Any medical procedure carries risks, and it is of the utmost importance that anyone considering facial plastic surgery be informed of the possible risks and make a well-versed decision on whether to move ahead.

We’ve comprised the most common surgical risks below. This list is not all-inclusive (as that would be impossible!). However, we believe that the guide below provides a comprehensive and insightful overview of many of the most common risks associated with plastic surgery. Once you have chosen your own personal surgeon, the risks will be discussed in greater detail while you prepare for surgery and sign your consent forms to allow the surgery to take place.

Read on to become well informed about the possible risks associated with surgery. We include general, overall risks, as well as surgery-specific risks related to facial cosmetic surgery.

  1. Health Risks: While the worst outcomes are rare, risks are a reality, and the risks and rewards need to be carefully weighed. Common health risks that are associated with all surgical procedures are infection, blood clots, delayed healing, keloids, persistent pain, loss or change of sensation, nerve damage, hemorrhage or hematomas (excessive bleeding), and tissue necrosis (tissue death along or around the wound). Anaesthesia risks can include respiratory failure, drug reactions, allergic reactions, cardiac arrest, coma, respiratory failure, shock, and even death. You can mitigate these risks by choosing a responsible, reputable surgeon who will walk through the preparation process with you carefully to eliminate as many possible risk points as possible and do the appropriate assessments prior to surgery to make sure you are safe and ready for your procedure.

  2. Depression: Surprisingly, studies have found a correlation between undergoing any kind of general anaesthesia and the onset of depression/dysthymia or low mood. This means that no surgery is exempt. If you undergo heart surgery, brain tumor surgery, orthopedic surgery, or plastic surgery, you do run a higher risk of developing depression afterwards because of the use of general anaesthesia. Depression can affect the way one views the outcome of his/her surgery and how he or she is able to function in regular day-to-day tasks. If a patient is affected post-surgery with depression, it typically can last a short span of time, but can last longer, especially if a patient has a previous history. The onset may be experienced immediately or months later and manifest in sleeplessness, joylessness, or feelings of unworthiness. The intensity of the depression can range from mild dysphoria to major depression that could require significant intervention. It’s important that there be excellent communication between the patient and the doctor if post-operative depression is suspected. That way, all possible causes and solutions can be investigated.

    The most typical reasons for post-surgical depression can be from the after-effects of the anaesthesia medications. Patients can be more sensitive, and it can bring out anxiety. Add to it the fact that patients need to stay in bed and are restricted in their daily activities, plus feeling bruised and sore, and it can become an unfortunate recipe to begin feeling down.

    Following this, post-surgical traumatic stress syndrome is not so far-fetched. However, having the knowledge that there is a cause and effect relationship between general anaesthesia and depression, the hope for a resolution can sometimes be enough to help someone overcome the symptoms. However, if the symptoms of depression are unrelenting, patients are encouraged to consult with their doctor as soon as possible.

  3. Constipation and Digestion concerns: Infection prevention and pain medications can cause constipation and other temporary digestive problems which isn’t great for those patients who can be highly affected by pain and discomfort. This type of risk is temporary and is simply a side effect of the medications.

  4. Psychological Risks: There are psychological risks associated with plastic surgery. This adverse effect may be surprising to some people, but it is a definite possibility. A lot of the effects may have to do with a patient’s expectations of surgery and their pre-operative emotional and mental state. Plastic surgery can bring positive rewards, but it cannot be relied upon to fix relationship problems or negative feelings you may have about yourself. What if you still feel inadequate after surgery? Patients must be prepared for the possibility of social gossip surrounding cosmetic procedures, sparking jealousy or insecurity within others. Emotionally, are you prepared to field questions about why you did what you did and the judgement that can (unfortunately) be associated with it?

    There is no such thing as perfection, but some patients can slip into another type of psychological risk called Body Dysmorphic Disorder. This is where patients can fixate on a perceived physical flaw or imperfection within themselves and can become obsessed with it. Patients with body dysmorphic disorder are chronically unhappy with the result of plastic surgery and often wish they had never done the surgery at all. Strong, negative emotions towards your physical appearance can often lead to other health concerns, so it is important to trust your doctors’ guidance and consult with him if you are feeling this way post-surgery.

  5. Need for secondary surgery if first result was unsatisfactory: The success or failure of plastic surgery can be subjective- after all beauty is in the eye of the beholder. You have to be mentally ready for aesthetic results that could be unsatisfactory- results that could be attributed to simply how your body has healed after surgery, or possibly related to the skill of the surgeon. Excessive scarring, asymmetrical results, contour irregularities and sub-par results can be devastating for patients. The knowledge that a second, revisional surgery may be necessary to achieve the best result is something to be considered.

  6. Your own health may mean you’re at greater risk: Certain people will automatically be at a higher risk than others depending on your medical history or your lifestyle choices- if you are obese, elderly, a smoker or have pre-existing health problems, you will be more prone to complications. Your surgeon will be able to help you determine if your current health puts you at a greater risk or not.

Let’s delve into some of the risks commonly associated to specific surgeries. This list is not complete, but will help educate you as you consider your procedure and speak to your surgeon for more information:

Rhinoplasty Risks

  • Stenosis in the nose, resulting in difficulty breathing. This is when the airways can narrow, causing airflow resistance. It can also be referred to as nasal valve collapse.
  • Implant infection – Rhinoplasty does not always involve the use of implants, but if it does, infection is a possible risk.
  • Nasal septal perforation – This occurs when the nasal septum which divides the nostrils develops a hole or fissure.
  • Cartilage harvest issues – Cartilage may need to be harvested (i.e. from behind the ear) to provide structure for the nose if an implant is not used. This can carry risks because is involves other incisions on the body in various areas.
  • nosebleeds
  • asymmetric nostrils
  • scar tissue pulling the nose in one direction to the left or right, rather than the nose remaining central on the face as the nose heals post-surgery

Facelift, Necklift and Browlift Risks

  • Facial nerve injury with weakness
  • Temporary or permanent hair loss at incision sites
  • Sutures may surface, becoming irritating and visible, thus requiring removal

Blepharoplasty (Eyelid Surgery) Risks

  • Dry, irritated eyes
  • Blurred vision or, rarely, loss of eyesight
  • Injury to eye muscles
  • Too much skin taken, resulting in difficulty closing your eyes or other eyelid problems (Ectropion/Lagopthalmos)
  • Asymmetric results

Chin Implant Risks

  • Shift in the location of the implant
  • Infection of the implant, resulting in possible implant removal if the infection cannot be effectively stopped through the use of antibiotics

Otoplasty Risks

  • Infection in the cartilage, which can cause scar tissue to form (keloids)
  • Inflamed, itchy ears
  • Haematoma auris – fibrous overgrowths that permanently deform the ears (often called cauliflower ears)
  • Over correction or inadequate correction
  • Asymmetric correction
  • Gradual reversal of treatment – ears springing back over time

As mentioned earlier, your surgeon’s credentials will go a long way to help you alleviate possible risks. We believe a facial plastic surgeon (not a general plastic surgeon) should be responsible for performing your facial cosmetic procedure. You should also find out if the facility you intend to have surgery at has been approved and holds the appropriate credentials. Discussing the possible risks with your surgeon and educating yourself about the procedure will help manage your expectations as well as give you a solid background for proceeding with your surgery of choice. If you have further questions about the risks of plastic surgery and would like to learn more, feel free to visit any of our web pages related to other procedure-specific cosmetic surgical risks:

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Dr. Cory Torgerson
Dr. Cory Torgerson
Dr. Cory Torgerson is one of Canada’s most talented and prominent facial plastic surgeons, focusing on head & neck facial surgery. Dr. Torgerson has been frequently invited to teach and lecture on these topics across North America. He has hospital privileges at Sunnybrook Hospital, one of the premier hospitals in the University of Toronto Health Network.
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