After Cosmetic Surgery
Both the eminent Beverly Hills board-certified plastic surgeon Stuart Linder, M.D. (Dr. Body) and the equally eminent Beverly Hills board-certified facial plastic surgeon Robert Kotler, M.D. (who blogs as Dr. Face) tell their patients that some unwanted conditions and complications can crop up after plastic surgery. The average complication for U.S. plastic surgeons is about once in every 100 cases. What to do if one rears its ugly head? The patient should call the surgeon. But when?
Here, Drs. Face and Body tell what signs you will notice in yourself if you should make that call, even if it’s in the middle of the night.
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Dr. Body (Dr. Linder): Some patients have complications after they leave the surgery center. But if you have selected a board-certified plastic surgeon, you always will be in good hands because they have virtually seen and treated any unwanted complication that can crop up.
Dr. Face (Dr. Kotler): Almost all board-certified cosmetic plastic surgeons tell their patients the usual, run-of-the-mill complications after a plastic surgery include:
- Bleeding
- Allergic reactions to anesthesia (very rare)
- Infection
- Hematomas (a collection of clotted blood under the skin)
- Seromas
Dr. Body: Seromas are a mass of watery blood just under the skin and can cause pain and, later, more scar tissue.
Dr. Face: Your surgeon should tell you during the initial consultation and before any surgery what complications are common to your particular rejuvenation procedure and what signs you should watch for. Most cosmetic plastic surgeons will include that information on pre-surgery hand-outs. It’s a lot of reading but well worth your time.
Dr. Body: Sure, if you know what signs and symptoms to watch for, the decision to call your surgeon will be easier.
Dr. Face: The leading complication nationwide is excess bleeding. It is not a gusher but just a little trickling of some blood under the bandages.
Dr. Body: In breast augmentation surgery, patients want to watch out for one breast being larger than the other. That may indicate bleeding in that breast.
Dr. Face: Another frequent complaint is temporary numbness. A slight loss of feeling is common to many procedures and happens because some nerve endings just under the skin have been severed. However, virtually all grow back and return feeling in two to four months.
Dr. Body: Another frequent complication in breast surgery is capsular contracture which is a type of internal scarring. It can create hardening, pain and distortion of the breast. Board-certified plastic surgeons see it often and know exactly how to treat it.
Dr. Face: Pain or swelling any time after the third day of surgery is a call-your-surgeon-now moment. Pain or swelling after cosmetic facial procedures should fade away in about 48 hours after surgery and then start to disappear completely.
Dr. Body: In tummy tucks, be alert for severe abdominal pain. Abdominoplasty requires a long incision, running hip to hip, unless you’re having a mini-tummy tuck. Pain in the tummy area worse than a stomach ache could mean bleeding.
Dr. Face: If the skin is reddened or sore to the touch near an incision, an infection may be present. Don’t delay on this one because the quicker we can jump on an infection, the quicker the problem comes under control. In fact, checking for signs of infection is the primary reason we see patients first thing in the morning after a cosmetic plastic surgery procedure.
Dr. Body: In surgeries that require long incisions, wound separation — known to doctors as dehiscence – the edges of an incision come apart after the stitches have been taken out. It happens only rarely but a properly trained and qualified plastic surgeon may be able to close the incision again in just a short appointment. The good news: revision surgeries are rarely needed for most instances of dehiscence.
Dr. Face: One extremely rare – but very serious — complication after liposuction is blood clots in the veins, a condition medically known as deep vein thrombosis. To help prevent it, most surgeons advise liposuction patients to get out of bed and start moving around as soon as possible.
Dr. Body: You are also at risk for deep vein thrombosis on very long airplane trips, where you must sit in a cramped position for many hours. One way to cope with the remote threat of thrombosis in an airplane is just make the same motion with your feet as when you step on the gas pedal in a car. That stretches your leg muscles, squeezes any pooled blood and gets it moving again.
Dr. Face: There are some very, very rare complications of people being allergic to anesthesia. But your best cosmetic plastic surgeons use highly trained anesthesiologists – who are also M.D.s – to watch over the patient while he or she is asleep under a general anesthesia. Anesthesiologists have seen every complication known. For instance, in the rarest of anesthesia complications, the patient does not even know he or she is allergic to anesthesia. But good anesthesiologists keep a very special — and rare – drug on hand to counteract it. That drug is used somewhere by American plastic surgeons perhaps once every two years. Most stocks of that special drug expire without ever being used. But fresh supplies must be kept on hand in the O.R. nonetheless.
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Look at some of Dr. Kotler’s rhinoplasty revision before and after pictures.
A revision is done on a nose job when another surgery somewhere else did not do a good job and left the patient still unhappy with his or her appearance.
Dr. Linder has a practice dedicated to revision breast surgeries. He, likewise, sees many breast augmentations, breast reductions or breast lifts that were botched by another surgeon somewhere else.
Here are some of Dr. Linder’s breast revision before and after pictures.
