be indicative of a clot having developed.

If you are confined to bed for a few days following surgery, try to move your ankles and knees even when you are lying in bed and try also to flex your feet, as this improves blood circulation and helps prevent blood clotting. After surgery you may have to wear anti-embolism stockings. It is important that you follow the surgeon’s instructions and wear the stockings for at least one week after surgery or until you are able to move around freely. Try to move about frequently, even up and down the hospital corridor or within your hotel room.

Allergic Reaction
You may experience an allergic reaction to the anaesthetic, antibiotics, dermal fillers, or sutures. If you are aware of any allergic reactions to any medications, anaesthetics, bandages or foods, be sure to let your surgeon or anaesthetist know prior to surgery.

If you develop a rash, hives, or itching all over your body, call your doctor immediately. This is a systemic reaction and is usually due to medication and if left untreated can result to breathing problems.